by StarmanSkye » Wed Jan 25, 2006 7:10 pm
"Thus the World Bank and IMF through SAPs have successfully destroyed domestic economies, disintegrated societies; enhanced the integration of countries into the global free market; increased the dependence of indebted countries on the North for their survival; empowered the role of the TNCs in controlling their economies; facilitated the spread of corruption; and increased poverty and hunger and a deterioration in health in these societies."<br><br>The PTB depend on the public's ignorance and disinterest of the true consequences of its Globalization program. I know John Perkins has taken some hard hits for the limited hangout effect of his 2004 book, 'Confessions of an Economic Hitman', which details his ten-year career in helping to defraud developing worlds and setting-up the enormous unpayable debt-burdens which became the basis for IMF/World Bank to twist the screws and wrest substantial concessions re: distressed-sale privatization and public services cost-cutting <br>-- essentially, a sophisticated global equity-mining strategy. <br><br>Catherine Austin Fitts in particular has delivered a ripping critique <<!--EZCODE AUTOLINK START--><a href="http://www.forestcouncil.org/tims_picks/view.php?id=1031>">www.forestcouncil.org/tim...p?id=1031></a><!--EZCODE AUTOLINK END--> that includes the claim that Perkins doesn't tell the 'whole story' or connect the dots re: the role of the City of London, the Vatican, organized crime, drug/arms-smuggling cartels, Global Banking syndicates and the Military Industrial Complex in finessing this systematic pillaging of Third World wealth to finance black budget projects and the continuing program of covert and psychological warfare on behalf of the NWO.<br><br>That's an important issue which probably deserves its own thread to discuss, or at least to consider. Personally, I think Fitt's is reading much too much into what or why Perkins chose to write what he did. He's pretty unique in being the ONLY agent indirectly working on behalf of the NSA and State Dept. on this scheme thru the 70s to write about what he did. Contrary to what Fitt's claims, that Perkins was promoting the 'big lie', ie. the 'secret' that there IS no bigger conspiracy, I didn't read Perkins with extreme blinders on, nor did I --nor do I-- expect to find all let alone most damning information re: PTB's schemes in one or a few sources. <br><br>But all this is beside the point of this post -- which I don't want to distract from or confound with incidental considerations. It's important enough in the sense of highlighting the fallacies and flawed assumptions that the IMF and World Bank have used to 'sell' their economic theories to a largely gullible, uninformed and disinterested public.<br><br>That the majority (if not all) 3rd world nations have been swindled and defrauded by the coerced complicity of ruling-class elites who either exceeded their authority, acted in bad faith, were not legitimate government representatives of the nation's peoples, or otherwise lacked legal authority to accept the package development-loans they did on behalf of a nation, a compelling case can be made that most third-world debt is fraudulant and the obligations should be repudiated as null-and-void.<br><br>This is an issue that the International Banks are keenly concerned about --as the World Bank/IMF has threatened economic repercusions to compell 3rd world political candidates to promise they will not endorse debt repudiation in any form.<br><br>I trust most people who make the effort to understand the tremendous suffering and injustices that have resulted through the west's (via elitist institutions) imposition of debt-peonage on the 3rd world through a variety of corrupt schemes are capable of considering the wider implications re: global peace, social and economic justice, human rights, rule of law, soverignty and genuine political institutions and public participation.<br><br>Starman<br>******<br><!--EZCODE AUTOLINK START--><a href="http://www.phmovement.org/pubs/issuepapers/hong09.html">www.phmovement.org/pubs/i...ong09.html</a><!--EZCODE AUTOLINK END--><br><br>Impact of Structural Adjustment Programs (SAPs) in the Third World<br>Evelyne Hong<br>August 2000 <br>(See url for complete Index of Issue Papers)<br>*****<br><br>Increased Poverty<br> <br><br>Since the 1980s, the social impact of SAPs has been recognised: poverty has increased both in the rural and urban areas; real salaried earnings in many countries have plummeted by more than 60 percent since the beginning of the 1980s; while the situation is much worse in the informal sector. In 1991, a university trained teacher in Hanoi received a monthly salary of less than US$15. In Peru after the IMF-WB sponsored reforms in 1990, fuel prices shot up 31 times overnight and the price of bread increased 12 times: the real minimum wage had declined by more than 90 percent compared to levels in the mid 70s (Chossudovsky 1997:3<!--EZCODE EMOTICON START 8) --><img src=http://www.ezboard.com/images/emoticons/glasses.gif ALT="8)"><!--EZCODE EMOTICON END--> .