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Context of '1991-1993: Ahead of Privatization, Water Rates Begin to Rise Rapidly in Buenos Aires'

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The Federation of Cuban Women (Federacion de Mujeres Cubanas, FMC) is founded to promote gender equality and the full integration of women into the economic, political, social, and cultural life of Cuba. [Partido Comunista de Cuba, 7/29/2006; Cuban Education Tours, 7/29/2006] The FMC, a non-governmental organization, will liaison with the Cuban government through the People’s Health Commissions to promote women’s health. [Feinsilver, 1993, pp. 32] Some of the organization’s members will serve as brigadistas sanitarias (health brigade members), helping polyclinic (see 1964 and after) nurses provide women with first aid, injections, and general health information. They are also responsible for seeing that all women in their district regularly have pap smears, and that all pregnant women do not skip any of their prenatal exams or check-ups. When Cuba implements its Family Doctor Program (see 1984) many of the brigadistas sanitarias’ responsibilities will be taken over by the family physician-nurse teams. The role of the brigadistas sanitarias will focus mainly on health education. They will also occasionally assist family doctors and nurses. [Feinsilver, 1993, pp. 66]

Entity Tags: Cuba, Federacion de Mujeres Cubanas

Timeline Tags: Other Health Care Systems

1964 and after: Cuba Creates ‘Polyclinics’

Cuba transforms its health centers into “polyclinics.” Each of the polyclinics administers health services to a specific geographical region comprised of between 25,000 and 30,000 people and serves as the point-of-entry for most patients. [Feinsilver, 1993, pp. 35] In addition to treating patients, the clinics educate patients by holding daily lectures on health care in clinics’ waiting rooms. [Feinsilver, 1993, pp. 67] The region served by a polyclinic is further divided into health sectors. Within these sectors, all people are seen by the same medical teams, which after 1976 are mostly comprised of a physician and nurse trained in the same specialty. So for example, within a health sector, all children have the same pediatrician and all women have the same gynecologist. The polyclinic medical teams operate according to a paradigm known as “medicine in the community” which aims to treat patients as a biopsycho-social being in their respective unique environments. The medicine-in-the-community model is also designed to focus on disease prevention by identifying risks present in the environment before they become health problems. By the 1980s, it is apparent that something more needs to be done to achieve these objectives. The polyclinic medical teams fail to establish close relationships with their patients and have little time for prevention. This shortcoming leads to the creation of Cuba’s Family Doctor Program in 1984 (see 1984). [Feinsilver, 1993, pp. 35-40]

Entity Tags: Cuba

Timeline Tags: Other Health Care Systems

testtest [Source: test] (click image to enlarge)The population of Buenos Aires grows from 3 to 9.5 million. During this time, the city’s public water and sewage utility company, Obres Sanitarias, is hit with a number of budget cuts recommended by the IMF and World Bank, and cannot afford to implement the needed upgrades and improvements. By the late 1980s, it is apparent that the utility will need a huge infusion of capital to extend its services to the new inhabitants of the city. [Public Citizen, 6/14/2007] Less than two thirds of the city’s population is connected to the water system while less than half has access to the sewers. Moreover, up to 50 percent of the system’s water is lost because of leaks. As a result, the per capita consumption of water is an extremely high 600 liters per customer. [Inter Press Service, 4/13/1993; CBC News, 3/31/2004] The World Bank steps in and offers to lend Argentina hundreds of millions of dollars to upgrade the city’s water infrastructure—but only on the condition that it privatize Obres Sanitarias. [Public Citizen, 6/14/2007] Critics of the privatization plan will later argue that despite its lack of cash-on-hand, Obras Sanitarias was a “well-run company” with little debt and was capable of expanding on its own—had it been sufficiently funded. [Santoro, 2/6/2003]

Entity Tags: Obres Sanitarias de la Nacion, World Bank

Timeline Tags: Water

1984: Cuba Launches its Family Doctor Program

Cuba launches its Family Doctor Program. This new system is designed to make up for the shortcomings of the “medicine in the community” model (see 1964 and after) which did not create the intended close relationships between physicians and patients and which had failed in the area of preventative care. Under the new system, Cuba aims to put a physician and nurse team on every city block and in the remotest rural communities. The plan calls for the creation of 25,000 such teams by the year 2000, 5,000 of which would be assigned to factories, schools, ships, and homes for the elderly. The teams are charged with providing comprehensive medical attention to everyone in their districts, both healthy and sick. Each district consists of between 120 and 150 families. Special emphasis is placed on prevention and people are encouraged to exercise, eat well, and avoid unhealthy lifestyle habits such as smoking. [Feinsilver, 1993, pp. 35, 40-42] Implementing the system also requires corresponding changes in the country’s medical schools. All medical graduates except surgeons, nonclinical specialists, and future medical school professors are now required to complete a residency in family medicine before completing a second residency in a specialty area. [Feinsilver, 1993, pp. 30] After the Family Doctor Program is implemented, medical costs begin to drop. The reduced costs are attributed to decreased hospitalization and emergency room use, better health monitoring, improved patient fitness, and more effective prevention. [Feinsilver, 1993, pp. 35, 45]

