The 47-day strike Bolivian by doctors drew to a close this week after President Evo Morales said he would send legislation to the Plurinational Legislative Assembly, controlled by his ruling Movimiento Al Socialismo (MAS) party, repealing the newly introduced articles 205 and 137 of the penal code.

The first article criminalizes doctors for “damage to health or physical integrity due to malpractice,” providing for sanctions that include economic compensation and prison. Similarly, article 137 criminalizes accidents experienced by truck drivers on Bolivia’s roads.

The doctors reached an agreement with the government that contemplates the creation of an arbitration entity to resolve malpractice conflicts.

The doctors’ struggle gained force with a successful 48-hour national strike on January 3-4 against the implementation of the new Unified Health System (in Spanish, SUS), which brought thousands of physicians and medical students into the streets of Bolivia’s main cities. Police used tear gas in attempts to disperse the crowds.

Aware of the growing opposition and the threat to extend the strike to 72 hours or even indefinitely, Morales chose to back down.

The doctors strike coincided with continuing protests over the decision taken in December 2018 by the Supreme Electoral Tribunal (in Spanish, TSE) to override the results of a popular referendum on February 21, 2016—known as 21F—which denied Morales the right to run for a fourth presidential term in this year’s election.

Doctors have opposed the implementation of the new SUS universal public health care system because, as it has been designed by the government, it is not sustainable. For the new health system to work properly, doctors have raised three central demands: an increase in the health budget from 3 percent of GDP to 10 percent; investment in infrastructure and equipment; better pay for health and medical specialists; and the government’s payment of Bs 200 million (US$28 million) that it owes to hospitals in La Paz, Cochabamba and Santa Cruz for unpaid medical services.

During the course of the strike, doctors continued to treat patients with serious conditions. However, it is estimated that 10,000 surgeries and 800,000 consultations were suspended.

Doctors, nurses and health technicians in their white lab coats, accompanied by university students, confronted police firing teargas. The protesters burned tires and tree trunks on the roads and squares of La Paz.

University of San Andrés students marched on the streets of Santa Cruz. In that city, cradle of the Bolivian right, the crowd took over and burned the TSE premises, as well as destroyed the facade of the Palace of Justice, with frequent marches and confrontations with the police.

Those interviewed by the online news program “En Directo” revealed that police fired teargas canisters aimed directly at the demonstrators. As a result, one protester suffered multiple fractures of his leg. Another suffered injuries to his foot and a third a broken arm.

“En Directo” interviewed a leader of the protests, Ruth Aguilera, and a representative of MAS, Rolando Cuellar.

Aguilera said: “Doctors are accused of being murderers, criminals. We did not go to university to learn to kill, but to save lives ... I have been in service for 27 years. I work in San Luis, we attend births. We are just a doctor and a nurse. There are no facilities, no medications and no staff. When a child is born, we ask the mother to buy a black bag to place the placenta. ... Now they want to send us to jail. They also threaten to take away our medical license. What message do we send to the youth studying medicine? It’s better to be a cocalero or a narco?”

MAS representative Cuellar responded arrogantly: “Put [yourself] in the shoes of the people who go to the hospital and leave with a dead son. You are dictators, you leave families in mourning, orphaned children. Article 205 contemplates up to four years in prison, but it should be 30.” He brazenly added, “The people do rule. You are not doctors, you are assassins.”

The doctors strike is an expression of the larger problem of pervasive poverty in Bolivia and the continuing turn by the MAS government to the right.

Bolivia is the poorest country in South America despite the initial years of economic boom that favored Morales’ first two terms in office, with high demand and prices for hydrocarbons and favorable terms for the sale of Bolivian gas to the Brazilian Workers Party government of President Luis Ignacio Lula Da Silva. These terms will not be renewed when they expire in late 2019 given the policies outlined by Brazil’s new extreme right-wing president, Jair Bolsonaro.

A recent IMF study concludes that Bolivia has the highest rate of informal labor on the planet, with 62.3 percent, followed by Zimbabwe, 60.6 percent.

Whatever reforms Morales pursued at the beginning of his long tenure as president, these are now being challenged by the world economic downturn. What prevails today in Bolivia, according to the IMF, is “more subcontracting, and temporary jobs without social security.”

According to the Center of Studies for Labor and Agrarian Development, “80-85 percent of jobs are precarious, 60 percent are extremely precarious.” The situation for young people is more fragile. In the city of El Alto in 2013, 97 percent were precarious, with 70 percent extremely precarious.” The report continued, “In La Paz 93 percent of young people work under precarious conditions.”

Morales, the first South American president of native origin, won his last two elections with nearly 65 percent of the vote. Today his approval rate is barely 40 percent.

Morales and MAS overrode the results of the 2016 referendum and the limits of two consecutive terms imposed by the Bolivian constitution by cynically invoking the Inter-American Human Rights Conventions, arguing that denying the president the right to run for a fourth term would violate his human rights.

Bolivian newspapers are beginning to speculate on possible alliances to defeat MAS with Morales as the party’s candidate in the October 2019 elections.

In three weeks, the TSE will hold primary elections for each party to select its presidential and vice-presidential candidates. Many consider this a useless exercise since there are no real contests in any of the parties.

Running against Morales and MAS is the governor of Santa Cruz, Ruben Costas Aguilera, leader of the right-wing coalition known as Movimiento Democratico Social (MDS) or Union Democratica (UD). It traces its origins to the brutal dictatorship of General Hugo Banzer and includes parties like the Greens and other environmentalist organizations.

Also opposing the incumbent will be the Frente Revolucionario de Izquierda (FRI), whose presidential candidate will be Carlos Mesa (who was president from 2003 to 2005 when he was forced to resign by mass popular protests). This electoral front is comprised of the so-called center-left bourgeois parties, the MNR and MIR, as well as sections of the country’s main trade union federation, the COB, whose various factions are determined to subordinate the struggles of the Bolivian working class to either the ruling MAS or the bourgeois political parties opposing it.