Guatemala Inauguration (Written January 15, 2008)

The inauguration  of a new president is a major historical milestone for any nation. Inaugurations  have attributes that resemble a wedding. 

The steps  leading up to the inaugural are similar.   There has been a courting period and proposal from competing suitors, a  decision, and then an engagement period or transition as we call it in  government. Finally, the ceremony where oaths are said finalizing long-contemplated  promises with legal authority used to seal them.

The ceremony and  ritual of a wedding or inauguration underscores the importance and seriousness  of the commitments being made.  Friends  gather to show support and respect for what is occurring. There are social dynamics  to both.  Who participates, who gets invited,  and where they sit is closely watched. Care is taken to assure that the second  spouse of a divorced parent is seated in a place that avoids tension. There are  parties held in celebration.

Monday, January  14, Alavaro Colom was inaugurated as the President of Guatemala.  President Bush assigned me to lead a  delegation to attend the festivities as a demonstration of the value our nation  places on our friendship with Guatemala.  The other members of our delegation included:

James M. Derham
  Ambassador to Guatemala

Rob Mosbacher
  President of the  Overseas Private Investment Corporation

Sara Martinez  Tucker
  Under Secretary  of the Department of Education

Christopher A.  Padilla
  Under Secretary  of the Department of Commerce

In Latin America, inaugurations are major convenings for heads  of state.  Presidents of more than a  dozen nations, mostly from the region attended.   That makes the day of the inauguration an opportunity for a lot of  business to be conducted in an efficient way. 

After my arrival  the night before, I carried the greeting of our President to outgoing President  Berger. We met at La Casa Presidential, the equivalent of our White House. 

This is the  second occasion I have represented the United States at an  inauguration.  A year ago I lead a  delegation to Nicaragua  when Daniel Ortega took office.  I have  found these meetings with outgoing Presidents fascinating.  It is a period of great reflection for them.  President Berger and his Vice President and  Foreign Minister were there.  We spoke of  lessons he has learned, things he is proud of.

Prominent on  President Berger’s list of important accomplishments is a democracy able to  transition in a fair and democratic fashion.   Twenty years ago Guatemala  was in crisis. He is right — it is a significant accomplishment.   

Early Tuesday  morning, our delegation met for an hour and 15 minutes with President-elect  Colom, Vice President-elect Rafael Espanda, and the new Ministers of Health and  Foreign Affairs, and Economy.  We got  better acquainted and spoke in specific terms about a number of common  interests. 

The significance  was not lost that the President would spend that much time with representatives  of the United States  on such a significant day. 

The new Vice  President of Guatemala is Refael Espada.   He has been a surgeon in Houston for the  last 30 years but each month he has returned to Guatemala to do surgery.  A year ago, he moved back to participate in  the election. He is not a politically experienced man, but has an enormous  amount to offer his country. 

The balance of  the morning was spent meeting with other heads of state.  I had 30-minute meetings with the Presidents  of Panama, El Salvador, Honduras,  and Nicaragua.  The meetings were each a little different mix  of issues.  I have spent a lot of time in  Central America the past couple of years and  have developed good working relationships with each of them. 

Late in the  morning I had a good meeting with the Mexican Minister of Health. We have an  ongoing series of issues we work together on:  border issues, product safety, disease  surveillance, etc.  We reviewed our  shared portfolio, setting some follow-up meetings for February and March, 2008.

Lunch was at the  Ambassador’s residence where we met with the other Ministers of the new  Guatemalan government.  We then traveled  to the swearing in ceremony at Centro Cultural Miguel Angel Asturias, a large  hall in Guatemala City. 

The heads of  state were seated on the front row.   Because the U.S.  delegation was headed by a non-head of state, my place was right behind the  various Presidents.  It was a great spot  to watch the interaction between various people.  Care had been taken to seat Hugo Chavez a  fair distance from a couple of people with whom he had well-published dust ups.  He was next to Daniel Ortega.

The President of  Taiwan was there with a delegation of nearly 100 people.  They flew in on over a hundred people in a  747 owned by China Airlines.  Guatemala is one of a small group of countries  which recognize Taiwan  as a nation. 

