The Nicaraguan government has been widely criticized for its lack of transparency concerning the impact of the COVID epidemic in the country. Unlike other countries, it has not revealed the amount of testing it has done, nor made tests widely available, nor given clear figures of test results. Numerous family members of those who have died report that the result of their relatives´ tests were frequently classified as “indeterminate”. The Social Security Administration (INSS) has said they will not state that sick leave is for COVID-19, and medical staff report that they have been indicated to give diagnoses of “atypical pneumonia” instead of COVID-19.
In light of this situation, a Citizen Observatory of COVID-19 was established. It is a “collaborative effort of an interdisciplinary team with information provided by organizations, networks, and the general citizenry who want to contribute to filling the vacuum of information on the COVID-19 situation in Nicaragua…We report on suspected cases of COVID-19 and irregularities that violate human rights, especially the right to health care. The Citizen Observatory receives numerous reports, nevertheless we only publish information that has been verified by our sources. We reflect the perception of the citizenry about the development of the epidemic in their territories, contributing in this way to filling the existing information gap. We only consider information verified if we confirm the authenticity of the report with the same or other sources. The network of informants are recognized community leaders in their territory, which allows them to verify the information.
… A person reported as a suspected COVID-19 case has to fulfill one or more of these requirements:
Presents symptoms associated or presumptive of COVID-19; or
In addition to symptoms, the person has a history of travel; or
In addition to symptoms, the person has been in contact with a case confirmed by MINSA
The Observatory does not do laboratory tests nor clinic diagnoses to determine whether a case is suspect.
The translation of their report for the week of June 18-26, 2020 follows. Note that the report also includes the official government count for the same week.
In this stage where the number of people with the disease continues to rise, it is the moment for increasing individual, family and community protection. We exhort the population to continue taking all the preventive measures like physical distancing, hand washing and the use of masks.
Yes you can, stay at home and let´s save lives!
On June 24th a cumulative total is reported of 6,775 suspicious cases, verified by the Citizen Observatory in all the provinces and autonomous regions, in 134 municipalities (87% of the municipalities of the country). 694 new cases were recorded this week, which represents an 11% increase in the period.
Managua (2,918), Matagalpa (687), Masaya (552), León (399), Estelí (325), Chinandega (272), Jinotega (208), Madriz (184), Granada (180), Carazo (169) and RACCS (153) are the provinces or regions that report the largest number of suspected cases.
Up until June 23 MINSA reported 2,170 confirmed cases, 607 active cases, 1,489 recovered and 74 deaths (death rate of 3.4%). This mortality rate reaffirms the urgent need that the government take measures to prevent infection, and that it have more detailed information that would allow directing decision making to deal with the situation.
Of the 70 irregularities [i.e. violations of human right to health care] reported this week, 22 refer to the exposure of people in activities or crowds, 17 to inadequate responses of MINSA and 10 to threats and reprisals.
Up until June 24th 1,878 deaths have been reported and verified, of which 129 (7%) are categorized as deaths due to pneumonia, and 1,749 (93%) as suspected deaths of COVID-19. These deaths have taken place in all of the 17 provinces and autonomous regions of the country. Managua (772), Masaya (224), León (140), and Matagalpa (118) report the largest number of deaths. In this week we have verified information of 189 new deaths, which represents an 11% increase in the number of deaths from the previous week.
These deaths are reported from 17 provinces and autonomous regions, 110 municipalities (72% of the total number of municipalities in the country). The province of Managua records 39% of all the deaths, Masaya 12%, León 7%, Chinandega and Matagalpa 6% respectively; Granada, Estelí and RACCN 4% respectively.
Of those 1,878 deaths, 212 (11%) took place in their homes and 18 (1%) during their transfer to a health unit.
Up to June 24th the Observatory received reports of 652 health workers with symptoms associated with or presumptive of COVID-19. This week ALL the provinces or autonomous regions reported cases (principally Managua, León and Matagalpa) and 67 municipalities.
On June 24th 78 suspected deaths of COVID were reported of health care personnel. 34 doctors, 21 nurses, 11 administrative staff, 3 medical visitors, 2 laboratory staff, and 7 categorized as “other” (technical or ETV staff, for example).
From 7 provinces or autonomous regions reports were received of inadequate response in different health units, the reports indicate:
Lack of supply of potable water
Scarcity of ventilators
Rejection of donations in health units where a need for these inputs exist
Lack of communication on the health status of the patients with their families
Lack of electric generators needed for the functioning of essential medical apparatus for patients in a critical status during the ongoing cuts of electric energy.
Little or no medical attention to hospitalized patients.
Diagnosis of pneumonia for patients who present symptoms of COVID-19
Use of neonatal ventilators for COVID-19 patients, which puts at risk babies who present respiratory difficulties.
Lack of follow up on the part of MINSA of contacts of people who present COVID-19 symptoms. Nor have the homes of the relatives of these patients been sanitized.
Sending home the majority of suspected patients of COVID-19 with treatment. A report was received of a patient who died hours after having been released from the hospital
Yes, you can, stay at home and let´s save lives!
Attached you can find the report for June 18-24, 2020 generated by the Observatory:
Suspected cases by the Observatory*: 6775
Deaths by pneumonia and suspected COVID-19 deaths reported by Observatory: 1878
Cases confirmed by MINSA: 2170
Deaths reported by MINSA: 74
*People reported as suspected cases by the Observatory, deaths by pneumonia and suspected COVID-19 deaths have been verified by the local source of information.
-Who isn´t afraid? Fear is the biggest enemy of reason. Think, Pipita, your love for others is stronger than anything…Besides, the rain is coming now!
The entire world is experiencing difficult days. People feel fear, impotence, the desire to cry. The only thing certain is uncertainty. Every person would like to support themselves with something, protect themselves under the shade of a tree. But there are almost no natural, supernatural nor social “trees” anymore. It is when that Nicaraguan phrase becomes even truer, “if you have your health, the rest doesn´t matter.” And health is like the rain, it does not fall from the sky with some prayers, it is something that is provided and strengthened with human actions. And who provides it? And how is it provided? Maybe “the love” that one feels for others provides it, maybe the love with which we were made in a passionate morning helps provide it. Maybe it is time to look farther ahead, because “the rain is coming now.”
In this article we reflect on this rural world, that thin strand between hygiene and the economy, between home, church, health center, and between individual and collective actions. To do this we list the facts or risks, we start to explain this “strand”, we look at how scientific recommendations help these different cultures revive – like plants which dry up become green again when the clouds release the first drops of water, and we point out the role of accompanying organizations. The importance of grassroots organizations in protecting their communities runs throughout the article, while the notion of community matures with the turning of each page.
1. Conditions that work for and against COVID-19
The situation with COVID-19 seems to be getting worse. The gap between the official information in any country and what is in the social networks is large, with which anxiety buzzes like a mosquito at night. In rural communities this concern is connected to the continuity of classes in school, religious celebrations in churches, and festive crowds, with or without quarantine. People think that through that “door” of the school, church or public transportation, the virus can get into their homes and pass through the community. What are the rural conditions that work for or against COVID-19?
