503 girls under the age of 14 were during 2020 in El Salvador; Of these, 250 were in the period of mandatory confinement decreed by the Government; that is, the minors lived 24 hours a day with their aggressor during the four months of confinement in El Salvador.
By: Nancy Hernandez
«I wasn’t planning to be a mother, not yet, but these are things that happen,» says Vanessa*, a minor who became pregnant during the mandatory confinement period in El Salvador decreed in El Salvador during the health emergency caused by covid-19 .
*Name changed for protection.
Sitting in the patio of her house on family land in the San José Las Mesas community, in the municipality of La Libertad, in the department of the same name in El Salvador, the young woman recounted her experience and the fear that invaded her when she learned that she would become a mother. Without being prepared, even more so, in the midst of an unprecedented pandemic for the entire world.
The teenager became a mother at the age of 16; the baby was born by cesarean section in May 2021. That is, her son was gestated during the months of confinement in El Salvador and the children had to be in the care of their parents.
The Online Morbidity System (SIMMOW), the National Network of Services of the Ministry of Health (MINSAL), recorded in the period from January to June 2020, a total of 250 pregnant girls between the ages of 10 and 14 and 6,581 adolescent pregnancies from 15 to 19 years old, including Vanessa.
According to the data presented by the United Nations Population Fund (UNFPA) in the document “Getting to zero pregnancies in girls and adolescents. Map El Salvador 2020”, during this year El Salvador registered 12,982 pregnancies in girls and adolescents between 10 and 19 years of age. The data becomes even more alarming when they reveal that of that total, 503 belong to girls under 14 years of age.
«Despite the reduction in adolescent pregnancies, still 1 in 4 pregnancies in El Salvador occur in girls and adolescents under 19 years of age,» the report details.
Confinement in El Salvador, pregnancies and
The confinement in El Salvador lasted around four months, during this period all the resources of the public health and care system were devoted to addressing the covid-19 infections, for this reason consultations with patients with chronic diseases were suspended, first level care , mental, sexual and reproductive health.
In addition, mobility restrictions made it difficult for people to travel to care centers.
UNFPA details in the document that compared to data from 2019, during the confinement in El Salvador, prenatal registrations in girls aged 10 to 14 decreased. but that after this period, starting in June, an increase was registered.
«You can see an increase in the prenatal registration of girls from 10 to 14 years old, which suggests that their families preferred not to go to health establishments or had limitations to do so during the period of confinement in El Salvador, proceeding to the registration once the restriction measures due to the covid-19 pandemic have been lifted,” the report reads.
Vanessa was the exception to these cases, since she was in prenatal control from the second month of pregnancy; However, the controls were not every month as usual, but every two, according to Angélica Pérez, mother of the minor.
According to the study «Differentiated impacts in the economic and social spheres of COVID-19 on the situation and condition of women in the member countries of SICA (Central American Integration System)», presented in October 2020, mandatory confinement and the suspension of transportation services made it impossible for women to go to health centers to continue their treatment, including access to contraceptives and prenatal check-ups.
«PAHO estimates that visits related to pregnancy were reduced by 40% in the Americas,» says SICA.
“It was in the quarantine period, starting the pregnancy controls; they left them late so that many people did not go to the unit very often. They were leaving the controls every two months,”, says Vanesa’s mother.
Fun factors played a role
According to Silvia Juárez, from the Organization of Salvadoran Women for Peace (ORMUSA), the increase in pregnancies in minors is due to various factors, the main one being the «culture of rape» because it is believed that «the bodies of women Girls and adolescents are usually a body that can be appropriated, available and for which there is a high probability of risk of victimization because there is a whole social scenario that favors (the girl) being quiet, silenced, where the sexual violence at home.
“The evidence tells us in the case of sexual victimization that around 68 percent to 70 percent of the events occur by an acquaintance, a family member of the victim’s environment. It does not occur at night, but occurs precisely in girls and adolescents between 12 noon and 3 in the afternoon, when the girls arrive from school and there are no other relatives. This victimization in the quarantine meant having a greater exposure of the girls at the mercy of the perpetrators,” explained the ORMUSA expert.