The ceremony to  transition power was conducted in a rather dignified way, I thought.  In Central America  the primary emblem of power is a colorful sash draped over the right shoulder  of the President.  The outgoing President  removes the sash and gives it ceremoniously to the Speaker of their legislative  body.  The Speaker then announces the  results of the election and calls the incoming President forward to take the  oath.  Once the oath has been sworn, the  sash is draped on the right shoulder of the new President. A similar thing is  done with a pin worn by the Vice President. 

The oath of  office, taken both in Nicaragua  and Guatemala,  were similar and interesting. The oath in the U.S. is an affirmative set of statements  related to supporting, defending and obeying the constitution.  The Latin American countries include a stern  warning that if the leader doesn’t meet the expectations of the people, they  will be held accountable by history and the people.

The President’s  speech was 45 minutes long.  He appeared  to put aside his formal speech and spoke without notes.  He passionately laid out his  aspirations.  It will be great if only a  faction of it could be accomplished in four years. I found interesting how openly  he referenced God and made other religious references. 

There were small  nuances worth observing.  Things like who  didn’t stand up to applaud. You could see the political coalition playing out  among the members of Congress sitting behind him.  A two-man band of indigenous Indians played a  squawking sort of tune with a reed instrument and drum as the transition of  power was occurring. It was a symbol of support for indigenous people.  The interaction between various heads of  state was intriguing to watch.  A lot of  Latin American politics was playing out in front of me.

In the evening, inauguration  parties and rallies were held throughout the capital city.  We dropped by a reception at the same  building where I met President Berger the night before.   

Just outside the  building, a crowd of 20,000 or more people waited for the event to start. We  could hear them, but couldn’t see them.   There were some doors which appeared to open toward the crowd, so  Ambassador Derham and I opened them up to see if we could watch the  festivities. The doors lead onto a balcony overlooking the gathering. 

As we walked on  to the balcony, the crowd apparently thought we were the official party walking  out to greet them.  A great collective  shout went up and the crowd began to cheer.   We realized we had unintentionally triggered a response and quietly  withdrew, closing the door behind us.   For just a second, however, I felt like Juan Peron.
 

Comments

I always love inaguration. It reminds me when I was in college.
I wish you luck in all your program, mister secretary.

Anne Ahira

Posted by: Anne Ahira | January 17, 2008 at 10:29 AM

Secretary, I think you'd make a great ambassador for the USA to another country. If asked at some time in the future, I hope you would accept. Frankly, this country needs leaders and representatives with your talents.

Posted by: Jeff | January 17, 2008 at 03:31 PM

Dear Mr. Secretary,

I enjoy reading your eye witness accounts and the humanity you bring to them.

Can you tell us whether the topic of H5N1 came up with any of the representatives of Latin American countries? Is there concern?

I was deeply moved by your posts on India. Had the H5N1 outbreaks started while you were there and did you take any particular precautions? I worry about the impact of this disease on such a densely populated country.

Posted by: Science Teacher | January 18, 2008 at 01:12 PM

Instead of talking about "safe" topics such as India or Guatemala, why don't you address meaningful topics to the American people, such as what efforts you and the Administration are undertaking to fix our healthcare system? Hello. Is anyone home in Washington?

I frankly do not care about your travels around the world. What I would like to hear from you is what our government is doing to make healthcare more affordable in a period of significant national and global economic downturn; in a period where many of our fellow Americans will soon find themselves out of work.

Please become relevant to the times and to the American people.

Posted by: David A. Haley | January 22, 2008 at 06:21 PM

You have a fascinating blog sir. Always enjoy reading it. Thank you for sharing...