Rural families have some advantages and some disadvantages in the face of the virus. The advantages are: the physical distance between people to avoid COVID-19 is facilitated by the low population density, and because a good number of families live on their own farms; the average age of the population is relatively young, which limits the effect of COVID-19, even though this advantage is evaporating because of poverty; living in areas with little air pollution; communities that have grassroots organizations with members and offices in the community itself, through which they access some information and some collective actions. The disadvantages are: if people are infected, it will be difficult for them to go to the health centers with the first symptoms and it will be difficult for them to stay at home, or prevent visits when rumors buzz along the footpaths of neighboring houses, all of which have the potential to infect more people; the quality of the health centers, in any country in Latin America, is less in the rural municipal capitals and is inexistent in rural communities.
Gatherings of people in schools and churches is the greatest risk; let us remember that in a church in Washington one member infected from between 52 to 60 members of the choir, 65 were infected in a Zumba class in South Korea, 80 people in a concert. Rural gatherings tend to happen in groups separated by the lack of connection between organizations. Cooperatives, schools, churches and party or governmental organizations (e.g. councils, mayor representatives) move in a “walled off” manner; each person in their own world, and under their own leadership. Churches move in their religious world and with their own leadership structure. Schools with their educational programs and with their own institutional leadership. Cooperatives focus on the economy with their own leadership structure. And so on. This separation means that the gatherings move separately, isolated, which is why people tend to behave in an opportunistic way: “let others spend on hygiene to prevent COVID-19”, “I don´t care, I don´t have children in school”, “I am going to church because God is protecting me, what better doctor than God?”
This separation is worse with external institutions. Markets are reduced to offering hygiene products, raising their prices because of increasing demand, and move by means of intermediation; States limit themselves to making an effort in health centers; aid organizations provide resources within the circles in which they move; and second tier organizations and NGOs expect to mediate resources. None of them tend to cross over “to the other side of the river”, in the sense of understanding how rural societies move, lack experience working at the community level with grassroots organizations. This limits our ability to understand rural population from their own perspectives, and limits the communities from understanding external organizations. We live in a world of one-eyed people that is attractive for any virus.
This separation or “fortress-effect” feeds the prevalence of beliefs. It is a universal truth that when there is less information and less articulate comprehension about certain habits, beliefs prevail. What beliefs? In peasant families: “If I believe in God, nothing is going to happen to me”, “lightening is not what kills you, it is just your time has come”; “long suffering people will resist any virus”; “I am not washing my hands because my hands are hot because of work”, “chloroquine and azithromycin get rid of the virus” (self-prescribing without evidence that it cures and without investigating its damaging effect on the heart; and according to the WHO seem to increase the risks and consequences of the disease). Beliefs in external institutions: “information confuses people”; “money makes the monkey dance”; “if the economy improves, all improves”; “give them alcohol and with that COVID-19 will not affect them”; “boil eucalyptus and cypress leaves”; “read the bible where it announces the end of the world”, “everyman for himself”. Doña Coronavirus laughs and is attracted by these beliefs!
We resist learning. We read about the 15 countries of the Asia-Pacific region, China, Korea, Taiwan, Hong Kong, Australia, New Zealand, Japan and the 10 member countries of ASEAN (Association of South East Asian Nations), Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam, as the region that has best dealt with COVID-19, a region that has 2 billion people of the 7.7 billion that exist in the world. How did they do it? With good public health: they closely observe the symptoms people have, if there are symptoms, they test them, if they are positive, they isolate them in their homes or in hospitals, and they do contact tracing. In other words, the more they diagnose, they more they know what to do, and thus save more lives. In contrast, national and international organizations tend not to do diagnoses to formulate and implement policies, except to appear to formally comply; our mentality of providentialism and resignation resists learning from rural populations, we do not seek to understand them, we believe that we already know them, that “the market knows more”. We are societies that seem to live like in the middle ages under the church with the inquisition, in those times “there was no reason to think, it was enough to believe”, when thinking was a sin and punished by death.
2. Hygiene in rural societies
What is it that we need to understand? We begin with some history, to then paint something about the rural reality and show the vein that we have to continue exploring.
There are several studies on diseases and the architecture of cities and homes, not much on rural spaces. Public health has contributed to the fact that the population lives longer, architecture has also done that. So closets were imposed instead of armoires, because they were anti-hygienic because they accumulated dust. In the last 150 years we know of great changes in the cities of London, Barcelona or Paris; in 1866 they cleaned up most of the river Thames in London, and that clean up saved most of the people of the city from the threat of cholera; in 1844 they redesigned the city of Barcelona, knocking down walls that contributed to the overcrowding, which made lack of hygiene worse and supported epidemics; also Paris was redesigned for health purposes. Other smaller changes also had large impacts: clean water and management of sewage to prevent malaria or yellow fever; in the face of the bubonic plague, that killed 12 million people between 1855 and 1959, they rebuilt homes with more concrete and metal to keep out the rats who carried that pestilence. In other words, the design of homes and cities for health purposes lengthened the lives of people.
Now with COVID-19 architecture is challenged to redesign homes. Even though architecture has not been able to respond to respiratory illnesses, COVID-19 can cause the redesign of the home, where the idea of what is private is reconceptualized, giving way to the home as a space for school, work, reflection and gymnasium.
Unfortunately, there are no studies about that same relationship between architecture and health for rural areas, at least none that I am aware of. In rural areas, hygiene has been in deficit for centuries, a situation that has been made even worse by the discrimination toward the rural world. This situation of hygiene is due in part to the fact that rural families every day are grappling with land, farming, agro-chemicals, small livestock, slaughtering or the fire in the kitchen, and they do it without having protective measures like gloves, boots or masks, partly because they are living with limited water or means of catching water, on large haciendas the patrons customarily do not provide protective equipment to their workers, and partly because they do not have access to information while beliefs lead them to not protect themselves.
This daily work of women with fire, or men with the land leads them to bathe less frequently. This is not necessarily, however, a lack of hygiene; in fact, many people during the winter in Europe and the Andean altiplano do not bathe very frequently. The difference is that peasant families think that after work a person should not touch water, it is an understanding about the combination of temperatures; so it is that after making tortillas they do not wash their hands, after weeding they do not bathe “because the body is hot”. Also the lack of water and minimal infrastructure has conditioned them to carry out certain practices; women gather dirty clothes to go to the river to wash them, they spend little water to wash dishes. Likewise, little access to information has an impact on daily life, for example, dishes are not washed with Clorox that could contain the salmonella bacteria, which tends to be found in food contaminated with animal feces. We mention these points to illustrate how difficult it could be the fact that, now with COVID-19, they have to wash their hands frequently and with soap, when customs and their natural (water) and economic conditions weigh in.
Most rural homes, particularly those of low-income people, have dirt floors and are closed structures with little ventilation. For example, it is known that Chagas disease, that “forgotten illness” because the pharmaceutical industries do not see it as profitable, mostly happens in homes with grass roofs and cracks in the clay walls where the insects that cause this disease tend to live. Peasant homes are a prolongation of the farm, or the reverse, for example corn is stored inside the home or above the hearth, while the cats deal with stalking the rats who are after the corn…
These rural practices became customs, and those customs, laws, which tend not to be seen by the eyes of State institutions, markets and international aid agencies. External actors, instead, tend to see agriculture or ecology as separate from hygiene in the home and family, and the economy as separate from health, education and religion. External actors, when they touch on the issue of hygiene, do so viewing the rural reality from the urban experience, and so any weed seems dirty to them, any home for them should be in towns or villages, any farm should be mono-cropped, and any insect should be fought with agro-chemicals. From the urban perspective it is hard to understand that a home on a farm probably is healthier than a city with an over-populated cattle industry, or chicken or turkey industry, which are true virus factories.