<br> <br>In South America, SAPs have rolled back the progress achieved in the 1960s and 70s. The number of people living in poverty rose from 130 million in 1980 to 180 million at the dawn of the 1990s. One decade of negative growth only worsened income inequalities, while the cost of adjustment fell on the middle and lower income groups, the top five percent retained and even increased their living standards. (Bello 1996:292). Income disparities widened with privatisation and deregulation as massive resources were concentrated in the hands of a few. In Mexico the richest 20 percent received more than 52 percent of the national income while the income of the poorest 20 percent had less than five percent. The number of billionaires rose from two to 24 while 17 million people subsisted on less than $350 per person per year during the Salinas administration (Heredia & Purcell 1996:283).<br> <br>The shift from food production for domestic consumption to export needs under SAPs has affected nutritional levels. In Brazil, production of foodstuffs per capita like rice, black beans, manioc and potatoes fell by 13 percent from 1977 to 1984. Per capita output of exports like soybeans, oranges, cotton, peanuts and tobacco shot up by 15 percent. As a result of these policies 50 percent of Brazilians suffer malnutrition (Morris 1996:223)<br> <br>In Mexico the health budget in the 1980s fell from 4.7 percent to 2.7 percent. Between 1980 and 1992, infant deaths from nutritional deficiencies tripled to rates higher than those in the 1970s as a result of cutbacks in social and health spending (Heredia & Purcell 1996:277). In 1990, half of all Mexicans (42 million) were living in poverty, with 18 million living in conditions of extreme poverty and ‘malnutrition has become the normal condition of society’ (Ibid:282).<br> <br>In Chile between 1980 and 1990, the proportion of families below ‘the line of destitution’ rose from 12 to 15 percent while those below ‘the poverty line’ (but above the destitution line) from 24 to 26 percent. Some 40 percent or 5.2 million people were classified as poor in a country that once boasted of a large middle class. (Bello 1996:291) This has led to increased hunger and malnutrition; for some 40 percent of Chileans the daily calorific intake dropped from 2,019 in 1970 to 1,751 in 1980 to 1,629 in 1990 (Ibid:291).<br> <br>Corruption<br><br>Privatisation of public enterprises and downsizing of the civil services have engendered the spread of corruption in the Third World. A recent report reveals that Western business interests pay bribes worth $80 billion a year - about the amount the UN believes is needed to eradicate poverty. It ‘is largely the result of the rapid privatisation (and associated practices of contracting out and concessions) of public enterprises worldwide: … this process has been pushed by Western creditors and governments and carried out in such a way as to allow multinationals to operate with increased impunity. Thus multinationals supported by Western governments and their agencies are engaging in corruption on a vast scale in North and South alike’ (Hawley: 2000).<br> <br>Efficient, accountable, adequately paid and well motivated civil services are essential for combating corruption. Civil service reform, a major plank of SAPs since the 1980s has meant downsizing. These cuts as the World Bank discovered produced neither efficiency or increased revenue: eight out of 15 countries in Africa actually increased their wage bills after downsizing from pay offs to retrenched workers. In 40 percent of cases laid off civil servants had to be rehired. An internal World Bank staff report noted in 1999, that civil service reforms were eroding governance (Ibid). SAPs induced decline in wages have resulted in lack of motivation, low morale and increased risks of petty corruption among civil servants who remain employed.<br> <br>Bribery enables companies to gain contracts like public works and military equipment, or concessions, which they would not otherwise have won. In 1999, the US Commerce Department reported that in the last five years, bribery was a factor in 249 commercial contracts worth $145 billion. Yet corruption is increasingly cited as a reason for withholding foreign aid or debt relief for the South, despite the fact that it is through WB-IMF led deregulation, privatisation, and SAPs requiring civil service reform, and economic liberialisation policies, and their manner of implementation that have increased corruption (Ibid).<br><br>Social Dislocation & Unrest<br><br>There is a brain drain from the Third World countries to the North: as many as 30,000 African PhDs live abroad, while the continent itself is left with only one scientist and engineer per 10,000 people. At least 30 million women migrants are in the Third World: a large share of migrants from the Philippines, Sri Lanka and Indonesia are women, many doing work that is dirty, dangerous and demeaning (UNDP 1999).