Nicaragua: the medical profession under attack by the Ortega dictatorship, again.

Salud en Nicaragua

By Ricardo Rugama

Political persecution of doctors and health professionals continues in Nicaragua. In 2018, the dismissal of doctors was denounced for treating the injured during the protests; and in 2020 for demanding the implementation of prevention measures in the face of the COVID-19 pandemic. Now, in 2021, the Ministry of Health is threatening sanctions for “spreading false news” and the prosecutor’s office has summoned a doctor for treating an opponent of Ortega, this has led to the exile of several doctors, while many continue to die due to government negligence.

This is the first of two articles denouncing the persecution of the medical profession by the Ortega dictatorship.

First stage: the order not to attend patients.

After the popular rebellion of April 2018, health workers have been at the center of the political repression of the Ortega and Murillo regime. The reprisals against health workers began after many disobeyed the order issued by the then Minister of Health and now presidential advisor on health issues, Sonia Castro (1); not to treat protesters injured during the protests in public and social security hospitals.

One of the most representative cases is that of Álvaro Conrado, a 15 year old teenager who in the protests near the National Engineering University (UNI) was wounded by a bullet in the neck coming from the area where the police were at the time (2). Alvaro was taken by other demonstrators and the Red Cross to the then Blue Cross Hospital of the Nicaraguan Social Security Institute, where he was denied entry and therefore the time of an intervention that could have saved his life was delayed. He was taken to Hospital Bautista, a private hospital in Managua where he died 3 hours later (3).

Many health workers opposed these orientations that violated all professional and medical ethics, so a process of persecution and dismissals, also guided by Castro, started (1). By August 2018, the Nicaraguan Medical Association publicly denounced that at least 135 physicians, mainly specialists and subspecialists from public hospitals and health centers, had been fired (4).

In October of the same year, the Nicaraguan Medical Unity (UMN), an organization born out of the union of medical professionals who provided care during the protests, registered at least 215 dismissed doctors, also mostly specialists and subspecialists (5). As of February 2020, more than 405 health workers have been dismissed (6).

You may be interested in International Statement: For a Single Public, Free and Universal Health Care System

In addition to having been unjustifiably dismissed, many workers still do not receive the money they are entitled to by law, such as severance pay, accumulated vacations or seniority in the case of those who have been working in the public system for years or decades (7). They were dismissed without following any type of institutional process, in clear violation of their labor rights and the laws that regulate the health system, and on several occasions after intimidating, aggressive acts and threats against their physical integrity and that of their families.

The FSLN union bureaucracy, FETSALUD, led by the president of the National Assembly and political operator of the regime, Gustavo Porras, turns its back on the fired workers and promotes abuses against opponents. Creating a hostile environment for doctors who prefer to remain silent in order to keep their jobs and continue providing care to the needy population.

Political persecution reached the classroom, where at least 8 medical science students were expelled from UNAN Managua in 2018, without following the due process according to the regulations of the institution, with multiple irregularities and without the right to defense (8).

In this first repressive wave, many doctors, physicians, medical students and health professionals had to migrate in a forced manner, a significant percentage went to the neighboring country Costa Rica where the Nicaraguan Medial Unity Association (ASUMN) was formed, and the rest to other parts of America and Europe. In most cases without the opportunity to practice their profession and without a work permit, living situations of job insecurity and difficulties to assume the cost of day to day life, in addition to racism, xenophobia and other difficult situations of exile that continue to this day.

Nicaragua has 9 doctors per 10,000 inhabitants (9), far from the 23 per 10,000 recommended by the WHO. In this stage of repression Ortega and his operators in the Ministry of Health, decided to fire doctors and health workers for not accepting his political indications, which in this case was to deny medical attention to injured people. They violated their human and labor rights, forcing the migration of many professionals. In the short, medium and long term, this has a negative impact on the quality of public health services, already insufficient in an impoverished system, which are accessed by the majority of the population who cannot afford private consultations.

In the following installments we will expose the next two phases of the repression, which continues to this day. We call on the Nicaraguan population to stay organized and if you are not organized we invite you to get organized. The vast majority of these data that are part of the collective memory that is being built in the struggle against the dictatorship and against the system of exploitation has been compiled thanks to citizen efforts, many were born in the heat of the protests. We believe that to turn this whole corrupt system around we need to build tools and one of them is a political party with a programmatic agreement to fight for everything. Despite the adversities, that is the task that we from Alternativa Anticapitalista and the International Socialist League promote: the construction of a political tool for the medical profession and a social majority. Join us.

1.       CENIDH, & FIDH. (2021). Accountability now! Extrajudicial executions and repression in Nicaragua, 2018-2020.

2.       GIEI. (s.f.). Obtenido de

3.       Luna, Y. (3 de Mayo de 2018). Papa de Álvaro Conrado: “No quería un mártir, quiero justicia”. Confidencial.

4.       García, K., & Lara, R. (3 de Agosto de 2018). Médicos denuncian 135 despidos. El Nuevo Diario.

5.       Nicaraguense, U. M., País, J. c., & Nicaragua, C. (2 de Noviembre de 2018). Construimos Nicaragua – Facebook. Obtenido de

6.       MESENI. (2020). Situation of Human Rights in Nicaragua.

7.       Mora Cárcamo, R. (29 de Enero de 2021). Ni reintegro ni liquidación para médicos despedidos en Estelí. Obtenido de RadioABCStereo:

8.       Rivera, E. (1 de Noviembre de 2020). Violaciones a Derechos Humanos de los Estudiantes Expulsados de las Universidades de Nicaragua. Obtenido de

9.       González, R. A. (1 de Noviembre de 2016). Nicaragua tiene 9 médicos por cada 10 mil habitantes. El Nuevo Diario.