We need to scrutinize the relationship between hygiene and agriculture, home and farm and school and church to understand the culture of hygiene in rural populations, to then look at improvements and changes to be made. Without understanding, one cannot see, Rodrigo López told us, a peasant from Waslala. How true that is! Otherwise, how can we imagine that just using chlorox and alcohol is going to prevent COVID-19? Without understanding, how they can reflect on and change their habits coming from their own cultures and farming systems, any chlorox or alcohol that they are given runs the risk of ending up in the municipal markets, as has happened with the donation of tin roofing sheets, pure bred hogs, coffee roasters or grain silos. The community, that heterogeneous amalgam of disputed realities, is like a book, inside of which dance letters, pages and imagination, opened up only by the reading of those who love it, a reading which is like a person who shells a corncob sensing a hot tortilla with “”cuajada.
Our challenge is to rethink community spaces from a perspective in which health and economics are embedded in each other. Homes on farms with materials that protect them from rats and the insects that carry Chagas disease, and at the same time are ventilated spaces, and agro-forestry farms, in communities with spaces for food, reflection, social interaction, entertainment, open field school and collective actions. Communities with fresh air, revived, which end up being the “tree” to protect oneself from the virus. This is the vein to dig into.
3. It is the moment for organized rural societies
While we study, let us not lose the pulse on COVID-19. What should we do? If classes and/or religious celebrations continue, and if markets and States do not show they are effective, grassroots organizations (cooperatives, associations, parent-teacher committees, water committees…), located in the communities, must act to protect their communities. The effectiveness of these organized rural societies can be better if supported by organized global societies (international aid organizations).
How? These grassroots organizations must turn themselves into entities that inform, connect with schools and churches to accompany them to understand the problem and their prevention practices in the face of COVID-19, and look up while they deepen their roots.
3.1 Informing yourself and analyzing the information
Dry cough + sneezing + body aches + weakness + high fever + difficulty breathing = coronavirus
Source: Pathology Department, UCH London
In the first box are the elements to tell whether a person has coronavirus, flu, a cold or just air pollution. The scientific community reveals that a person with COVID-19 can show mild symptoms, and days later have other more serious symptoms. In other words, a person could have a cough and sneezing, and not have a high fever, which does not mean that they do not have COVID-19, in the days following the other symptoms may appear. Box 1 is a simple aid to differentiate, it does not assure you that you do not have COVID-19 with the first symptoms, but at the same time helps you to not get alarmed with the first symptoms, helps you to stay calm and discern; this is a big help in rural areas where it is difficult to go to a hospital.
COVID-19 is not just a new virus, but the scientific community still does not know much about it. Current evidence reveals that a little more than 40% of people with the virus were infected by people who did not have symptoms of COVID-19. This obviously makes prevention difficult, at the same time, knowing this helps us to get a grip on the problem and respond in the best way possible.
Box 2. Recommendations
1. Do not touch your face–because the virus enters through the mouth, nose and eyes
2. Wash your hands with soap – the virus is dissolved with 20 seconds of hand washing.
3. Maintain physical distancing (1.5 mts) from another person; avoid groups of people
4. If you do not feel well, stay home. The family can help you determine whether it is coronavirus (see box 1)
5. Avoid meetings in closed spaces without ventilation
6. Above all, think, think, and think–it is the most vital thing that we should practice.
Box 2 has information also based on studies. Grassroots organizations can disseminate it in their communities, but first they should read and analyze it: why shouldn´t you touch your face? Why should you wash your hands with soap? Why maintain a distance of 1.5 meters with other people? Why should you stay home when you have a cough, mucus and sneezing? The more we think about it, the more we understand it, the more we are going to put it into practice and tell other people. Talking through information allows us to think about reorganizing activities, for example, the measure of maintaining a physical distance of 1.5 meters can help so that in a religious celebration, a meeting in the cooperative, or a class in the school people take their seats maintaining that distancing, so that the meetings be for shorter periods of time or with frequent recesses, or so that the meetings might be better prepared in advance so that, like chickens, you go straight to the “grain.” Information that is thought through can save lives.
Grassroots organizations also should reflect on other contributions from scientists. Let us look at 3 contributions. The first, studies show that children under the age of 12 do not get infected much, compared to adults; in the cases when they are infected, they almost never get seriously sick, nor are they great transmitters of the virus, like they were in the case of the flu, because the amount of receptors that COVID-19 needs are less in children under the age of 12, and consequently the viral charge (in other words, the amount of the virus that they can gather) is much smaller. Statistics confirm this statement, minors under 12 are less than 0.2% of COVID-19 deaths.
Second, statistics how that men become more infected by COVID-19 than women, and they tend to suffer more from the virus than women who are affected. This is due to the fact that “the blood of men has higher concentrations of the converter enzyme of angiotensin II (ACE2) than the blood of women (…). This receptor is found on the surface of healthy cells, and helps coronavirus infect them” (see: https://www.iprofesional.com/actualidad/315900-coronavirus-por-que-hombres-se-contagian-mas-que-mujeres ). Active genes linked to the X chromosome provide women (XX) greater protection against coronavirus than men”. In addition, be it for the type work in which rural women are more involved, in general they have more hygienic habits than men, for example, they wash their hands more frequently, be it because they are washing dishes, clothing or for personal care. This indicate the importance of hand washing.
Third, studies also tell us that the use of masks is preventive, but they also warn us of the risk of reusing them, because they can become a means of infection, because the virus can remain for hours and even days in the masks. The masks are more for infected people, with or without symptoms, so they do not infect other people. Why the masks? Because they reduce the particles that come out of the mouth when a person breathes or talks. When should masks be used? They can use them in school during classes in closed classrooms with little ventilation, in relatively closed churches during celebrations, when it is not possible to maintain physical distancing, when the interaction lasts a certain length of time, in places with human crowding (banks, markets…). They should also be used when you travel to town, on returning home you should wash it, in this way the mask will be ready for a new outing or meeting. Countries that have overcome COVID-19 have used the masks as part of their strategies, which is why rural communities probably will have to introduce the use of masks as part of their culture of care, particularly for the moments we just pointed out.
3.2 Linking to and contacting schools and churches
It seems easy to connect to and assume that any organization or institution will be happy to be contacted. Nevertheless, churches, schools and party structures are not accustomed to coordinate with community organizations, except to “orient them” about what to do, and treat them as their dependents. Their worlds and leadership which we mentioned previously really carry weight, they are true walls to community coordination. How is a grassroots cooperative going to react if the pastor of a church tells them, “God is our doctor, we trust in God?” What is it going to say and do if the principal of a school tells them, “we can only receive support if it comes through the ministry of education”? What are they doing to do if a committee of a political party, the councils or mayor deputies say that “directions and projects only come from above?”. What can you say to the parent of a family who only believes in the patron of their hacienda? How difficult it is to be community and work for the community! There, where things get complicated, money will not even make monkeys dance.
