| Abstract: | Objectives. We investigated themes related to the health and environmental impacts of gold mining in El Salvador.Methods. Over a 1-month period in 2013, we conducted focus groups (n = 32 participants in total) and individual semistructured interviews (n = 11) with community leaders until we achieved thematic saturation. Data collection took place in 4 departments throughout the country. We used a combination of criterion-purposive and snowballing sampling techniques to identify participants.Results. Multiple themes emerged: (1) the fallacy of economic development; (2) critique of mining activities; (3) the creation of mining-related violence, with parallels to El Salvador''s civil war; and (4) solutions and alternatives to mining activity. Solutions involved the creation of cooperative microenterprises for sustainable economic growth, political empowerment within communities, and development of local participatory democracies.Conclusions. Gold mining in El Salvador is perceived as a significant environmental and public health threat. Local solutions may be applicable broadly.Mining activities raise significant public health concerns in the Americas and globally.1–3 Many countries in Central America have experienced increased mining activity by national and foreign corporations in the wake of trade agreement liberalization and erosion of environmental protections.4,5 This increase in mining activities has led to tension between mining corporations and local populations concerned with the health effects of mining.6 Nongovernmental organizations have begun to document such conflicts, which currently affect 19 countries from South to North America, with 191 ongoing mining conflicts.7 Case reports from other countries undergoing metal mining (e.g., gold, silver, and nickel) reveal significant health effects from mining. These range from hearing loss and mercury poisoning8 to elevated arsenic levels in the blood of local inhabitants.9Although these toxicological studies have delineated direct threats to health from metal mining, little if any research in Latin America has explored other detrimental effects on public health. In addition, the effects of mining in the historical context of civil war and foreign intervention in Latin America have not yet been explored. We therefore undertook a qualitative inquiry of a representative Latin American country, to explore attitudes about the public health ramifications of metal mining in a postwar context.El Salvador is unique in Latin America for historical and demographic reasons. The population of El Salvador experienced a civil war from 1980 to 1992. Up to 75 000 Salvadorans died (out of a population of 5.2 million), and a third of the population were internally displaced or fled the country.10 The civil war in El Salvador received extensive funding from foreign countries, primarily the United States, which contributed to the ongoing conflict and its associated deaths and disappearances among the local population.11,12 The mental health impact of the civil war is only now being understood.13El Salvador has among the highest population densities in the Western Hemisphere. Thus, the traumatic effects of disasters such as war, earthquakes, or environmental degradation have significant impact on large sectors of the population. Past exposure to such disasters—natural and manmade—have perhaps sensitized the population to the potential for extensive harm from future disasters.14 This has yet to be formally explored in a Salvadoran context.Since the end of the civil war in 1992, gold mining activities have increased in El Salvador, with public health concerns increasing in parallel. This may explain, in part, why local opinion polls reveal concern about mining activities. In 2007, the Instituto Universitario de Opinión Pública (University Institute of Public Opinion) of the Central American University conducted a poll among citizens living in metal-rich areas, typically in the north of the country. It found that 70% of Salvadorans opposed the initiation of a mining project in their community and felt this would have a detrimental impact on the lives of their children and grandchildren.15 Because limited data are available in the medical literature about the population health effects of mining specifically in El Salvador, it is unclear exactly how mining activity would be detrimental.Although the political, social, and historical context of El Salvador is unique in the region, many parallels exist with neighboring countries. We explored Salvadoran community leaders’ attitudes toward gold mining in a postwar context. We also wished to understand solutions and alternatives to mining that might be proposed by community leaders. Their attitudes, although specific to El Salvador, might be relevant to other countries in Latin America with a similar history and increases in mining-related conflict. The lessons learned from the experiences shared in El Salvador may therefore be relevant to countries beyond Central America.16 |