<br> <br>The situation in many Third World countries is desperate if not hopeless. Anti SAP riots have occurred in many countries as reported by Chossudovsky (1997:36) like the following:<br><br>Venezuela: In 1989, the President declared a state of emergency to quell riots in Caracas sparked off by a 200 percent increase in the price of bread; men, women and children were fired upon and unofficial reports listed a thousand people were killed; <br><br>Tunis, Tunisia: In January 1984, bread riots occurred as a result of the rise in food prices; <br><br>Nigeria 1989: anti-SAP student riots led to the closing of six universities by the military government; <br><br>Morocco 1990: There was a general strike and popular uprising against the government’s IMF sponsored reforms; <br><br>Mexico 1993: Economic polarisation and declaration of war by the Zapatista Army of National Liberation (EZLN) in Chiapas, and the assassination of a presidential candidate; <br><br>Bolivia 2000: WB pressured the sale of Cochabamba’s water to the US firm Bechtel: the company hiked water rates and citizens took to the streets. Martial law was declared (The Ecologist June 2000). <br><br>Social Conditions Worsen<br> <br>Reforms in the social sector have had dramatic impact on the status of education, health, environment and women and children. The restructuring of the health sector had led to the collapse of both preventive and curative care due to the lack of medical equipment, supplies, poor working conditions, low pay of medical personnel and the resulting low morale. User fees in primary health care and education have led to the exclusion of large sectors of the population from health services as they are unable to pay.<br> <br>In fact the utilisation of health centres by high risks groups dropped when cost recovery schemes and user financing were introduced. In Kenya, user fees at a centre for sexually transmitted diseases, caused a sharp decline in attendance leading to a likely increase in the number of untreated STDs in the population. In 1994, medical experts voiced fears that the introduction of user fees, along with SAPs may be contributing to the rapid spread of AIDs in Africa. In the Upper Volta region of Ghana, health care use plummented by 50 percent when cost recovery was introduced. In Dar es Salaam, Tanzania, the three public hospitals saw attendance drop by 53.4 percent in a matter of months in 1994 when user fees were introduced. In Niger, cost recovery measures implemented between 1986 and 1988 led to: a sharp decline in the use of preventive care services; increased exclusion of the most impoverished from care at Niamey Hospital, where outpatients who did not pay for care would wait some 24 days before seeking care while an outpatient who did have to pay for care would wait an average of 51 days; exemptions that were applied to the benefit of urban, military and civil service families and not for the intended beneficiaries (the most impoverished) led to a drop in already very low primary school enrolment rates: these went from 17 percent in 1978 to 28 percent in 1983 to 20 percent in 1988 (50 Years is Enough July 14, 2000).<br> <br>In Nicaragua, about one quarter of primary school children have not enrolled in primary school since charges for registration and a monthly fee were introduced. However, when school fees and uniform requirements were eliminated in Malawi in 1994, UNICEF reported primary enrollment increased by some 50 percent virtually overnight from 1.9 million to 2.9 million and the main beneficiaries were girls (Ibid).<br> <br>In China, when user payment for tuberculosis treatment was introduced, some 1.5 million cases of TB remained untreated, leading to 10 million additional persons infected: many of the three million deaths from TB in China during the 1980s could have been prevented (Werner & Sanders 1997:103). Elsewhere, community involvement in health care amounts to replacing the government salaried nurse or medical assistant by an untrained and semi literate health volunteer. The shortage of funds for medical supplies like disposal syringes and pharmaceutical drugs as well as price hikes in electricity, water and fuel (required to sterilise equipment) have led to an increase in the incidence of infection (including AIDS) (Chossudovsky 1997:72). In Sub-Saharan Africa (SSA), the inability to pay for prescription drugs tends to reduce the levels of visits and the use of government health centres so that health infrastructure and personnel is no longer utilised cost-effectively (Ibid:72).<br> <br>Cuts in public expenditure under SAPs have led to a drastic decline in control and prevention measures. As a result, diseases, once under control or eradicated have made a comeback. Sub-Saharan Africa records a resurgence of cholera, yellow fever and malaria. In South America the prevalence of malaria and dengue has worsened dramatically since the mid 80s. The outbreak of bubonic and pneumonic plague in India in 1994 has been seen ‘as the direct consequence of a worsening urban sanitation and public health infrastructure which accompanied the compression of national and municipal budgets under the 1991 IMF-WB, sponsored structural adjustment programme’ (Ibid: 72). The three country studies of the impact of SAPs on health outlined below are from Chossudovsky’s research (1997).