Entity Tags: Cuba

Timeline Tags: Other Health Care Systems

By this date, Cuba has 6.0 medical assistance beds per 1,000 inhabitants and 1.3 social assistance beds per 1,000 people. The island boasts a total of 263 hospitals, 420 polyclinics (see 1964 and after), 163 dental clinics, 229 dispensaries, 3 medicinal spas, 148 maternity homes, 23 blood banks, 11 medical research institutes, 153 homes for the elderly, and 23 homes for the physically and mentally impaired. These facilities are distributed relatively evenly across Cuba, though there is a slightly higher concentration of beds in those provinces that serve as regional health centers. The Havana province also has a larger number of beds per capita because it is a national referral center. [Feinsilver, 1993, pp. 58-59]

Entity Tags: Cuba

Timeline Tags: Other Health Care Systems

A number of French dignitaries, including French Minister of Commerce Bruno Durieux, travels to Buenos Aires to lobby on behalf of two French companies—Compagnie Générale des Eaux and Lyonnaise des Eaux—which are trying to win a concession to operate the city’s water utility. On one visit, Durieux reportedly says that France will increase its investments in Argentina based on “how many privatizations we win.” Daniel Chain of Aguas de Buenos Aires will later recall, “The Embassy of France was hyperactive throughout the concession process. Every week it invited political leaders to lunches attended by French ministers. However, the Embassy of Great Britain, which supposedly was supporting the bid of the British company, Thames, had a low profile. It was an unequal fight.” [Santoro, 2/6/2003 Sources: Daniel Chain]

Entity Tags: Suez Group, Compagnie Générale des Eaux, Bruno Durieux

Timeline Tags: Water

After the decision is made to privatize Obres Sanitarias, Buenos Aire’s public water and sewer utility, rates climb 62 percent. Additionally, the utility introduces an 18 percent sales tax. [CBC News, 3/31/2004; Public Citizen, 6/14/2007]

Entity Tags: Obres Sanitarias de la Nacion

Timeline Tags: Water

Aguas Argentinas, a recently formed consortium of private companies, wins a 30-year concession to operate Buenos Aire’s water utility. It is awarded the concession because it promised a greater reduction in water rates than the other bidders. But it was close. Aguas Argentinas’s bid was 26.9 percent, just a fraction higher than the bid of another company, Aguas de Buenos Aires, which offered a rate decrease of 26.1 percent. According to the concession agreement, the company cannot raise rates for at least 10 years (rates have risen 62 percent since privatization was put on the agenda two years ago (see 1991-1993)). Additionally, it must invest $1.4 billion in the system, and connect more than 4,200,000 people to water and 4,800,000 to sewage systems. The foreign stakeholders in Aguas Argentinas include French companies Compagnie Générale des Eaux (later known as Vivendi; 8 percent), Lyonnaise des Eaux (later known as the Suez Group; 25.3 percent), Sociedad General de Aguas de Barcelona (12.6 percent), and Anglian Water (4.5 percent). The remaining stakes are held by Argentine companies Bank of Galicia (8.1 percent), Grupo Meller (10.8 percent), and Sociedad Comercial del Plata (20.7 percent). Grupo Meller is run by Sergio Meller, a supporter of Argentine President Carlos Menem, and Sociedad Comercial del Plata is owned by businessman Santiago Soldati, another close ally of Menem. [Santoro, 2/6/2003]

Entity Tags: Grupo Meller, Anglian Water, Aguas de Barcelona, Bank of Galicia, Ente Tripartito de Obras y Servicios Sanitarios, Sociedad Comercial del Plata, Suez Group, Obres Sanitarias de la Nacion, Compagnie Générale des Eaux, Sociedad General de Aguas de Barcelona

Timeline Tags: Water

Buenos Aires’ public water utility, Obras Sanitarias, is privatized under heavy pressure from the World Bank, the IMF, and the US government. It is taken over by Aguas Argentinas, a recently formed consortium of private companies that won a 30-year concession to manage the city’s water and sewage system (see December 9, 1992). The deal represents the largest transfer in history of a water service and watershed to the private sector. The consortium will be responsible for providing water to the residents of Buenos Aires and 14 surrounding municipalities—some 10 million people (see also 1980s-1993). Oversight of Aguas Argentinas will be conducted by the newly formed regulatory body, ETOSS (Ente Tripartito de Obras y Servicios Sanitarios). Its task will be to monitor the quality of service, represent customers, and ensure that the company fulfills the terms of its contract. [Inter Press Service, 4/13/1993; Santoro, 2/6/2003; CorpWatch, 2/26/2004; CBC News, 3/31/2004; Public Citizen, 6/14/2007]