The UNFPA document also points to sexual abuse as the main factor in underage pregnancies in this period.
«This allows us to assume that these girls were victims of sexual abuse during the confinement in El Salvador in their homes, which ended in a pregnancy,» the document says.
According to official data, between 2015 and 2020 alone, 105,930 pregnancies among girls and adolescents were registered in El Salvador. Of these, 5,104 occurred among girls between the ages of 10 and 14, which, as recognized by Salvadoran legislation, involve crimes of sexual violence.
On the other hand, between 2015 and 2019, the Institute of Legal Medicine (IML) carried out 10,947 examinations or physical expertise for various types of sexual violence in girls and adolescents between the ages of 10 and 19, of which 53 percent were carried out in girls between 10 and 14 years of age.
Comparing with the monthly figures registered in 2019 of prenatal registrations in the MINSAL, a clear decrease in these numbers is observed during the period from March to August in which the measures with greater mobility restrictions were established to prevent infections by Covid-19. .
The faces of barbarism during
In the first three months of 2021, 100 girls arrived in the delivery room, according to an article published by El Diario de Hoy on May 16, 2021.
According to the publication, «the girls were raped during the confinement period in El Salvador, in the context of the pandemic, but in hospital delivery rooms, the alerts went off at the beginning of this year (2021), when girls, victims of rape, between 10 and 14 years old, came to give birth”.
In addition, it indicates that only in January and March of that year, 100 girls had deliveries in public hospitals, becoming young mothers for the first time. None were enrolled in prenatal check-ups, revealed Mario Soriano, coordinator of the Comprehensive Care Unit for Women, Children and Adolescents of the Ministry of Health (Minsal).
“Between January and March we have received a good number of girls and adolescents (deliveries). I am going to refer to girls from 10 to 14 years old, because we have already served almost 100 adolescents, which means sexual violence, typified in this way by our Penal Code. And the question is: where did these pregnant women come from, if we have been in total quarantine for nine months? So, this means that sexual violence is present at home,» Soriano told the media.
“The increase in pregnancies in women under 18 years of age or girls and adolescents during the pandemic, especially during quarantine, is identified from the following period where there is a significant increase of around 20% of pregnancies in girls and adolescents. This increase implies not only an increase in general terms in women of reproductive age, but also in girls and adolescents, which is more critical,” declared Juárez.
The SICA document, cited above, reinforces this approach: «Another factor is the exposure of girls to their aggressors, since being in confinement they had to live with them 24 hours a day, this facilitated the abuse, especially if it it takes into account that the main predators are known people and even relatives of the victim”, says Silvia Juárez.
Vanessa’s mother explained that she found out about the pregnancy because of rumors from other people in the community.
«At first I didn’t know why one ignores, but then they start to gossip and I realized it, but then the boy came and talked to me, he told me that he was responsible for her, that he was not just playing with her, that if he gave the permission. I had to do it because she was already pregnant, ”says the parent.
The Penal Code of El Salvador, in its article 159, determines that the penalty for of a child under 15 years of age is 14 to 20 years in prison. While the crime of is specified in article 163 and is in adolescents from 15 to 18 years old; This crime has a penalty between four to 10 years in prison.
Legally, Vanessa’s pregnancy can be considered the product of because she was a minor, and her partner is four years older than her; this type of relationship is considered under the crime of. However, no one questioned the relationship, nor did state law enforcement authorities.
“They expressed that it had been voluntarily both her and him. In the health unit, I had no problems in the sense that I did it as a mother because she was a minor. But he is with her, he accompanied her and he was responding financially (…) if she had to be taken to the clinic, «said Vanesa’s mother.
In the months of 2020, the Salvadoran health authorities also stopped caring for patients with different diseases and controls for teenage pregnancies, because people diagnosed with Covid-19 were a priority.
At that time, the Central American country was beginning to experience the first peak of infections and deaths caused by the SARS-CoV-2 virus; In fact, the first week of August 2020, the website covid19.gob.sv recorded 77 deaths, without taking into account the underreporting caused by deaths caused by pneumonia or suspected Covid that were not included in the official data of the administration Of the President of El Salvador, Nayib Bukele. Vanessa, her family and even the neighbors in her community feared that the minor would get infected and die with her baby from the disease, which was almost unknown at the time.