<br> <br>SAPs Reform in Peru<br><br>Peru implemented SAPs at the outset of the debt crisis and by 1985 estimated food intake had fallen by 25 percent in the space of ten years since 1975: real earnings at the minimum wage level fell by more than 45 percent; the average decline in earnings of blue-collar workers and white-collar workers were 39.5 percent and 20 percent respectively. The annual rate of inflation for the same period was 225 percent. In 1990, a new government carried another round of economic reform under IMF tutelage. Since 1985, Peru had declared a moratorium on the payment of debt servicing obligations and the country was on the IMF blacklist. The new government unconditionally accepted to reimburse Peru’s debt areas to the IFIs. This was through negotiations of ‘new loans’ earmarked ‘to pay back old debts’. Peru was obliged to start servicing its debt immediately. As a direct result of these loans Peru’s debt servicing obligations more than doubled in 1991 from US$ 60 million a month to over $150 million (Ibid:193).<br> <br>The growing economic crisis led to another round of economic stabilisation, which entailed an ‘economic shock treatment’ as a condition for the renegotiation of its external debt. To solve Peru’s hyperinflation, wages were further lowered and social expenditures cut further together with the massive lay-off of public sector workers. A few days before the ‘Fuji shock’ a state of emergency was declared in Peru on 8 August 1990. The IMF austerity measures led to a reduction of health and educational expenditure and the collapse of civil administration in the regions. The Sendero Luminoso (Shining Path) insurgency gained ground and under the Fujimori regime, controlling the insurgency became a pretext to systematically harass civilian opposition to the IMF programme like the peasant movements, trade union leaders, students, intellectuals and activists. The IMF programme had an immediate impact on the rural economy: domestic producers were displaced by cheap food staples imports; immediate and abrupt hikes in the prices of fuel farm inputs, fertilisers and agricultural credit; in many areas cost of production was more than the farmgate price; many peasant communities could not sell their surplus in local markets and increased prices of fuel and transportation cut them off from the cash economy (Ibid: 205-207).<br> <br>The cholera epidemic in 1991 received worldwide news coverage. News reports at that time quoted the President who blamed it on the debt crisis. With a thirty-fold increase in cooking oil prices, the population including the ‘middle classes’ could not afford to boil their water or cook their food. Some 200,000 declared cases of cholera were detected and 2000 deaths registered in a six-month period (Ibid: 201). Since August 1990, tuberculosis had reached epidemic levels aggravated by malnutrition and the collapse of the state vaccination programme. The breakdown of the public health infrastructure had led to a resurgence of malaria, dengue and leishmaniasis. In July 1991, an indefinite strike by teachers and health workers had closed down schools, hospitals and universities as monthly wages were on average $45-$70 which was 40 times lower than wages in the US. In the-mid 90s, more than 83 percent of the population did not meet the minimum nutritional requirements. Peru had the second highest rate of child malnutrition in South America (Ibid: 201).<br><br>Famine in Somalia<br><br>Until IMF-WB intervention in the early 1980s, agriculture in this country was based on reciprocal exchange between nomadic herdsmen and traditional agriculturalists. In the 70s commercial livestock was developed and this affected the nomadic herdsmen. Until 1983, livestock contributed to 80 percent of export earnings. Despite recurrent droughts, Somalia was virtually self sufficient in food until the 1970s. From the-mid 1970s to mid 1980s, food aid increased fifteen fold at 31 percent per annum. The influx of cheap surplus wheat and rice in the domestic market soon displace local producers and caused a shift in food consumption patterns to the detriment of traditional maize and sorghum (Ibid:102).<br> <br>The IMF led austerity reform to service Somalia’s debt led to a dramatic decline in purchasing power, the deregulation of the grain market, and the influx of ‘food aid’ led to massive impoverishment of the farming communities. In June 1981, the devaluation of the Somali shilling led to hikes in the prices of fuel, fertiliser and farm inputs. This affected both the rainfed agriculturalists and irrigated farming communities. At the same time Somalia was encouraged to produce ‘high value added’ fruits, vegetables, oilseeds and cotton for export, on the best-irrigated lands.<br> <br>Prices of livestock drugs increased with devaluation: user fees for veterinarian services and the vaccination of animals were introduced; the functions of the Ministry of Livestock were phased out and the Veterinary Laboratory services were to be fully financed on a cost-recovery basis. The privatisation of animal health together with the absence of emergency animal feed during drought periods, the commercialisation of water and the neglect of water and range land conservation led to the decimation of the herds and the pastoralists who represent 50 percent of the population. The World Bank had succeeded in wiping out the herdsmen and the traditional economy (Ibid:103).