In the midst of these worlds we have learned the following steps. First, discussing the information in figures 1 and 2 really empowers people, it is in-forming, and informing is forming. Information can be an antidote to despotic religious, political and economic leaders. Second, the cooperative or association should start from what it is and has; what do they have and who are they? Each member has, at least, a family member who is a student, believer of some religion and/or is member of a political party; they should talk with them, discuss the COVID-19 situation, and the information provided here. Third, members of the organs of the cooperatives, having now conversed at the grassroots level, visit the parent/teachers committee of the school, people with positions in the churches, (e.g. deacons, delegates of the word) and party members or government authorities, reflect with them and discuss the information. Finally, the board members of cooperatives communicate with the parent/teacher committee of the school and with deacons and delegates of the word. In other words, connect with the grassroots of different organizations and institutions, their intermediate leaders, to then connect with the leadership of the organizations and institutions. In these steps, it is not a matter of convincing anyone, but of listening, bringing together elements that help to understand, and once each person understands, they will be able to see and then act – it is like preparing the soil and planting a seed, then you have to let the seed germinate and struggle to grow.
Table. Cost of kit for 90 people (1 month; in US dollars)
Chlorox (cleaning equipment) (liters)
Hand towel (units)
Bar of soap (units)
Re-usable masks (units)
With these steps, each organization can supply itself with a kit of hygiene products to prevent COVID-19 (see table). Cooperatives have a social fund that they can use to acquire the kit, unless they have used it for other social agendas that they tend to have. Schools can, through the parent/teachers committees, gather resources to acquire the kit. If the cooperatives, with or without international support, can gather resources to support the schools and churches, it could make a difference, strengthening the bonds in the community, and the entire community would benefit. The more bonds there are, the more autonomous the community will be.
3.3 Looking forward
The sixth recommendation in Figure 2 is the most important reason for a grassroots organization rooted in the community to exist: think, think and think. Thinking is the most important element to resisting COVID-19. Thinking is looking forward and seeing beyond our noses. A cooperative is not a church nor a political party, its members are there voluntarily, they are not subordinated to anyone, they discuss and reach agreements in their assemblies, which is why they must examine their beliefs and fight with and against them. Individually they can believe or not in God, but they should not expect God to send them angels or saints to wash their hands for them, or put their masks on, just as they would not expect that he plant beans for them or remove botflies from their cattle; they can believe in their political leaders, but it is shameful to subordinate themselves to anyone. As cooperative members they have free will, their source of power is the assembly composed of the members themselves, and their reason for being is thinking, thinking and thinking in favor of their communities.
Part of this thinking is reflecting about COVID-19: How to protect their own community? If the State does not show up in a community, the cooperative must also take on that role. If the health system capacity is overcome, grassroots organizations should discuss how to help prevent the outbreak in their communities, and how to help people who might be affected by the virus. If in any country COVID-19 is being controlled, in all countries there are waves of outbreaks of the disease, so the cooperative should keep looking for those possible outbreaks. In Central America the urban waves of COVID-19 are still ongoing, which is why the rural waves that come later, can be lethal, not just for the reasons mentioned in this article, but because we are in the midst of the rainy season, which will make it more difficult for infected people to get to a health center or any support. If a community receives external support, the cooperative must be careful that that support not be counterproductive, because there can be support that displaces grassroots organizations, and when that donation ends the community´s own autonomy and their own efforts can be left eroded.
Cooperatives need to organize how a network of women can sew masks, how to make soap with lard, how to recover old ways of making alcohol in order to use on hands, how to recover natural medicine… Cooperatives need to think about connecting hygiene, economics, social and environmental elements, thinking about the food in the community beyond COVID-19, thinking about environmental sustainability with pure air and water, thinking, thinking, thinking.
4. Role of international organizations in living communities
Even though for multiple reasons most of the international aid organizations have withdrawn from Central America, there are still international organization that are supporting the region. There also is the fair-trade network, as well as local-global networks among national and international organizations, unions, churches, social banks and universities in the world. When there is the will, there is the way, as the saying goes. If each person feels a mission of service, we can deepen those relationships of collaboration and reactivate “dead” relationships, because “where there are ashes, there was fire.” Each person and organization can play an important role if in this COVID-19 context they realize the importance of working on the community level that is organizing: what good does it do to provide individualized credit or training, as neoliberalism does, promoting mono-cropping, environmental degradation and the erosion of communities? The current situation wakes us up: people who organize and follow rules agreed upon in their assemblies, instead of gurus or chiefs who see themselves as the law, are those who really energize their communities, sustainable farming systems and contribute to social and environmental equity. Communities save communities.
Within this framework, what role do aid organizations have? Traditional donations, involving donating and awaiting reports invented by organizations “confined” to the cities, can be counterproductive, particularly if they displace the efforts of the communities themselves, which in the long term would undermine communities. Aid organizations need to connect with counterparts who really are working with grassroots organizations that meet the following criteria: they are democratic, redistribute their surplus, are transparent with their information and are rooted in their communities or specific micro-territories. This type of organization will persist in the communities, while other external organizations, or those with disperse membership, will continue treating the communities like their lovers, showing up from time to time and leaving. Forming alliances with grassroots organizations so that a donation might provide an initial push, for example, with what is indicated in the table, supporting wash basins in schools with access to water, or working on agro-forestry systems that would protect water sources, where grassroots organizations might accompany their communities, and that their national partners might accompany them in the communities themselves, being careful, but overcoming fear, is the network which need to be built now and always. The dilemma is not whether to leave your urban home or a rural farm; it is how we strengthen internal community assets, how we can take advantage of this “momentum” that exists in global awareness as an effect of COVID-19 to see the importance of communities. In this way, external financing to build a community response would decisively help the community deal with the virus and its new outbreaks, and help in the long term to democratize the community itself.
5. By way of conclusion
In this article we showed the risks of COVID-19, we have begun a reflection on the relationship between hygiene, the economy and social factors, we described the strength of communities if they build lasting connections, we have emphasized the role of grassroots organizations to reflect on their values and principles in light of what is happening in their communities, and generate ways to cooperate in the prevention of COVID-19, and to innovate in ways of accompanying their communities in the midst of the uncertainty. We showed that, through these short term measures, and starting from an analysis of the processes which we are experiencing, it is possible to look forward to the medium and long term: to improve, correct, and generate habits of hygiene connecting home, farm and nature, and home, school, health center and community building.
The impact of what we are proposing, nevertheless, will be seen above all on more structural issues. For example, an exponential increase is coming of people in extreme poverty, the goal of eliminating extreme global poverty for 2030 is going to be only left on paper. The crisis for rich families of the world is how to have less desert options in their dinner, while for our communities the crisis means that they might miss a meal or face empty plates, becoming vulnerable again to any disease. This article and the previous one on basic grains aim at preventing those impacts.