Entity Tags: Aguas Argentinas

Timeline Tags: Water

Aguas Argentinas (see also April 28, 1993) cuts off the supply of water to non-paying customers, roughly 10 percent of Buenos Aires’ population. [Public Citizen, 6/14/2007]

Entity Tags: Aguas Argentinas

Timeline Tags: Water

Aguas Argentinas, a privately owned company that provides the city of Buenos Aires with its water supply, petitions the newly established government authority, ETOSS, for a rate increase of 13.5 percent. The company had previously agreed not to seek any rate increases for 10 years (see April 28, 1993). But according to Carlos Ben of Aguas Argentinas, “What was said in 1993, that there was not going to be an increase in rates for 10 years, was not meant in absolute terms. It was to indicate to the bidders that they should not put a speculative number [on rate reductions]. There was not a presumption of a freezing of rates.” [Santoro, 2/6/2003] The company also claims that it has suffered $23 million in losses because of “extra-contractual costs,” such as speeding up service in very poor neighborhoods. ETOSS, whose operations are financed through the collection of 2.6 percent of Aguas Argentinas’ revenue, approves the request on the condition that the company expedite expanding water and sewage service to the “villas de emergencia” (shanty towns), and that it implement a plan to eliminate the use of well water, which is heavily contaminated with nitrates. [Santoro, 2/6/2003; CBC News, 3/31/2004; Public Citizen, 6/14/2007] A decade later, Menahem Libhaber, the chief water and sanitation engineer for the World Bank in Latin America, will tell the International Consortium of Investigative Journalists that false promises are simply part of the game. “You get into the business with low rates or high commitments—all the while telling yourself, ‘When we are in we will renegotiate,’ The public sector has to be aware,” he says, that companies are disingenuously putting their best foot forward. “Sometimes it’s a game to get into the business.… And they [the companies] have leverage once they are in.” [Santoro, 2/6/2003]

Entity Tags: Aguas Argentinas, Carlos Ben, Ente Tripartito de Obras y Servicios Sanitarios

Timeline Tags: Water

By this date, Aguas Argentinas, the company hired in 1993 to provide water and sewer service to the residents of Buenos Aires (see April 28, 1993), has invested roughly 45 percent less ($300 million) on expanding services than required by its contract. The company blames the failure on bad debt, late payments, and a downturn in the Argentine economy. During this period, the company has been able to maintain a comfortable 20 percent profit margin. [CBC News, 3/31/2004]

Entity Tags: Aguas Argentinas

Timeline Tags: Water

Aguas Argentinas, a consortium of North American and European private water companies, announces an $800 water and sewer connection fee. The new fee is met with large scale protests, and thousands of demonstrators block the roads leading to the city (see April 1996). [Santoro, 2/6/2003; Public Citizen, 6/14/2007]

Entity Tags: Aguas Argentinas

Timeline Tags: Water

Residents of the suburban Buenos Aires town of Lomas de Zamora protest the new $800 water and sewage connections fees being charged by Aguas Argentinas (see Spring 1996). The movement quickly spreads and thousands of new water clients block roads into the capital. [Santoro, 2/6/2003]

Entity Tags: Aguas Argentinas

Timeline Tags: Water

An Argentine congressional commission issues a report accusing Aguas Argentinas, a consortium of private water companies that took over management of the city’s water and sewer system in 1993 (see April 28, 1993), of “serious and grave” breaches of contract, failing to meet goals regarding infrastructure development, and failing to inform its regulatory body, ETOSS, of its operations. It orders the company to suspend new connection fees for 800,000 new users in Buenos Aires. [Santoro, 2/6/2003; CBC News, 3/31/2004; Public Citizen, 6/14/2007]

Entity Tags: Aguas Argentinas, Argentine Congress

Timeline Tags: Water

Aguas Argentinas and the regulatory body that governs it, ETOSS, come to an agreement on the controversial $800 water and sewer connection fee (see Spring 1996). The company will lower the connection fee to $200, but create a new “Universal Service” fee that all of its customers must pay. In agreeing on the fee, ETOSS essentially allows the company to impose a fee that had not been specified in the 1992 concession agreement (see December 9, 1992). An investigation by the International Consortium of Investigative Journalists will later point out, “The real winner was Aguas Argentinas. It had succeeded in imposing fees not described in its contract.” [Santoro, 2/6/2003]