<br> <br>Aid was increasingly given in the form of food aid. By the 1980s, ‘ the sale of food aid’ (government would sell this on the local market) was the principal source of state revenue and the donors were thus in charge of the nation’s budget determining what monies were spent where. When the herds’ died and nomadic herdsmen were pushed into starvation, the small farmers could not barter or sell their grains for cattle. The entire social fabric of the pastoral economy disintegrated. The collapse in foreign exchange earnings from declining cattle exports and remittances (from the Gulf) affected the balance of payments and led to a breakdown in the government’s economic and social programmes (Ibid:105).<br> <br>By 1989 health expenditure had declined by 78 percent in relation to its 1975 level. From 1981-1989 school enrolment dropped by 41percent. Nearly a quarter of primary schools closed down. By 1989 real public sector wages had declined by 90 percent as compared to the-mid 70s. Average wages in this sector had plunged to US$3 a month, leading to a breakdown in the civil service. Debt servicing obligations represented 194.6 percent of export earnings. IMF cancelled its loan because of outstanding areas. WB froze a structural adjustment loan for $70 million in June 1989 due to Somalia’s poor macro-economic performance (Ibid:104). Somalia has not had a national government since faction leaders overthrew the 21 year dictatorship of Mohammed Siad Barre in January 1991.<br> <br>Thus famine in Somalia and the collapse of civil society was not (due to a shortage of food) caused by drought, desertification and civil war which were the official causes and which led to US military intervention in 1993 in the guise of ‘Operation Restore Hope’. It was the disintegration of the peasant economy and the destruction of its agriculture. US grain surplus destabilised domestic food production. Since the early 80s grain markets were deregulated under WB supervision (Ibid: 106). The nomadic and commercial livestock industry was destroyed by SAPs. Subsidised beef and dairy products from the European Union destroyed the pastoral economy. European beef imports to West Africa increased seven fold since 1984. EU beef sells at half the price of locally produced meat, and Sahelian farmers are finding that no one is prepared to buy their herds (Ibid: 106). Thus food aid leads to famine. Years of economic deprivation and conflict have swelled the capital Mogadishu with the influx of refugees and gunmen.<br> <br>SAPs role in undermining food security has been repeated throughout Africa. Food aid to Sub-Saharan Africa since 1974 has increased by more than seven times and commercial grain imports have more than doubled. SAPs undermine all economic activities that do not serve the interests of the global market (Ibid: 106).<br> <br>Economic Reform in Vietnam<br><br>The end of the Cold War and the demise of the Soviet Union affected the Vietnamese economy. In 1986 free market reforms under the guidance of the WB - IMF was launched. The same prescriptions were doled out; devaluation of the currency; the closure of state enterprises; downsizing the civil service; removal of tariff barriers, subsidies; deregulation; and restructuring of the Central Bank. One of the conditions for the normalisation of economic relations and the lifting of the US embargo was that Vietnam had to pay for the debt incurred by the US backed South Vietnamese regime during the liberation war. The effects of the economic reforms can be compared to a new phase of economic and social devastation in the aftermath of the Vietnam War, which ended in 1975 after 50 years of struggle (Ibid: 149).<br> <br>By 1994, the free market reforms had contributed to the closing down of more than 5000 out of the 12,300 State owned enterprises. The most valuable state assets were transferred to joint venture companies. Through a series of deliberate manipulation of the market forces, and IMF intervention, the State economy collapsed. There was a hidden agenda to the economic reforms in Vietnam, namely to destabilise the country’s industrial base such that all heavy industry, oil and gas, natural resources and mining, cement and steel production were restructured and taken over by foreign capital with Japanese conglomerates in the lead role (Ibid:152). In the agriculture sector, Vietnamese farmers were encouraged to switch to ‘high value’ cash crops for export. The ‘local level self sufficiency in food’ policy which was devised to prevent regional food shortages was done away with under the guidance of the World Bank and the FAO. Thus overcropping of coffee, cassava, cashew nuts and cotton together with falling world commodity prices and the high cost of farm inputs have led to severe food shortages and outbreak of local level famines. In areas where rice growing had been abandoned following the policy of ‘regional specification’ food shortages struck (while rice was being exported below world market prices) (Ibid:159).<br> <br>In 1994 famine occurred in a border province with China which affected 50,000 people. In the Mekong Delta, World Bank data revealed that more than a quarter of the adult population had a daily energy intake below 1800 calories. Fall in real earnings, massive unemployment and soaring food prices (due to the removal of food subsidies and price controls) also affected the urban population with lower levels of food intake and a deterioration in the nutritional status of children as a result (Ibid: 160). The deregulation of the grain market triggered famine and led to a high incidence of child malnutrition.