On June first, more than 700 Nicaraguan doctors who are members of 34 specialist associations, signed a joint statement in which they warned about the collapse in the public and private health systems. They denounced the saturation in hospitals, the lack of supplies and the infections suffered by many health professionals treating patients with COVID-19.
“The working conditions of health personnel in Nicaragua are very precarious. There was no prevention or training plan for patient care nor preparation for personal protective equipment,” said Róger Pasquier, President of the Association of Anesthesiologists of Nicaragua, in an interview with Toward Freedom. “We have heard that doctors are sent to COVID units only with cloth masks, all this makes the level of infections quite high.”
“At a certain point in the pandemic, many of the colleagues who were going to work without the necessary requirements protested and signed a letter asking for compliance with the regulations set out by the World Health Organization (WHO) and the Pan American Health Organization (OPS),” said Pasquier. “Surprisingly, the letter caused a wave of layoffs of highly qualified personnel. The group most affected are low-income patients who attend public hospitals.”
In Daniel Ortega’s Nicaragua, dissidents are silenced, and even during a pandemic, doctors are no exception.
Just three days after the publication of the letter, a lawyer appeared at the Roberto Calderón hospital in Managua, Nicaragua, looking for infectious medicine doctor Carlos Quant, a founding member of the Multidisciplinary Scientific Committee (CCM), a group of health professionals created to issue recommendations based on scientific evidence. Quant was one of the doctors who signed the letter
“I was working when a lawyer came to give me a dismissal letter,” said Quant in an interview with Toward Freedom. “They asked me to sign it immediately and they told me to take my personal items and leave, I decided to leave to avoid a confrontation.”
“It’s also a very clear message for everyone, that if you speak out against the government or the measures they are enforcing, you can not only be fired but also imprisoned,” said Quant. In the days following Quant’s dismissal, 16 other doctors were fired from various hospitals around the country.
According to the latest report available, dated July 7th, the Nicaraguan Ministry of Health reported that there are 2,846 confirmed cases, 91 deaths and 1,993 that tested positive for Covid-19 but are already recovered.
However, the COVID-19 Citizen Observatory, an independent initiative made up of an interdisciplinary team involving medical, communication and research professionals, estimates that as of July first, at least 7,402 people have been infected with COVID-19, and 2087 people from pneumonia or symptoms suspected to be related to the coronavirus.
At the end of February, as some countries had already closed their borders and panic purchases were occurring throughout the world, the Nicaraguan government continued to promote tourism, calling for mass activities in public squares while sports activities were carried out with total normality.
On February 28, Dr. Carolina Dávila Murillo, former head of the Ministry of Health (MINSA) announced the care and prevention measures the country would take against the virus. The first point of her statement reads: “Nicaragua has not established, nor will it establish, any type of quarantine.”
“We are going to walk with the force of faith and hope throughout the country, in permanent prayer and solidarity with all the peoples, families and brothers in the world affected by the coronavirus,” said Rosario Murillo, Nicaragua’s Vice President and official spokesperson, on March 13th. Her call for prayer came as the government when announcing a “Love in times of Covid-19” march.
The next day a crowd of government officials and supporters crowded the streets of Managua, with Nicaraguan and the Sandinista National Liberation Front (FSLN) flags held high. Curiously absent were Vice President Murillo and her husband Daniel Ortega, President of the Republic.
Finally, on April 15, after a 34-day absence from public life, Ortega reappeared with Murillo and several of his ministers to deliver a message to Nicaraguan society. It was the first statement by the President since March 11, the day the Director General of the WHO, Tedros Ghebreyesus, declared the SARS-COV-2 outbreak a pandemic and urged governments around the world to act aggressively to stop the virus from spreading.
Fifteen days later, in his second public appearance, Ortega accused the opposition of promoting the #StayAtHome campaign for political purposes. “Those who have been promoting that discourse are the same ones who wanted to sink the country in April 2018,” he said. “Now they want to take advantage of the epidemic to sink the country.”
Front-line doctors have not been the only ones to raise alarm in light of the serious health situation in the Central American country.
In a letter sent to the WHO and PAHO authorities, five former Health Ministers, including former guerrillas Lea Guido and Dora Maria Tellez, stated that there were no preventive or containment actions being carried out, nor were there any mitigation actions in place to stop the virus from spreading.
“We are especially concerned about health personnel who are in the front line of care for those who suffer from COVID-19,” reads the letter. “They have been working without the necessary and sufficient protection and have been forced, under pain of severe penalties, to manipulate health information to artificially deny or decrease the number of cases and deaths due to the pandemic.”
Adding fuel to the fire, in recent days, Swedish epidemiologist Anders Tegnell, who was in charge of implementing the Nordic country’s similarly lax strategy in the face of the pandemic, has declared that their approach led to too many deaths. “Knowing exactly what we know today, I think we were content to do something between what Sweden did and what the rest of the world has done,” Tegnell told Radio Sweden.
In response to the government’s refusal to impose quarantine and heath measures, the people have decided to organize themselves and launch collective actions such as voluntary quarantine and social distancing measures, even though such measures have been harshly criticized by the authorities, who have called them extreme and radical.
Through the pandemic, the government of Nicaragua has continued to hold massive events, concealed data and fired doctors critical of national health policy. The Ortega government has politicized this crisis and minimized the danger that SARS-CoV-2 represents, especially in a country with a battered health system.
Today, the numbers of deaths suspected to be connected to COVID-19 in Nicaragua continue to rise, funeral homes have had record casket sales and at least 13,o00 Nicaraguans have sought medical attention in Costa Rica. But Ortega’s government has shown no sign of changing its strategy, which appears to be based on abandoning the people during a global pandemic.
Rafael Camacho is a documentary filmmaker and independent journalist with an interest in conflict zones and land defense. He’s based in Mexico City.