Public health repercussions of metal mining in El Salvador: A qualitative exploration with lessons for the americas

Background: Mining initiatives in El Salvador have been considered to have negative repercussions on population health. Salvadoran community leaders have supported a national moratorium on mining activities, with backlash from North American corporations. As a representative country from Latin America, we chose to interview Salvadoran community leaders concerned with mining activities to explore local perspectives. Methods: Focus group and individual semi-structured interviews with community leaders were conducted until thematic saturation was achieved. A combination criterion-purposive and snowballing sampling technique was used to identify participants. Interviews were transcribed, coded and conceptualized with hypothesis generation using Grounded Theory methodology. Results: Six focus groups of 32 community leaders with 11 individual interviews were conducted in May 2013. Multiple themes emerged including i) the fallacy of economic development ii) environmental contamination in a water-stressed country iii) negative health impacts iv) mining-generated violence and historic parallels with the civil war. This included testimonials about community leaders who had been threatened, tortured, or killed for their “anti-mining” activities. Solutions involved the creation of co-operative micro-enterprises for sustainable economic growth, political empowerment within communities and developing local participatory democracies. This allowed Salvadorans the opportunity to simultaneously resist North American mining practices while creating popular power as an alternative to neo-liberal pressure. Conclusions: Metal mining in El Salvador represents a significant environmental and public health threat for the population. Coercion used by foreign forces is reminiscent of historic violence. This may be similar to other ‘North-South' interactions throughout Latin America, with local solutions that may be applicable broadly.