The Fight to End Neoliberal Madness in Honduras

• Author: Adrienne Pine
• DOI: http://doi.org/10.1177/0094582X221131516
• Published date: 01 November 2022
• Date: 01 November 2022
• Subject Matter: Articles

https://doi.org/10.1177/0094582X221131516

LATIN AMERICAN PERSPECTIVES, Issue 247, Vol. 49 No. 6, November 2022, 33–54

DOI: 10.1177/0094582X221131516

© 2022 Latin American Perspectives

33

The Fight to End Neoliberal Madness in Honduras

by

Adrienne Pine

While limited in numbers, unionized workers at the two psychiatric hospitals in

Honduras have had an important impact in the evolving struggle to improve condi-

tions in their facilities and their country. In the 57 years since the union was formed,

its members have modified their strategies in response to major political changes,

including the implementation of neoliberal policies led by international financial insti-

tutions, and the 2009 coup. The union has fought to achieve better conditions for work-

ers and patients while facing serious challenges, including a context of institutional

psychiatry that has dramatically failed to meet the mental health care needs of the

Honduran population over the past century and neoliberal policies that have increased

structural vulnerability, trauma, and the incidence of associated embodied manifesta-

tions—including mental illness—among Hondurans while increasing stigma against

the mentally ill and drastically weakened the infrastructure and quality of health care

through defunding and privatization.

Aunque limitados en número, los trabajadores sindicalizados en los dos hospitales

psiquiátricos de Honduras han tenido un impacto importante en la lucha progresiva

por mejorar las condiciones en las instalaciones y su país. En los 57 años transcurridos

desde la formación del sindicato, sus miembros han modificado sus estrategias en

respuesta a los principales cambios políticos, incluyendo la implementación de políticas

neoliberales liderada por instituciones financieras internacionales, y el golpe de estado

de 2009. La lucha militante del sindicato por mejorar las condiciones para los traba-

jadores y los pacientes ha enfrentado serios desafíos. Estos incluyen un contexto de

psiquiatría institucional que ha fracasado dramáticamente, probándose incapaz de sat-

isfacer las necesidades de atención de salud mental de la población hondureña durante

el siglo pasado, así como las políticas neoliberales que han aumentado la vulnerabilidad

estructural, el trauma y la incidencia de manifestaciones somáticas asociadas (como las

enfermedades mentales) entre los hondureños. Al mismo tiempo el neoliberalismo ha

aumentado el estigma contra los enfermos mentales, mientras que la infraestructura y

la calidad de la atención a la salud se han debilitado drásticamente a raíz de la desfi-

nanciación y la privatización.

Keywords: Honduras, Neoliberalism, Psychiatry, Labor, Mental health

What sane person could live in this world and not be crazy?

—Ursula K. LeGuin, The Lathe of Heaven

Adrienne Pine is a medical anthropologist and the author of Working Hard, Drinking Hard: On

Violence and Survival in Honduras (2008) and coeditor (with Siobhán McGuirk) of Asylum for Sale

(2020).

1131516LAPXXX10.1177/0094582X221131516Pine/ENDING NEOLIBERAL MADNESS IN HONDURAS

research-article2022

34 LATIN AMERICAN PERSPECTIVES

Under capitalism our heads hurt

and our heads are ripped off.

In the struggle for Revolution the head is a delayed-action bomb.

In the construction of socialism

we plan for the headache

which doesn’t alleviate it—quite the contrary.

Communism will be, among other things,

an aspirin the size of the sun.

—Roque Dalton, “Sobre dolores de cabeza”

“Neoliberalism” is a term used to describe a broad set of “austerity” policies

(and accompanying hyperindividualist ideology) implemented over the past

half century through international financial institution–led national and local

restructuring programs and trade agreements enforced through violence. These

policies have effected a form of capitalism unfettered by regulations that could

otherwise protect communities at every level against labor abuses, environmen-

tal destruction, climate change, land grabs, forced migration, and many other

harms that are embodied as illness and injury. At the same time, they actively aim

to destroy the very collectivities that could resist their advance by “imped[ing]

pure market logic” (Bourdieu, 1998). In this paper, I explore the ways in which a

small union of psychiatric hospital workers has approached the devastating

impacts of neoliberalism on both mental health and mental health care in

Honduras in the context of shifting cultural understandings of the overlapping

cultural category of madness (locura) and biomedical categories of mental illness

and of the history of institutional psychiatry there. I argue that in developing

strategies framed by an anticapitalist and anti-imperialist analysis and imple-

menting them through a multiplicity of tactics including frequent militant direct

action, these workers have had an outsized positive impact—staving off even

greater harms to themselves and their patients and working toward a better

future for mental health and mental health care in Honduras.

On June 28, 2009, members of the Honduran financial elite financed a coup

that was carried out by a general trained at the U.S. military’s Western

Hemisphere Institute for Security Cooperation (The School of the Americas),

ousting the democratically elected president Manuel Zelaya. This led to a

12-year period of accelerated implementation of neoliberal policies, imposed

through the criminalization and violent militarized suppression of dissent, that

I have elsewhere described as “neoliberal fascism” (Pine, 2019; see Gill, 2004,

for background on the institute). Prior to but especially during the 12 years that

followed the coup, public health care in Honduras was under attack. The post-

coup neoliberal restructuring of hospitals and clinics, including defunding,

privatization, and union busting—accompanied by ideological shifts ever far-

ther away from health care as a human right and toward the medicalized stig-

matization of the poor, the sick, and the mentally ill—contributed to increased

morbidity and mortality and to forced migration. During the same period of

U.S.-supported militarized dictatorship,1 Hondurans were somatizing dra-

matic increases of political and everyday violence, terror, and trauma, which in

turn created a far greater demand for mental health care.

Workers in the country’s two inpatient psychiatric hospitals, Hospital

Mario Mendoza and Hospital Santa Rosita, come face-to-face with these two