The current situation also provides us with opportunities, because “behind every adversity there is an opportunity”. What opportunity? Mitigation of climate change which, in the case of rural communities, means water, land with life, biodiversity; it is the moment to rethink farming systems and intensify more sustainable forms and farming systems that stop the loss of nutrients in food because of the decreasing quality of the soil. It is the time for communities, never before has the importance been so clear of investing in communities who organize and embrace a culture of care; now is the hour for life, amen.
To look at these structural issues we must understand that it is not the economy that solves health care, it is not a matter of knowing whether the chicken or the egg is first, now the economy is public health and community health; and health, the economy, social and environmental reality are like a mountain slope, if you are on the higher part it looks different than seeing it from below, if you are on the very top, it looks different from one side than from the other, but it is the same slope, the same mountain slope.
“Think, Pipita, your love for others is stronger than anything else…Besides, the rain is coming!”
 It is likely that air pollution facilitates the virus and makes its impact worse, which in part would explain why countries in Europe have had high mortality, measured by the indicator of “over-deaths” or “over-mortality” (number of deaths above the average deaths from previous years) as an effect of COVID-19.
 Many people even with clear signs of having been infected, decide not to go to the health centers or hospitals. Why? “They say the hospitals have no room”, “I don´t want to die intubated”, “I want my family to wake me” and “we want to now where he is going to be buried to be able to go to pray for him”. The express burials frighten the population.
 L. Engelmann, J. Henderson and Ch. Lynteris (eds), 2018, Plague and the City. Londron: Routledge. They study the relationship between plagues and measures to fight plagues and cities from the middle ages up to the modern era; they also include cities like Buenos Aires.
 Inspired in these realities and by actions of Dr. Mazza and his team, in 1995 they filmed the movie Casas de Fuego. See: https://www.youtube.com/watch?v=A6yWNBytu3U The movie illustrates the relationship between disease-insects, homes (shacks) and social inequality, the wealthy class is against homes being rebuilt, because “they are not concerned” about the millions of poor people.
The movie Casas de Fuego (footnote No. 5) illustrates the duality science/faith and committed science/academic science. The priest is opposed to science benefitting the most impoverished and affected communities; for him “faith and science are fighting over the same people”; a Manichean dilemma that smacks of the middle ages and that did a lot of damage to humanity. Also in this movie, that captures a good part of that experience, the University blocks the mission of Dr. Mazza and his team; fortunately Dr. Mazza and his team persist, their commitment is worth more than restrictive science, a commitment that nevertheless, they paid for with their lives, caused by the Chagas disease itself.
 If there are other organizations in the community, like alcoholics anonymous, water or road committees, the same is done as with the schools and churches.
 Note that traditional organizations tend to do just the opposite: the meet first and only with the leadership of the organizations, and then send technicians to “train” (in other words, convince).
 If some national or international organization wants to provide support under this spirit, they can contact the Coserpross cooperative (http://coserpross.org/es/home/) in Nicaragua, the Comal Network in Honduras (http://www.redcomal.org.hn/). Coserpross and the Comal Network accompany dozens of grassroots organizations in the region, synthesize verified information to provide to the grassroots organizations, and move about in those same territories. There are also organizations like Aldea Global and ADDAC that we mentioned in footnote 5; their uniqueness is that their network is present in dozens of communities.
 What would happen if a bee stayed in its hive? It could live as long as the food that it stored lasted, the honey that it produced, and then? We must understand that we, flowers, bees and humans, are all one network. The bee leaves its hive and goes from flower to flower, pollinizes, does it at the risk of losing themselves and of losing their lives. So is the network. So are we accompaniers, taking on the corresponding measures (use of mask and frequent hand washing), we should not “pass by on the other side” like the priest and Levite in the parable of the Good Samaritan, we should be inspired by people like Chagas and Mazza did and their teams in Brazil and Argentine that the movie Casas de Fuego portrays.
This call for a National Quarantine by 34 Medical Associations in Nicaragua is in response to the exponential growth of infections, and increasing national and international criticism of the Nicaraguan government for its response. It was published as nearly a half page ad in La Prensa June 2, 2020. The same day the announcement was released COSEP announced their full support for this call.
In the face of the unstoppable advance of the Coronavirus pandemic in Nicaragua, we the different Medical Associations of the Country, address today the Nicaraguan people and the International Community, to once again warn about the dramatic situation that our country is going through, and that threatens to worsen in the next days and weeks with terrible and fatal consequences for Nicaraguan homes.
As had been warned by International Centers for disease control and different National Medical and Epidemiological Specialists, the exponential increase in COVID-19 cases has caused a collapse in the public and private health care system of Nicaragua: saturated hospitals, lack of beds, lack of medicine and such essential products like oxygen are added to the fact that dozens of doctors and health care workers are infected by COVID-19, with the result of an important number of deceased Doctors, nurses and technicians. Which is reducing the number of medical and paramedical resources in different institutions, causing overtime workloads, physical and emotional exhaustion on the part of health workers.
Nicaragua finds itself currently in the phase of accelerated expansion and community transmission, which will continue worsening with greater loss of life, if the corresponding authorities continue denying the situation, and anti-epidemic measures are not taken urgently and at a large scale to try to contain the advance of the pandemic.
With the moral, academic and workforce authority that the fact of being in the front lines in treating this dramatic health crisis confers on us as doctors, we the Medical Associations of Nicaragua call on the people to urgently begin a voluntary NATIONAL QUARANTINE, that might help reduce the impact of this disease with the reduction of Contagion, transmission and death among the population. This NATIONAL QUARANTINE consists in staying at home for at least 3-4 weeks, doing food purchasing once a week, ensuring distancing of at least 1.5 meters between people, using face masks or protective screens outside of the home, and constant hand washing.
We demand that the private sector take strong measures in the face of the propagation of the virus and protect life, instituting actions that might reduce the risk of exposure and transmission, not just with personal hygiene measures, but with actions like the temporary closing of non-essential businesses until the growing number of those infected be reduced.
As of today, all of us are potential sources of contagion and transmission of the disease; which is why we reiterate the call to the Nicaraguan population, private enterprise and public institutions to stay at home. We are capable of controlling the pandemic with your decisive support and the power that you have to avoid the spread of the virus. This is the only way that has demonstrated the control of the disease based on the experiences of other countries who have mitigated and diminished the transmission, obtaining the flattening of the curve and control of the Pandemic.
The COVID-19 pandemic came to the world without anyone expecting it, even more, without anyone being prepared to confront it.
Also, the pandemic came to our beloved Nicaragua, an impoverished country with the aggravating circumstance of a social and political crisis.
We note that all of our faithful people are aware of the fragility and vulnerability in which the health care system finds itself, the speed at which the infection is spreading, the truth about the number of those infected and deaths caused by the virus. With our people we are suffering their uncertainty, grief and death. The grief and impotence lead to desperation, families who are mourning their dead without saying good-by, the fear and insecurity that the population is suffering in light of the silence of the State, and the disinformation about the progress of the epidemic, the fear or impossibility of visiting hospitals, suffering diseases in the silence of their homes, the manipulation of consciences, coercion and political opportunism in the management of the pandemic.
We reiterate our prayers for all the sick, those who have passed away and the families affected by the virus.