<br> <br>According to the World Bank: ‘Vietnam has a higher proportion of underweight and stunted children (of the order of 50 percent) than in any other country in South and Southeast Asia with the exception of Bangladesh. The magnitude of stunting and wasting among children certainly appears to have increased significantly…. it is also possible that the worsening macro-economic crisis in the 1984 - 1986 period may have contributed to the deterioration in nutritional status’. A FAO nutrition study revealed that Vitamin A deficiency (which causes night blindness) is widespread among children in all regions of the country except Hanoi and the southeast. The FAO study also confirmed a situation of severe undernourishment, with the adult mean energy intake per capita per day for the country was 1,861 calories with 25 percent of the adult population below 1,800 calories. In nine percent of households, energy intake by adults was less than 1,500 calories (Ibid: 160-61).<br> <br>Health System Collapse<br><br>Until 1989, the district hospitals and commune level health centres provided medical services and essential drugs free of charge. With reforms, a user fees system was introduced and cost recovery and the free market sale of drugs were applied. Consumption of essential drugs (through public distribution) declined by 89 percent. With complete deregulation of the pharmaceutical industry and the liberalisation of drug prices, imported branded drugs sold exclusively in the free market at enormous costs have displaced domestic drugs. By 1989 domestic production of pharmaceuticals had declined by over 98 percent compared to its 1980 level. A large number of drug companies closed down and Vietnam’s pharmaceutical and medical supply industry was pushed into bankruptcy.<br> <br>The government discontinued budget support to the health sector (under the guidance of the donors) which paralysed the public health system. There was no money for medical equipment and maintenance; salaries and working conditions declined. With the emergence of private practice, tens of thousands of doctors and health workers fled the public health sector. By 1991, commune level health centres were not working. There was no annual check-up for TB; no medicines, and farmers could not afford user fees at district hospitals.<br> <br>With the public health system in shambles, there was a resurgence of infectious diseases like malaria, tuberculosis and diarrhoea. A WHO study revealed that malaria deaths increased threefold in the first four years of reforms with the collapse of curative health and soaring prices of anti-malarial drugs. In the words of the World Bank: ‘despite its impressive performance in the past, the Vietnamese health sector…there is a severe shortage of drugs, medical supplies and medical equipment and government clinics are vastly under utilised. The shortage of funds to the health centre is so acute; it is unclear where the grassroots facilities are going to find the inputs to continue functioning in the future’ (Ibid: 16<!--EZCODE EMOTICON START 8) --><img src=http://www.ezboard.com/images/emoticons/glasses.gif ALT="8)"><!--EZCODE EMOTICON END--> .<br> <br>In the area of education, Vietnam had 90 percent literacy rates and school enrolments were among the highest in Southeast Asia. However economic reforms have resulted in shrinking the educational budget, depressing teachers’ salaries, and commercialising secondary, vocational and higher education through the introduction of tuition fees. School enrolment declined and a high dropout rate in the final years of primary school has been recorded. The proportion of graduates from primary school who entered the four-year lower secondary education system declined from 92 percent in 1986 - 87 to 72 percent in 1989 - 90. A total of nearly three quarters of a million children were pushed out of the secondary school system during the first three years of the reforms. The economic reforms have systematically undone some 40 years of struggle and efforts of the Vietnamese people. This will have severe repercussions on health as education is an important determinant of health: where the mother’s educational level is the single most important determinant of infant mortality among the poor.<br> <br>According to the Ministry of Labour, War Invalids and Social affairs (MOLiSA) joblessness is becoming a major concern for this nation of 77 million people. Unemployment has risen from 6.8 percent in 1998 to 7.4 percent in 1999. With less land for cultivation and increasing unemployment, uncontrolled migration to the cities is now widespread. More than 30,000 Vietnamese have gone to work abroad. Vietnam has workers in some 38 countries and the numbers are expected to increase by about half a million in 2005 (Nguyen Nam Phuong July 11 2000).<br> <br>Thus the World Bank and IMF through SAPs have successfully destroyed domestic economies, disintegrated societies; enhanced the integration of countries into the global free market; increased the dependence of indebted countries on the North for their survival; empowered the role of the TNCs in controlling their economies; facilitated the spread of corruption; and increased poverty and hunger and a deterioration in health in these societies.<br><br> <p></p><i></i>