All this panorama frightened Vanessa, who despite her age was aware of the danger that the virus represented for her life and that of her future son.
Vanessa is currently one year and 6 months old. Photo: Nancy Hernandez.
“I was very afraid, that someone pregnant like this was said to be very dangerous to get this disease; they were afraid that this could happen to them,” she says.
At that time, both Vanessa’s family and the other members of her community organized and took containment measures against the virus. In addition, the town is located about 25 kilometers from the city, connected by a difficult access road that takes more than an hour by car and two hours by walking.
The precautions that she and her family practiced saved her from contagion. Her baby was born by cesarean section in May 2021.
But that was not all for Vanessa; when she became pregnant; she was barely in sixth grade, equivalent to the last year of the first cycle of studies in El Salvador.
Vanessa had to drop out of school
«She no longer continued studying, that was one of the consequences she faced, she had to drop out because when she was pregnant everything was difficult for her, so she no longer continued studying,» says Vanessa’s mother, a year after the birth of her grandchild.
Last September Vanessa turned 18, a year and four months had passed since the birth of her baby. Now she dedicates herself to taking care of him and taking care of her home. Assuming her role as a mother.
She was in sixth grade when President Bukele announced on a national television channel that by legislative decree classes were suspended at all levels and throughout the national territory for a period of 21 days.
«The State portfolio in the field of Education in accordance with its powers, in order to protect the health and life of our students, must order the suspension of educational activities during the period of 21 days, of all educational centers, of any category. , even recreation such as sports centers, culture and the like”, reads Article 6 of this Decree.
The temporary closure of schools, colleges and universities in March 2020 was one of the first actions established by the Government of El Salvador to contain the spread of the virus.
The other measures
The action was established together with the state of emergency, after the Executive’s announcement, more than 1.5 million students and some 60,000 teachers of all educational levels had to leave schools and move to mandatory confinement in El Salvador, without a clear method to follow his academic background.
“The schools where they went suspended classes, then they posted that my daughter could not continue online because I did not have a cell phone at that time. She needed a telephone because the guides sent her there, so since my daughter didn’t have one, I had to take her out of school. Here the signal for the internet is very bad. They have to walk, they go to the mountain or they go to the side of the field to get a signal,” said Vanessa’s mother.
Said “temporary” suspension lasted until April 6, 2021, when schools gradually began to reopen in a multimodal way.
Despite the data presented by various organizations and the aforementioned studies, Professor Daniel Rodríguez, general secretary of the Union of Teachers of Public Education of El Salvador (SIMEDUCO) assured that school dropout in girls and adolescents due to pregnancy has been minimal.
“Pregnancies have been few; however, there has been and is not a reason for girls to drop out; it was more on the boys’ side. A girl gets pregnant and is given the opportunity to continue studying. In the male, desertion does not occur much because they do not take charge, «said the teacher.
According to the aforementioned UNFPA report, «pregnancies represent an interruption of the life project of each of the girls and adolescents, it is a multi-causal and multi-factorial public health problem based on social determinants that affect physical and mental integrity , being a reflection of the violation of the rights of girls and adolescents who suffer from being immersed in cycles of intra-family and sexual violence, many of these crimes are perpetrated by people close to the victims, and the reports of each case are still limited” .
In addition, it indicates that in 2018 the educational system identified a total of 21,804 girls and adolescents between the first grade and the third year of high school who dropped out of their schools, of these, most (55%) dropped out between the II and the III Cycle of Basic Education (from Fourth Grade to Third Year of Baccalaureate).
In fact, estimated enrollment by educational cycle has experienced a decrease from 2015 to 2020 and has maintained a substantially lower percentage in Baccalaureate.
Vanessa is among this population group that «sees their dreams cut short» due to a premature pregnancy. However, Angélica, her mother, still hopes to see her daughter go back to school, as long as her partner offers her support.
