The Association of Communitarian Health Services (ASECSA) and the Role of Religion and Health in Central America
The Association of Communitarian Health Services (ASECSA) is a transnational, religiously influenced health program in Central America created during the Cold War. ASECSA was founded in 1978 by a small group of international health professionals with ties to programs started by Catholic and Protestant clergy and laity in Guatemala’s western highlands in the 1960s. It introduced a model of healthcare in which Maya health promoters and midwives became partners in healing rather than objects to be cured. Support for the health programs and ASECSA came from secular and religious international agencies, including the United States Agency for International Development (USAID), German Misereor, Catholic Relief Services, and the World Council of Churches. ASECSA was founded to disseminate knowledge of popular health education strategies used by health promoters and midwives to provide preventive and curative medical services to their communities. The education methods grew from Paulo Freire’s Pedagogy of the Oppressed and its use by religious agents influenced by liberation theology. Although it was founded in Guatemala, ASECSA’s publications and meetings attracted participation by health professionals and paraprofessionals from Mexico, Central America, and even the Caribbean. Ecumenical religious centers affiliated with liberation theology in the 1960s and 1970s facilitated the development of popular health programs that played a defining role in the region.
During the Cold War’s earliest years, right-wing governments and oligarchic elites in El Salvador, Guatemala, and Nicaragua fostered closer relationships with the Catholic Church. Dictatorial leaders like Guatemala’s Carlos Castillo Armas and dynastic regimes like Nicaragua’s Somoza family regarded the Church as an ally against supposed Marxist influence in the region. Those ties began to fray in the late 1960s, as the Second Vatican Council’s foundational reforms moved Catholicism farther to the political and social left around the globe. This shift was especially prominent in Central America, where Catholics like El Salvador’s Archbishop Óscar Arnulfo Romero and Guatemala’s Father Stanley Rother were among Central America’s most visible critics and reformers as political violence increased across the region during the 1970s. Relatedly, evangelical Protestants, particularly Pentecostal groups based in the United States, flooded Central America throughout that decade. Their staunch anticommunism and established ties to influential policymakers and political lobbyists in the United States, among other factors, gave evangelical Protestants greater influence in US-Central American relations. Their influence was strongest during the early 1980s, when José Efraín Ríos Montt, an ordained Pentecostal minister with Eureka, California’s Verbo Ministries, seized Guatemala’s presidency via a coup in March 1982. Notable US evangelical leaders like Jerry Falwell and Pat Robertson praised Ríos Montt’s regime for its rabid anticommunist ideology, while President Ronald Reagan claimed that the dictator had received a “bum rap” in the global press. Concurrently, some US evangelical missioners and pastors also foregrounded the Sandinista government’s anti-Protestant activities as additional justification for US support for Nicaragua’s Contra forces. Religious actors were also instrumental to Central America’s peace processes after the Cold War, as Catholic and Protestant leaders alike worked closely with regional governments and the United States to end decades of political violence and enact meaningful socioeconomic reforms for the region’s citizens.
The role of religion shifted dramatically in Central American politics during the 20th century, as the Catholic Church moved from a position as conservator of the status quo to a powerful force for reform and human rights. The century also witnessed the rise, then the “boom,” of Protestant—specifically Pentecostal—religion. By the century’s end, Central America had become among the most Protestant regions of Latin America, with every country except Costa Rica and Belize measuring a large and rising evangélico minority. These changes unfolded alongside, and deeply affected, one of the most traumatic and violent periods in the region’s history, the so-called Central American crisis of the late 1970s and 1980s, when Nicaragua, El Salvador, and Guatemala became the battlegrounds for one of the last large proxy wars of the larger Cold War, between Marxist insurgencies and authoritarian governments.