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Nicaragua's surprising response to COVID-19

2020; Edinburgh University Global Health Society; Volume: 10; Issue: 1 Linguagem: Inglês

10.7189/jogh.10.010371

2047-2986

Andy A. Pearson, Andrea Prado, Forrest D. Colburn,

Global Public Health Policies and Epidemiology

Nicaragua' s response to COVID-19 has been surprising; the government has not only dismissed the recommendations of world health authorities to take precautions but has flouted them by organizing large-scale public events [1].The Nicaraguan government' s dismissal of the danger of COVID-19 has not only led to an international outcry, especially from neighboring countries, but has also put Nicaraguan doctors and other health professionals in an agonizing dilemma.While nominally a democracy, Nicaragua has come to be governed by an all-powerful husband and wife: the government of President Daniel Ortega and his wife, Vice President Rosario Murillo [2].They together govern as a dictatorship, with no institutional check on their authority.They are subject to no public accountability or even pressure exerted by interest groups.Consequently, Ortega and Murillo can be -and are -capricious.Managua' s streets, for example, are adorned with two-hundred or so garish, metal "Trees of Life," 42 to 56 feet high, inspired by a Gustav Klimt painting.They glow at night thanks to some 2.5 million small electric bulbs (in a country where many homes lack electricity).Murillo decided Nicaraguans needed inspiration.Neither Congress nor any other representative body had a say in erecting the trees.Health policy during a pandemic is a severe issue.The case of Nicaragua, though, suggests that even in the time of a crisis threatening the lives of an entire nation, leaders of authoritarian governments, free from any kind of public censure, are likely to be more concerned with preserving their rule -or even their image -than with protecting citizens from a public-health disaster [3].Moreover, authoritarian governments, such as that of Ortega and Murillo, may be powerful enough to turn professional bureaucracies, such as those of health, into sycophants.The COVID-19 threat in Nicaragua is worrisome not only because government policy is to dismiss the threat, but also because the country' s health care professionals have been cowered by threats, and a generalized atmosphere of fear, not to challenge reckless government policy.Nicaraguan health care professionals protest, even when told not to wear masks while working, at great professional and even personal risk.The COVID-19 crisis in Nicaragua is thus truly alarming.Nicaraguans, including prominently doctors and nurses, have been left to the uncertain vicissitudes of the novel coronavirus.Nicaragua is the second poorest country in the Western Hemisphere.In 2018, the country' s gross domestic product (GDP) per capita was US$ 1860 (compared to an average for US$ 9889 for Latin American and Caribbean countries), and 50.5 percent of its population was living under the poverty line.For the same year, its population was approximately 6.5 million people, with 41.5 percent living in rural areas.