“Well, I think so (he could come back). If she wants it and he supports her because she was also taking a course at the Santa Inés school, I had sent her to study cosmetology. She wanted to be a cosmetologist, at the time of the pandemic her classes were suspended and all that, she was no longer there and that was where she met the boy, but she did go to study before, but she never returned,» says Angélica, Vanessa’s mother
According to the mother, Vanesa’s dream was to be a professional cosmetologist, so she paid for her studies at a private school with a sacrifice when the pandemic and the subsequent teenage pregnancy arrived.
“When they called her, she could no longer go, so that was when it was difficult for her to no longer continue studying. But one of her dreams was to be a cosmetologist; but with the fact that she got pregnant, her dream was cut short. But I think that if she has the will and the boy supports her, she can do it,» said the mother.
Female vulnerability, the case of mothers in El Salvador
For Angélica, the months of confinement in El Salvador represented a challenge not only for her physical health and the diabetes she suffers from, but also mentally, since her three daughters (including the pregnant minor) dropped out of school because face-to-face classes were suspended, and Instead, the virtual option was installed, but they did not have the financial and technological resources they needed.
Two of them had to drop out for various reasons, which the Government surely did not consider when establishing the virtual modality for all educational levels.
Among the causes is internet access; in the community, there is no coverage. Added to this is the lack of economic resources, since the mother of the three girls did not have the money to recharge the cell phone and that they received or sent the tasks by WhatsApp, as well as connecting to Facebook groups.
According to the SICA study, the region was not prepared for educational systems to function under a virtual modality, since more than 60% of households cannot guarantee that girls and boys carry out their studies through digital means.
Angélica’s husband stopped working and receiving income, with his entire family at home, including siblings and parents, housework, stress and fatigue tripled from taking care of the whole family without rest every day.
The SICA study adds that prior to the occurrence of the pandemic, between 20% and 65.7% of the population of the countries of the region were in a situation of poverty, with the rural population and households headed by women being the ones in poverty. Greater situation of poverty.
“The children stopped going to school; there was a lot of stress for the women because we as women had double the time at home. In that time of quarantine, everyone was there; you had to cook for everyone. As women, at least I felt stressed, I felt psychologically pressured,” said Angélica, who is also a member of the women’s committee in her community.
School in Las Mesas. Photo: Nancy Hernandez.
The psychological burden during confinement in El Salvador
Angélica also recounted that the meetings of the community women’s committee to which she belongs were suspended, but sometimes they met and talked about the situation in the community. In these meetings, comments about the extra work, her psychological and emotional burden slipped through. And its neighbors:
“We all comment on the same thing, headaches, back pain, stress. Women who said that their husbands did not help them and demanded that they take care of them all day, it was difficult,” she said.
Carmen Urquilla from ORMUSA assured that Angélica’s situation was repeated in thousands of women who were left in charge of their homes during the period of confinement in El Salvador.
“In general, there was a psychological affectation for people mainly during the quarantine period; however, there were specific effects on the mental or psychological health of women with the period of confinement in El Salvador. The issue of educating sons and daughters online from home, loneliness, not being able to go out, as well as other situations of despair and lack of control over reality, «said Carmen.
The specialist assures that the physical exhaustion that led to psychologically affect women and cause anguish, loneliness, worry, stress, anxiety that has long-term have caused severe depression.
«The double shift or increased workload for women is known to have repercussions on health, cause stress, chronic fatigue, psychosomatic disorder because the rest time necessary to recover is reduced by increasing the number of hours spent to care,» he explained.
The international NGO Medicus Mundi published a statement on June 20, 2020 where it addressed the condition and gender violence that prevailed in the country during the months of the pandemic, one of the aspects that it highlighted was the «significant increase in economic vulnerability, given Women do most of the informal work.
Well, during the time of confinement in El Salvador, women who worked stopped receiving the same income.
Also, the report Violence does not respect the quarantine of the Government Ethics Tribunal emphasized the «exhausting work overloads» to which women were exposed, stating that «homes become a different space saturated with that emotional burden.»
Femicides during confinement in El Salvador
But this is not all, according to data from the Directorate of Information and Analysis (DIA) of the Ministry of Justice and Public Security; from January to August 2020, there were 84 femicides; of these 56 occurred in the period from April to August, that is. That is, during the confinement in El Salvador ordered by the Government.
