COVID-19 in Guayaquil: from global notoriety to family responses
From the virus-ravaged Ecuadorian city come personal accounts of struggles to survive.
In early April, international news headlines such as ‘Bodies on the sidewalk’ (Miami Herald) and ‘Troops gather scores of bodies’ (Jakarta Post) brought sudden global notoriety to Guayaquil, a little-known Pacific coastal city in Ecuador with a population of less than three million people.
Dramatic reportage accompanied the headlines: dead bodies wrapped in sheets or body bags, dumped on the roadside; bodies kept for days in homes in 30°C heat, or stacked in cardboard coffins outside city graveyards. Video footage showed local authorities, hospitals and funeral homes overwhelmed.
Harrowing images left the city looking like it had been hit by a natural disaster. The press offered grim warnings for other Latin American cities, a harbinger of things to come.
This blog seeks to go beyond the sensationalism, documenting the COVID-19 response based on accounts direct from the people of Guayaquil.
How did the devastation start?
Guayaquil’s first recorded case was widely reported as being a 71-year-old woman who flew in from Madrid in mid-February, and died mid-March. But transmission was far more complex.
For this case was just one from Guayaquil’s extensive transnational migration network, rapidly returning from Spain, Italy and the United States before lockdowns were enforced. With no airport screening on arrival, any number of returnees could have been carrying the virus. Many travelled back to the suburbios, the sprawling, closely packed low-income settlements, home to 70% of the city’s population.
In March and April, the Guayas Civil Registry registered 13,162 deceased – 9,344 more than in the same period in 2019 (Spanish language site). For March and April, Ecuador reported the second highest number of COVID-19 cases in Latin America, surpassed only by Brazil’s (with ten times Ecuador’s population).
On March 17th, the government declared a national emergency, an international travel ban and a 5pm to 5am curfew, which was later extended from 2pm to 5am. Guayaquil’s overstretched health sub-centres closed because of lack of oxygen or protective equipment.
In hospitals – without enough beds or equipment – people were left dying. Guillermo, a professional and political activist, described the fallout: “In the first weeks the problem was the dead, it was horrible. There were abuses – a monetary charge to take bodies out of hospital, or for visiting the morgue to identify bodies. This continues, but now the problem is finding space for the bodies, in morgues or in containers – there is no room in the cemetery.”
Fatalities: elite or poor, old or young?
The virus does not discriminate who it afflicts or who it kills. But COVID-19 has revealed deep inequalities.
Ana, a 50-year-old grandmother living in the city’s middle-class area explained how those with financial resources and medical contacts would get their fever checked at a private clinic, or receive home treatment. In desperation they may pay exorbitant prices for scarce drugs, or oxygen from private pharmacies. By contrast, Guayaquil’s poor in the suburbios have less access to medical help. Existing health problems make them less likely to recover.
In terms of risk by age, the elderly and young men seem most affected. Arturo, a 64-year-old community leader, told us that many in the Plan Piloto neighbourhood got sick; but while the middle-aged recovered, three older people died at home.
If the difficulty in accessing food continues, very soon people will take to the streets to protest - Guillermo
Often, as with Carmen, a retired washerwoman from Cisne Dos, no clear diagnosis was made: according to her daughter Marta, Carmen died in hospital from a “respiratory infection”. But Marta was grateful they could at least get her mother’s body into the city’s cemetery while there was still room.
A younger resident of Plan Piloto, 32-year-old Ricardo, shed light on the high infection rate among youngsters living in overcrowded conditions: “The young need the streets,” he explained. Young people use public spaces as an extension of their home; many were exposed to the virus while playing volleyball.
Family matters: when government and healthy systems fail
Bodies in the street. Closed local health centres. Both are indicators of a dysfunctional local government and health care system. This leaves people fearing for their lives, and they turn to extended family – reciprocal family networks – for daily subsistence needs.
The suburbios have a long history of intergenerational reciprocity based on trust and cohesion. Networks often stretch beyond the house and block, to family members living within the neighbourhood and beyond.
Elsie, a lawyer, currently unable to work, said: “I don't move around the neighbourhood much, now we are more focused on the family".
Galo Jr, a 34-year-old man from Batallon, told us how family members depend heavily on him – he has a car and “salvaconducto” (permission granted to sailors to travel without restriction during curfew). He can drive to get food and (non-COVID-19) medicine for his 80-year-old father. Galo Jr also transported his brother-in-law, aged 42, infectious with COVID-19, to hospital – although he later died.
Maria, 36, who works in business administration for a north Guayaquil seafood processing company, explained that working from her extended family’s house has saved her job. “Thank God I could continue my job," she said. "We do not have internet access, so I just sleep at home. During the day I work at my grandmother and uncle’s, who live close by.”
Magaly, 49, moved her elderly mother in with her, to protect her. “My mom is 72, she can't go outside. Not even to the corner shop. Now she is living safely with us”.
What about the civil society or state response?
Under the restrictions, few community organisations are active. One or two, like CUBE (Confederación Unitaria de Barrios de Ecuador), working on social inclusion at city and neighbourhood level, continue to operate using the Zoom online video tool.
Long standing tensions between the municipality and national government has meant limited, but duplicated, responses. A joint military-police operation was deployed to recover bodies, and city mayor Cynthia Viteri fronted door-to-door food parcel deliveries (although reputedly only for political gain).
In Guayaquil the national government is now carrying out COVID-19 testing door-to-door.
But these interventions are bringing little substantive relief to those hit hardest: the city’s poorest. And activist Guillermo foresees their problems deepening: “The most serious problem is lack of income and food. The poorest families do not have enough to eat... if the difficulty in accessing food continues, very soon people will take to the streets to protest”.
Large numbers gathering in close proximity risk ramping up the infection rate. And as we have heard from the residents of Guayaquil, it is the poorest households that will likely bear the brunt as the virus spread continues.
With thanks to Nelson Carofilis, Lucy Zavala and members of low-income neighbourhoods in Guayaquil for their contributions to developing this blog.