We are happy and grateful for the effort of the doctors and nurses of our country, and we encourage them to be faithful to their vocation and mission.
The contagion of COVID-19 in Nicaragua coincides with the liturgical seasons: Lent and Easter, privileged times of grace and blessing, that for the common good of our faithful and the entire country we have celebrated in empty churches, masses without the presence of faithful but – we give thanks to God – strengthening the faith of many Catholic families as domestic churches, celebrating in the intimacy of the home the passion of the Lord and his glorious resurrection.
Let us take care of life.
In the face of this global, national and family tragedy that threatens our lives, what is our response? What can we do? We are afraid of losing our own lives and the lives of those we love, but, life is a gift of God, it is in his hands, like we also are also in his hands, as all of humanity is in the hands of their Creator.
Nothing is more important than life, “life is above all else”, the problems that come after the pandemic are many, the challenges very big, and just remaining alive and united will we be able to face them; many of us have maintained social distancing, and we have done it out of responsibility and love; we should continue doing so, when contamination is local and the risk of contagion is greater; the most important thing now is protecting life, and that each one does what is necessary and possible to preserve and protect the lives of others, those who are stronger, generous and compassionate carrying those who are weaker; those who have wealth, may they multiply their works of mercy to share with those who do not have anything, may they take diligent care to protect men and women who are working in enterprises of production and institutions of administration and services; that all of us without exception prioritize the care of life, life above the economy, life above ideological and political interests, we repeat, life above all else. This implies the urgency of strengthening citizen solidarity. Taking care of one another and caring for others, following all the measures of precaution, prevention and mitigation.
We exhort the rulers and all sectors of the country to open themselves to alliances and consensus to seek and find alternatives and joint solutions that would prevent us from a larger human catastrophe.
During the storm, the beating of the waves threatened to sink the boat, Jesus was asleep in the stern which is the first part to go under in a shipwreck, sleeping in the most dangerous place and the storm did not disturb his sleep, because Jesus slept trusting in the hands of his Father. His disciples were afraid and shouted to him, in addition to their fear they had doubts, were men of little faith (cf Mt 8: 23-27). For us the time has come to shout, Lord, save us because we are going to drown! And of recognizing our little faith. We implore the Holy Spirit to give us the strength of faith, Christ has power, but do we have faith? More than once Jesus said to those who were tormented that “let it be done according to your faith” (Mt 9:29); “your faith has saved you” (Mt 15:28) “I did not find as much faith even in Israel” (Lk 7:1-10); let us be strong in faith and let us not doubt the love of God for us and, given that we are weak, let us implore the Lord to increase our faith (Mk 9:24).
Jesus loves us, “the greatest value of life is love.” In the face of this situation, we turn our eyes again to Jesus, we Christians should have present a response motivated by our faith. Faith implies hope. Faith without hope turns lukewarm and dies, it will not be any more than a sterile knowledge. We human beings, we are such fragile people that crises undermine our emotions and thoughts, that is why faith and hope must take their place in the face of threats, in this way we also are careful about our actions.
In this crisis and throughout our lives Jesus comes to encounter us, He, conqueror of death, leaves the empty tomb and comes to the encounter with his disciples, “let us open the doors of our hearts wide open” (St John Paul II) so that Jesus might enter, live in us and we live in Him (cf Jn 14:20).
St Paul encourages us with these words: “Because in hope we were saved; but the hope that is seen is not hope; because who hopes for what they already have? But if we hope for what we cannot see, with patience we await it. And, likewise the Spirit helps us in our weakness; because we do not know what we ought to pray for, but the Spirit himself intercedes for us through wordless groans” (Rom 8:24-26). Do not give in to the night: remember that the first enemy to defeat is not outside of you: it is within. Therefore, do not give way to bitter, dark thoughts. “Trust in God and trust also in me” (Jn 14:1) – Jesus says – God does not disappoint: if he has placed hope in our hearts, he does not want to destroy it with ongoing frustrations. Everything is born to flower in an eternal spring. God also made us to bloom” (Pope Francis).
“Do not listen to the voice of the person who spreads hate and division. Do not listen to those voices. Human beings, as different as they may be from one another, have been created to live together. Love people, Jesus gave us a light that shines in the darkness: defend it, protect it. This light is the greatest wealth entrusted to your life. And above all, dream! Do not be afraid to dream. Dream! Dream about a world that cannot yet be seen, but that certainly will come. Live, love, dream, believe. And, with the grace of God, never lose hope” (Pope Francis).
Follow the path of love.
The pandemic will end, “because everything has its time under the sun.” Once the crisis is overcome, it will be up to us to ask ourselves, what lessons have we learned? What meaning will God continue to have for my life? What will be my attitudes toward others from now on?
We are called to have an attitude of conversion about our way of thinking, living, and acting, in accordance with the Good News of Jesus Christ, being docile to his teachings under the action of the Holy Spirit who was bestowed on us from our baptism. “Love one another” that commandment of the path of salvation, expressing that love in works, in actions of social and labor justice, in larger investments to strengthen health care systems, in the construction of an economy where the common good of humanity prevails above all else.
Certainly poverty is increasing, unemployment is worsening the economy of families, we need to take on this challenge as a society, the needed changes must happen, and technical, economic, scientific etc. solutions are not enough. Political speeches empty of responsibility and content do not work to solve the problem, it is important to recover the direction of human life, give it back its dignity, its sanctity, from its conception to its natural extinction; it is necessary to follow the path of love.
Life of prayer
“When the sadness and bitterness of life try to crush our gratitude and praise to God, the contemplation of the marvels of his creation ignite, again, in the heart the gift of prayer, which is the principal force of hope. And hope is what shows us that life, even with its trials and difficulties, is full of a grace that makes it worthy of being lived, protected and defended” (Pope Francis).
This crisis strains all of us, demands of us more effort, the task may seem overwhelming, nevertheless, “nothing is impossible for God” (Lk 1:37). Stress causes fatigue, anxiety and irritability, even anger, it reduces the time for rest and drains energy, “the flesh is weak”, and let us strengthen the spirit persevering in prayer (cf Mt 26:41). The humble and trusting prayer: “My God have mercy on me” (cf. Lk 18:9-14), will give us back the joy of salvation” (cf. Psalm 50), and our voices will proclaim his praises, prayer will give us peace and strength to turn the stress into the energy that we need to resolve this situation.
We implore Mary Help of Christians, that “Woman clothed with the sun, with the moon under her feet, crowned with twelve stars on her head” (Rev 12:1), she is “the one that appears as the dawn, fair as the full moon, bright as the sun, majestic as the stars in procession” (SS 10:6), Mary Help of the Christians will crush the head of the serpent, and will cover us with light “like a mantle, stretching out the heavens like a curtain” (Psalm 104:2).
Issued in the Office of the Episcopal Conference on the 24th day of May 2020, the feast of Mary Help of Christians.
[Signature] [SEAL of the Episcopal Conference of Nicaragua]
This is the Executive Summary of a White Paper the Nicaraguan Government released May 25, 2020 in response to international criticisms of the Pan American Health Organization (PAHO), the Costa Rican government, and other nations to what they describe as a lack of adequate response of the Nicaraguan government to the health crisis caused by COVID-19. In addition there has been widespread national criticism of the government´s response, including six former Ministers of Health of Nicaragua, the Civic Alliance for Justice and Democracy, COSEP and over 700 Nicaraguan doctors and health care professionals.