“The data shows that women are not safe, neither at home nor on the street,” Juárez said in this regard.
For Angélica, the obligations and affectations increased when in May 2021 her daughter Vanessa brought a new member to her family.
“Yes, affectation because there is a saying: a girl taking care of another boy because they do not have experience, so one as a mother helps them. In her case, I was accompanying the first days, teaching her how she was going to do with the child because she did not know all that, «he said.
She also said that as a mother she has had to explain family roles. “I have been guiding her, but it is difficult for her alone. But she already took on her role, washes her clothes, makes her food. They live apart (with their partner)”, he affirms.
In this sense, it indicates that what represented the most difficulties for Vanessa was managing the home. “At home it was very different for me. She had her sisters and not everything was recharged to her, and when she went home she had to face everything a home has to do. All of that cost her a lot, but thank God that she has already learned the role and is already learning more there,» she said.
Vanessa, for her part, affirms that “it has been hard; it has not been easy, but they are still responsibilities that a woman like this has to take, already with a home. I think being a mom is what has cost me the most, when they get sick, when they cry, all of that,» she says.
Sixth wave of Covid and children, the most vulnerable
Vanessa is still worried about catching Covid-19 and even more so, that her baby will acquire the disease. Especially now that the medical community has warned about the excess cases of respiratory syncytial virus (RSV) in the United States and other Central American countries and that it affects minors to a greater extent.
The alert for the ‘triple epidemic’ that combines SARS-CoV-2, the influenza virus and RSV is a latent concern for medical personnel in El Salvador, because according to the Minister of Health, Francisco Alabí, in addition to the four variants of omicrons circulating in the country, there is also an increase in the other two respiratory diseases.
«They are the variants (referring to those of omicron) that are described internationally, but we also have other respiratory affectations in parallel that are the day-to-day viruses that are influenza, the respiratory syncytial virus, those are like the important points to take into consideration, that they can affect a person’s respiratory system, «said the official in a television interview on the Frente a Frente program.
However, despite the increases, Alabí assured that the Central American country cannot be considered to be in a ‘triple epidemic’.
«No, I don’t think we can talk about that particular aspect, I think we are facing a very particular situation… SAR-COV-2 (covid-19) is the priority, we are dealing with monkeypox in parallel, but also of the viruses that we are talking about such as influenza and the respiratory syncytial virus, which are viruses that have always been around, “he explained.
Is there medical capacity?
The official clarified that the public health system of El Salvador has the capacity to attend to these respiratory infections because during the pandemic the response capacity of the health system was strengthened, especially the national laboratory to carry out tests and detect respiratory problems.
Regarding the issue, the epidemiologist Jorge Panameno assured that once again the situation is being downplayed, especially since the country has the sixth wave of Covid-19 at its doorstep and the record of deaths from pneumonia is increasing.
“Here there has never been a comprehensive approach to the problem; in my opinion we are at the beginning of the sixth wave. I am seeing ten to fifteen cases a day. The number of deaths from pneumonia in El Salvador has increased, more than a thousand deaths, the global number has not increased, but the number of people who are admitted to hospitals due to pneumonia and die is increasing and it is striking when one sees that most of dead people are 65 years old and up, but children under five are also dying, it turns out that the pneumonia that kills in this way is the fingerprint of a virus called influenza A”, he declared.
Also read: Intensive care units: advances and consequences in a stressed health system.
These deaths are added to the underreporting that El Salvador has, which could be 24,000 according to The Economist, The Lancet, WHO, Our World in Data, which would represent an accumulated underreporting of Covid deaths of +500% in El Salvador.
Panamanians assured that the flu in public health centers is crowded with symptoms characterized by symptoms of the common cold or mild influenza, sore throat, body aches, headache, nasal and runny nose congestion.
According to the official website of the Salvadoran government, there are 4,634,978 people vaccinated with the first dose and only 1,847,442 with the third; that is, not even 80 percent of the population has the complete vaccination schedule.
The entry of the sixth wave of Covid-19 in El Salvador and the world only shows that the virus is mutating and adapting to the host to continue spreading; therefore the lethality is low. If the host dies, so does the virus.