PHM-Exch> Relentless persecution against doctors in Nicaragua.

[Claudio Schuftan]

To: Medical Associations and Organizations of Ibero Latin America and the
world.
>From the Medical Association of Nicaragua
26 07 2021
Relentless persecution against doctors in Nicaragua.
The last few years have been of real torture for doctors in Nicaragua. The
dictatorial regime of Daniel Ortega and his family1 (his wife and 8 of
their children assume the highest government positions in the country) have
used the health system to punish their detractors.
During the protests of 2018, the regime prohibited the provision of medical
care in the public health system to opponents of its government; this
caused the medical union to turn to serve the population in churches,
universities and makeshift clinics in the neighborhoods of the cities which
prevented a greater number of deaths among the population protesting at
that time. It is estimated that between 320 and 600 people lost their lives
as a result of the forces of the regime, as well as thousands of injured by
firearms2.
The regime fired doctors who dared to treat injured patients, as reported
by the Spanish newspaper El País. Many of them had to go into exile to
avoid being imprisoned at the time.
After two years of harassment to doctors and pressure on health units a new
crisis took place: the COVID 19 pandemic. The regime's response was not
only indolent. Thousands of massive activities were generated and continue
to be generated where state workers and activists of their
political-military organization are forced to join with others, with fatal
consequences.
1 His wife serves as vice president, head of the Communication Council and
spokesperson, and 8 of his children assume the highest government positions
in the country, representing the government in different spaces and
qualities.
2 Grupo de Interdisciplianario de Expertos Independientes (GIEI), Informe
sobre los hechos de violencia ocurridos entre el 18 de abril y el 30 de
mayo de 2018, Diciembre 2018. For more information
https://www.canalcidh.org/meseni that includes a series of documents and
publications of Human Rights Interamerican Council on Nicaragua
With this way of dealing with the health crisis, it is not surprising that
the situation is
catastrophic. However, the official numbers of sick and deceased people
from COVID 19 in
Nicaragua are among the lowest in the world.
As reported by the EFE agency in August 2020:
An analysis of Nicaraguan doctors based on documents "hacked" by Anonymous
...
... coordinated by the epidemiologist Álvaro Ramírez ... the Ministry of
Health has a record of
9,683 positive cases of coronavirus and not the 4,115 that it recognizes to
date, which even
exceeds the 9,646 reported by the independent COVID-19 Citizen Observatory.
Ramírez, who said that the report corroborated the authenticity of alleged
official documents
"hacked" by Anonymous, highlighted that the situation of the pandemic in
Nicaragua could be
more critical if one takes into account that so far only access to severe
cases.
"That means that for each case there have been from 96 to 98 more
circulating on the street,
which are not serious, and if we talk about 9,683 confirmed, we could think
that until July 24
there could be about 100,000 infected with COVID-19", explained the
Nicaraguan
epidemiologist from his office in Ireland.
ONE OF EVERY TWO TESTS IS POSITIVE
According to the report, the documents of the Ministry of Health "hacked"
and that the
Government "has hidden" show that 56% of COVID-19 tests are positive, which
the expert
described as "the highest percentage of positivity in the world".
Faced with this situation, once again, the Nicaraguan medical guild has
stood up. The
population has been served with a great sense of commitment, without
resources, with a
government that denies the seriousness of the situation, forcing them to
buy their Personal
Protective Equipment, being unable to provide even the simplest of masks.
They have been
doing this in secret, due to the regime's harassment and persecution of
people they consider
to be opponents.
In May 2020, around 700 medical and health professionals make public a
critic about the
situation of the system, the lack of measures, the forced exposure of
health personnel,
without any protection and request more attention, among other things3.
The regime's response was to fire at least 15 of these professionals, all
highly qualified and
even with unique abilities in the public health system4.
They prohibited the Catholic Church5 and civil organizations from providing
health care in the
midst of the pandemic, without any explanation. In the same way, they
canceled his legal
status and forced to close a Civil Association with 35 years of community
work, ASODHERMU,
arguing that it did not comply with the requirements of the law, after it
announced that it was
forming a Municipal Prevention Committee for the COVID6.
The coronavirus in Nicaragua remains uncontrollable and the government is
hiding the
information, refusing to inform, prohibiting relatives from commenting on
the cause of death,
if it is COVID, with death certificates with false causes and creating an
environment of
persecution for personnel working in hospitals and health units.
New assault to health personnel:
In July 2021, we found a new attack from the government: civil death to
medical
associations. They will initially cancel about 60% of all the legal
entities of medical
associations in the country. These are the biggest, the most important and
the most active
groups. This was preceded by summons to some medical professionals by the
Public
Ministry7 for questioning and by the Ministry of Health to be threatened8
with a recently
created law (Cybercrime Law) for spreading information about COVID.
The members of Congress of the regime, appointed from the electoral fraud
in which 90% of
the seats were awarded to the FSLN, and the government as a whole have
decided to sabotage
the union's organizational forms, without caring that these associations
are scientific in nature,
that they promote medical updating for the benefit of patients, who are not
political entities
or supporters. But precisely by its nature, they could not ignore the
pandemic and made
efforts to keep their members informed fluidly about the news of the virus,
its clinical
presentation and its management.
3 See
https://elpais.com/sociedad/2020-06-02/los-medicos-de-nicaragua-exigen-una-cuarentenanacional-
ante-colapso-del-sistema-de-salud-provocado-por-la-covid-19.html
4 See
https://www.dw.com/es/preocupa-a-la-onu-despido-de-m%C3%A9dicos-en-nicaragua/a-
53755341
5 See
https://panampost.com/mamela-fiallo/2020/04/09/coronavirus-nicaragua-iglesia/
6 See
https://www.laprensa.com.ni/2020/06/25/politica/2689446-diputados-orteguistas-cancelanpersoneria-
juridica-a-asodermu-una-ong-opuesta-al-regimen
7 See
https://www.laprensa.com.ni/2020/06/25/politica/2689446-diputados-orteguistas-cancelanpersoneria-
juridica-a-asodermu-una-ong-opuesta-al-regimen
8 See
https://www.laprensa.com.ni/2020/06/25/politica/2689446-diputados-orteguistas-cancelanpersoneria-
juridica-a-asodermu-una-ong-opuesta-al-regimen
The decision to cancel the Associations will include the expropriation of
all the assets of the
associations, as they have already done with 10 NGOs that played a role in
the defense of
human rights and citizen education, considering them critical of the
government in 20189 and
the one already mentioned in 2020.
It should be noted that in Nicaragua there is no Medical College, despite
having been approved
by the National Assembly in previous periods, due to the opposition of this
government and its
officials. The state system does not participate in education on health and
medical issues. It is
within the associations that this acquisition of knowledge is optimized and
it is socialized with
other specialists.
The medical associations with closer links to COVID and their care are
going to disappear and
with them, the mechanisms for Updating and Continuing Medical Education,
the certification
and recertification tools that some develop with their supranational
counterparts, with
consequent irreparable damage in the search for the quality of care.
The medical guild will be deprived of one of its most valuable inputs, the
updating of
knowledge, and without its organizational instruments, many with decades of
existence.
We present this to the international medical community for their knowledge,
while we
request their solidarity expressing their rejection of this policy that in
the end hurts our
patients and violates our right to organize.
While the world builds bridges for the improvement of patient care, for
Continuing Medical
Education, Certification and Recertification; in Nicaragua there is a trend
towards denial,
isolation and insensitivity to the health needs of the population.
Without medical associations, we will be isolated from our peers in Latin
America and the
world.
9 See https://www.oas.org/es/cidh/prensa/comunicados/2018/265.asp
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