We present to the Nicaraguan people and the international community the “NICARAGUA WHITE PAPER IN THE FACE OF THE COVID-19 PANDEMIC: A UNIQUE STRATEGY”, which has an analysis of the public policies, presenting a vision of the health care model of Nicaragua as a unique model in the world, based on the reality and conditions of the country, which responds to a preventive approach to people, families and communities with proactive actions. Within this model we have a strategy of balance between the Pandemic and the Economy, vigorously fighting Coronavirus and COVID-19 without closing down our economy. The policy is based on the fact that 40% of the population lives in the countryside, and 80% of the workers in the urban area belong to the informal sector and earn their daily sustenance. At the same time, we are defending the economic recovery of an economy weakened by the coup attempt of April 2018, that continues under attack by false news (“fake news”) campaigns and disinformation, as well as illegal coercive measures.
The country has been well prepared for this fight against COVID-19, due to:
1) The strengthening of the health care system (2007-2020);
2) Preparation since January 2020, two months prior to the appearance of the first case;
3) The entirety of the actions undertaken.
Strengthening health care 2007-2020
It presents how Nicaragua is in a better position today, compared to the sixteen years of the neoliberal period, to face the pandemic, with more modernized health care infrastructure (18 new hospitals), more trained personnel (36,649 health workers in 2020 compared to 22,083 in 2006; 6,045 doctors in 2020 compared to 2,715 in 2006) and flagship and solidarity programs that make manifest the sacred commitment of the Government of Reconciliation and National Unity (GRUN) to restore the rights of the population (Everyone with voice, Love for the smallest, Operation Miracle), since the organization of the Family and Community Health Care Model (MOSAFC), working jointly with the community network and a larger budget investment (US$ 468. 6 million dollars in 2020 compared to US$111.9 million in 2006.
Preparation for COVID-19
When the COVID-19 outbreak happened in Wuhan, China on January 21, the Ministry of Health (MINSA) held a press conference to warn the population about the risk, and to communicate prevention measures. This was almost two months before the presentation of the first case in Nicaragua on March 18.
Since the declaration of the World Health Organization on COVID-19 as a Public Health Emergency of International Importance on January 30, 2020, Nicaragua established an Inter-institutional Commission to ensure a comprehensive approach.
On February 9 MINSA released a “Preparation and Response Protocol in the face of the Risk of Coronavirus (COVID-19) in Nicaragua” to ensure the monitoring and early detection of suspicious and confirmed cases. Preventive measures were established to reduce the transmission of the virus, and an ongoing communication plan was implemented, directed to the population, and educational and border control actions have been carried out, always based on the Protocols of the WHO/PAHO.
The Protocol also designated 19 Hospitals to be specialized in COVID-19, one of them, the Nicaraguan German Hospital, exclusively for respiratory diseases; it included more preparation for the primary treatment units to address the respiratory symptoms on the national level, the training of public and private personnel, and the acquisition of protection equipment. Nicaragua also had established a capacity for contact tracing. In this way Nicaragua was prepared before the appearance of the first case of COVID-19 in the country on March 18.
Actions in the face of COVID-19
As part of the Protocol designed by MINSA in response to the Coronavirus and COVID-19 pandemic, in Nicaragua 470 people suspected or who have had contact with confirmed cases in the country, have been treated and provided responsible and careful follow up.
Likewise, more than 42,000 international travelers were the object of monitoring for 21 days to detect possible cases of COVID-19.
This follow up provided to travelers, suspicious cases and contacts of positive cases, includes doing daily control by the closest Health Post or Health Center to their homes, based on which the medical staff daily decide about the pertinent actions: continuation of the monitoring, hospitalization, or release, depending on the case.
More than 4.6 million multiple educational house-to-house visits were carried out in a country of 6.2 million people, by 98,224 volunteers to promote family and community health.
In addition to an intensive informational campaign in the media about the prevention measures, the publication of the symptoms and behavior in the face of the disease, a National Information Center has been created that has a free telephone line where prepared staff and doctors clarify any questions that the population may have and appropriately direct them about how to act in the face of the pandemic.
In addition, there is a program for the disinfection of public transportation units, collective (buses) as well as selective (taxis); popular markets, governmental buildings and schools at all levels, preschool, primary, secondary and public universities.
The Ministry of Education and the National University Council, in coordination with the Ministry of Health, in addition have adapted their physical installations, designed prevention protocols, and have adapted their study programs to include talks on preventive health and reinforcement of healthy habits for all their students.
In synthesis, Nicaragua, the second poorest country of Latin America and the Caribbean, has been prepared to face the COVID-19 pandemic and any other similar one, as well as it has been prepared to face natural disasters due to the climate, like hurricanes and droughts, or to geological phenomena, like earthquakes or volcanic eruptions, principally for reasons of its own health response model, which is a highly preventive nature based on the active participation of the family and the community, but also because it has invested a fundamental part of its scarce resources in the construction of new health units and the modernization of existing ones, as well as in the numerical growth and ongoing improvement of its medical, nursing and technical staff, in addition to their more equitable distribution throughout the national territory.
In addition, in the face of the appearance itself of COVID-19, the responses provided by the Government of Nicaragua have been carried out in coordination with the regional entities of SICA and in addition with the cooperation of sister nations like Taiwan, Cuba and South Korea.
Nicaragua ratifies, then, its confidence in the success of its policies based on the defense of the health and lives of families and communities, with their active participation in the prevention of epidemic and non-epidemic diseases, but also in the protection of the family, community, local and national economy, which has allowed for and will continue allowing for new accomplishments in the fight against poverty and for the human development of the country, even in the adverse times of economic crisis and climate change, even in times of COVID-19.
*an earlier version of this article was published here on March 27th. This more extended version was published in the May 2020 edition of ENVIO, no. 466. We reproduce the text here at the request of the author.
Viruses multiply when humanity provides the conditions. Deforestation, the agricultural model and factory farming, breaking up public health systems, even individualism, and so many other features of the development model imposed on the world by neoliberal capitalism, facilitate the appearance of viruses such as COVID-19. A firewall is a swath of land left uncultivated to keep forest fires from spreading to crops. What firewalls will stop the coronavirus and those that come after?
by René Mendoza Vidaurre / Inti Gabriel Mendoza Estrada
“ Coronita, little crown, how hungry you are!” SARS tells COVID-19. SARS (CoV-1)—which caused the 2002-3 epidemic affecting 26 countries and feasting on only 8,000 people but with 774 fatalities—is closely related to COVID-19, the coronavirus causing the current pandemic affecting 210 countries and over 3.7 million people with 257,000 dead so far… and counting by the minute.
“Hungry, little brother? Not me… Seven hundred years ago our great-great-grandmother, the Black Death, wiped out a third of humanity.”
“And how many do you plan to take with you…?”
“Only a few!… But it’s the humans themselves who are calling me from hither and yon…”
“And how do they do that…?”