Posted by: AP | January 24, 2008 at 10:03 AM

Thanks for the report on the inauguration. You mentioned Guatemala’s vice president is a physician practicing in Houston. When compared to the third world, Texas' physician patient ratio is one physician for every 657 Texans, a little better than Panama at 1 physician per 666 population, and a little lower than Mexico at 1 physician for 584 population The U.S. average is one physician for every 454 Americans. Texans have about twice the ratio of Guatemala at 1 physician for 1,111. As for the other countries mentioned in your blog, Nicaragua has 1 physician for 2,702 population, El Salvador has 1 physician for 787 population, Honduras has 1 physician for 1,754 population, Argentina (Juan Peron on the balcony) has 1 physician for 333 population, and Venezuela has 1 physician for 515 population. There is only one primary care physician for every 1,408 Texans, compared to one primary care physician for every 1,234 Americans.
Texas trains a little less than half its own quota of physicians. 44% of Texas’ physicians went to medical school in Texas, about a fifth of the physicians were trained overseas (international), and a third from the rest of the U.S. Texas has about 1355 resident positions per year, fed by the medical schools. Texas, with 32 Congressman has 1200 1st years medical students, and California, with 54 congressmen, has 1,000 1st year medical students. Texas expands its residency program for first year medical doctors to 110% over its home taught med students, while California balloons to 227%, picking up medical students for graduate education from out of state or out of country schools. The annual cost of faculty to train 6150 residents is $92 million (apparently Texas funding), or only $15,000 per resident. Medical students’ cost is about $47,000 each. Texas has about 35,000 physicians. Assuming 3% retire, quit or die each year, the replacement number would be 1,039 new physicians. Texas is producing an additional 160 physicians. But if 4% leave, the replacement number is 1,400 per year, and it is under producing that by 200 per year.
Consider other statistics, the Veterans Administration maintains a ratio of about 60 patients per physician. Texas has twice the number of practicing lawyers (70,000) as physicians (35,000). Texas has the same number of law schools (9), as medical schools (9). But in 2005, Texas had 2,845 new attorneys pass its bar exam, or nearly three times the number of its medical students. If Texas wants a Veterans Administration ratio, it needs 380,000 physicians.
Sources: 1. [ Physicians / 100,000 TX 152 US 220, Primary care/100,000 71 TX 81 US - http://www.utsystem.edu/News/2004/BORMay2004-Presentations/GradMedEdPresentation05-13-04.ppt#291,6,Physician Workforce (2003)]

2 Source for Guatemala and country ratios http://www.who.int/globalatlas/dataQuery/reportData.asp?rptType=1
Global Atlas of the Health Workforce Category: Human Resources for Health, Topic Aggregated data 2006, density per 1000, physicians total, world
Source for Texas
3. [ Presentation to the Board of Regents Health Affairs Committee, By Kenneth Shine, M.D. May 12, 2004]
4. Ibid.
5. Ibid.
6. Ibid. The references to number of Congressmen, which representation is based on population, is given for general comparisons.
7. Ibid.
8. [http://www.texasbar.com/]

Posted by: J.I.M.C. | January 28, 2008 at 03:48 PM

I am proud to be writing to the Secretary of Health and Human Services Honorable Mike Leavitt. Presently, I am enrolled in a class "Understanding Chemical Dependency". We are all God's children and each carry the spark of divinity. All we have to do is talk it out. Amazing things happen when the chemistry is hungry for health. Best of Health and Well Being.

Ella Lipchik

Posted by: Miss Ella Lipchik | January 29, 2008 at 01:08 PM

PLEASE RECONSIDER YOUR POLICY ON HOME OXYGEN. DME AND OXXYGEN ARE NOT THE SAME THING I AGREE WITH YOUR POSITION ON THE DME BUT PEOPLE W/OUT OXYGEN WILL END UP IN THE HOSPITAL AND IT WILL COST 5000.00 INSTEAD OF 50 DOLLARS

Posted by: KATHY | February 13, 2008 at 11:41 PM

Secratary Leavitt, thanks for covering this - my father is Guatemalan and my grandmother was a Consul General to the US from Guatemala in the '70s. The country has seen such political unrest - let's hope new leadership will bring more stable times.

Posted by: Cyndee Haydon | February 29, 2008 at 11:53 AM

hi, secretary! I am from one of those Latin American countries and I would say that Costa Rica is a peaceful and a developing country. I think one of the reasons is the complete military absence since 1948. Don't you think so? Thanks for the post!

Posted by: Costa Rica Real Estate Jack | March 31, 2008 at 09:07 AM