Entity Tags: Ente Tripartito de Obras y Servicios Sanitarios, Aguas Argentinas

Timeline Tags: Water

Aguas Argentinas, the private company that is managing Buenos Aires’ water and sewer services, asks ETOSS, a government regulatory agency, to raise water rates by 11.7 percent. When ETOSS approves only a 1.61 percent increase, the company turns to Secretary of the Environment Maria Julia Alsogaray, who then persuades President Carlos Menem to authorize a 5.1 percent rate hike. It eventually turns into a 17 percent increase. When a judge freezes a portion of the rate hike, the government successfully appeals. [Santoro, 2/6/2003] Aguas Argentinas’ original 1992 contract with Argentina had stipulated that the company could not raise rates for at least ten years (see December 9, 1992). This is the second such increase in rates (see also (Early 1994)).

Entity Tags: Carlos Menem, Ente Tripartito de Obras y Servicios Sanitarios, Maria Julia Alsogaray, Aguas Argentinas

Timeline Tags: Water

Aguas Argentinas signs a new contract with Argentina for the management of Buenos Aires’ water and sewer services. In negotiating the new contract, the company enlisted the support of Argentine President Carlos Menem. Additionally, it threatened not to invest any more funds into expanding water and sewer access to poor neighborhoods until the new contract was signed. The new agreement significantly reduces the company’s obligations to Buenos Aires. The original 1992 concession agreement (see December 9, 1992) required Aguas Argentinas to invest $1.4 billion in the system, and connect more than 4,200,000 people to water and 4,800,000 to sewage systems, which the company has failed to do. While the company says it currently collects 62 percent of its customers’ sewage—just shy of its commitment of 64 percent—the actual percentage of sewage that it treats is only 5 percent. The rest is dumped untreated directly into the Rio de la Plata (River of Silver). The new contract allows the company to delay construction of the crucial Berazategui wastewater treatment plant as well as a fourth sewer main. It also eliminates the requirement that rate increases be tied to investments and waives $10 million in fines that were imposed for alleged contract violations. Additionally, the contract pegs rate increases to fluctuations in the US inflation rate, calculated in pesos. [Santoro, 2/6/2003]

Entity Tags: Carlos Menem, Aguas Argentinas

Timeline Tags: Water

The Argentine government approves Aguas Argentinas’s request for another hike in water rates (see also (Early 1994) and May 1998). This time the rates increase by 9.1 percent. In exchange, the company says it will expedite its plan to spend $1.1 billion expanding services to Buenos Aires’ poorer neighborhoods. [Santoro, 2/6/2003]

Entity Tags: Aguas Argentinas

Timeline Tags: Water

A 2003 report by the Center for Public Integrity finds that 10 years after the privatization of Buenos Aires’ water and sewer services (see April 28, 1993), poor neighborhoods still lack access to safe drinking water. The report cites the example of the Parravicino household, which lives in one of the poorest areas of Buenos Aires. “Mario Parravicino, who lives with his family in the dusty city of La Matanza, gets up each morning praying silently that it won’t rain. ‘When it rains it often floods and the sewage gets into everything,’ says the 60-year-old factory worker. ‘You can’t use the toilet because it backs up. It’s disgusting.’ La Matanza is among the poorest districts in the Buenos Aires metropolitan area, a maze of tiny cinder-block homes wedged together along dirt roads. There are no sewers, so the rains flood its houses and septic tanks, which often overflow into wells. Boiling is the only form of water treatment, and not everyone can afford the gas to boil the water. Nitrate levels, caused by sewage contamination, are dangerously high and waterborne diseases common. In Argentina, intestinal infestations cause 20 percent of infant deaths. Across town in Laferrere, the Rusman family has the same problem. Their well is only two meters from the septic tank, and the water is often suspiciously murky after a rainfall. ‘Whenever we can we boil it before drinking,’ Alejandra Rusman explained. ‘But we don’t often have money to pay for gas.’ The local church provides drinking water to those who can’t pay for gas, but the Rusmans don’t wish to be beggars. Alejandra worries constantly about her two sons Pablo and Martin, aged 7 and 4. ‘This situation is dangerous because we forget and the boys drink this cloudy water and it makes them sick,’ she said.” The reports also notes, “A country that only 10 years earlier had Latin America’s highest standard of living was now on a level with Jamaica; half of Argentina’s 37 million people lived below the poverty level.” [Santoro, 2/6/2003]

Entity Tags: Mario Parravicino, Alejandra Rusman, Center for Public Integrity

Timeline Tags: Water

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