“They destroy the soils and fill them with poisons, they destroy the forests to make roads, they fatten those they call animals with chemicals and then eat them… And with all that they do, what do they expect from me…?”
that attracts plagues
Over the years we have learned that unhealthy conditions cause problems when demographic growth, social deterioration and environmental degradation are combined. People’s wellbeing depends on their being healthy in mind and body, living in a healthy social community and in a sustainable environment.
Researchers of plagues that have decimated humanity at various times in history show that viruses, bacteria, fungi, bacilli, all pathogenic germs, multiply when they find the right conditions that humanity has created for them, consciously or unconsciously.
When the rust blight hit Central America, the coffee plantations were weak, overcrowded and in “tired” soils, largely thanks to mono-cropping, a system that had even permeated the agricultural cooperatives. These conditions attracted the parasitic rust fungus and it devastated the coffee plantations. It hit Nicaragua harder, Honduras a little less, and even less the other countries in the region, as I wrote in “Who’s responsible for the coffee rust plague and what can be done?” (envío, March 2013).
William H. McNeill, in his interesting book Plagues and Peoples, studied dozens of plagues that have devastated humanity over the centuries and explains how the Black Death, which arrived in Europe in the 14th century, created a crisis affecting all aspects of the feudal system as half the European population died, creating a scarcity of labor, and the institutions supporting feudalism lost prestige.
Neoliberal capitalism was
the incubator for COVID-19
Neoliberal capitalism—led by the world elites and strengthened by the rest of humanity’s passivity or powerlessness—has damaged the social, health and natural conditions of every country in the world, propitiating the spread of all kinds of plagues.
A similar view has been expressed in various ways by others. In a report published in Brazil by the United Nations Environment Programme (UNEP), Roberta Zandonai states that the coronavirus pandemic “reflects environmental degradation.”
The Argentinian illustrator and journalist Marina Aizen wrote in 2016 that epidemics “are nothing other than the result of the annihilation of ecosystems—mostly tropical—razed to plant industrial-scale mono-crops. They are also the result of handling and trafficking in wildlife which, in many cases, is in danger of extinction.” She explained how more deforestation results in more explosions of viral diseases, and more mono-cropping and agribusinesses result in more epidemics.
Robert Wallace, a biologist who has studied a century of pandemics, argues that the capitalist production model (mono-cropping and industrialized fattening of animals), which mixes pesticides, transgenic foods, antibiotics and antivirals at the expense of natural ecology generates increasingly more dangerous pathogens for humanity.
Wallace believes that COVID-19 is related to these production methods. The corporations and companies behind this agri-food system and the industrial breeding of animals for human food are so powerful that they govern those who say they rule our countries.
Bayer, Monsanto, Syngenta, BASF and Corteva are in the transgenic business while Cargill, Bunge, ADM and others are in the animal feed business.
Where markets rule
State authority has been reduced throughout the world in the last 40 years and market forces such as these agri-business corporations have taken over world governance, even education and health systems, which have to a large extent been privatized.
The markets imposed strict fiscal discipline on the States—reducing spending, increasing interest rates and eroding social rights—in order to attract foreign investment. The result: global big capital moved its companies to countries where the working class receives low wages and has no unions or laws to protect it.
According to the Gimbe Foundation, in the last 10 years Italy has lost 70,000 hospital beds; 359 hospital wards have been closed and many small hospitals have been converted to other purposes or abandoned as a result of the reduction in social spending.
In Spain, unions report that between January and February of this year, in full coronavirus expansion, 18,320 healthcare workers were laid off, similar to what happened in 2013, a year of adjustment policies and cutbacks. These policies turned health into a commodity subject to the laws of the market, dominated by the corporations.
Making matters worse, healthcare systems in Latin America tend to be bureaucratic, urban, racist and non-preventive. People who go to a health center with a serious illness are very frequently given an appointment several months later. Furthermore, the rural population in multiethnic countries rightly resists going to what they see as mono-cultural systems.
It was capitalist greed
Was it bats, pangolins, a Wuhan seafood market or a virus created in a Chinese laboratory? Whatever the answer, the causes are found in capitalist voracity. For more than a century, capitalist “culture” has misled us into individualism: into taking advantage of others, having no interest in collective collaboration, making us live under the rule of “I am, if I destroy you.” It has led companies to the principle of “the more resources I control, the more I dominate you.” It has driven us to consumerism at the cost of debt. As they said in a rural Central American community, “When the price for coffee was good, we bought a motorbike or a car, even though we didn’t need it and only used it once a week.” Put more succinctly, the causes lie in greed.
Capitalist ambition has contaminated humanity, nature, ecosystems, the planet. Throughout the world, it has induced diabetes, obesity, hypertension and more in the human population. It has paved the way for plagues to multiply and affect us. This is the factory for COVID-19 and the other future pandemics the scientific community is warning us about.
does make distinctions
It is said, without much reflection, that COVID-19 makes no racial, social or national distinctions… only differentiates by age, in that it affects children less and the elderly more.
By simply looking at the data on victims, however, we realize that it does make distinctions: it targets the most vulnerable, especially those most affected by capitalism.
It has affected more men than women and much more those living in overcrowded cities, especially in the poor neighborhoods of big cities such as Guayaquil in Ecuador; more of the African-American and Latino populations in the US; and more of those over 70 years of age…
The Spanish writer and activist Clara Valverde says in her book The necro-politics of neoliberalism (2015) that neoliberalism applies necro-politics: it leaves those people who aren’t profitable for capitalism to die, those who neither produce nor consume, or, as this graffiti puts it: Under the dictatorship they killed us, now they just leave us to die.
The expansion of COVID-19 in Latin America could be especially lethal for its indigenous peoples. According to the United Nations Department of Economic and Social Affairs (DESA: https://www.un.org/development/desa/indigenous-peoples-es/areas-de-trabajo/salud.html), over half of indigenous people older than 35 suffer from type 2 diabetes, one of the preconditions worsening vulnerability to COVID-19 .
There’s a palpable difference in the life expectancy of indigenous peoples and other peoples. In Guatemala they live 13 years less, in Panama 10, in Mexico 6, in Nepal 20, in Australia 20, in Canada 17, and in New Zealand 11.
COVID-19 could be brutal to them, which would also affect the forests, because where there are forests there are indigenous peoples: it’s their habitat. Despite this, it’s notable that the word indigenous doesn’t even appear in the repeated statements by governments about the pandemic.
COVID-19 among those above
and those below… way below
This differentiation between the effects of COVID-19 on the health and economy of certain sectors and others, of certain places and others, leads us to the award-winning Korean film Parasites (2019). We can imagine or guess that the pandemic’s effects would be very different in the poor and resourceful family that lives cramped up in the basement and the very rich family that lives in a huge and practically vacant house with all the comforts.
For example, the rain in Parasites, which the son of the rich couple perceives as a diversion, a relief from the heat and even motive for a party the next day, is a veritable tragedy for the poor family, which loses the little it has because their basement and those of their neighbors get flooded.
The same is true for COVID-19. For the elites of the world, who live “above,” the problem is one of health, and the compulsory quarantine is a huge nuisance that interrupts their lifestyle. For the millions who live “below” and survive hand to mouth in the cities and the countryside, the problem is also one of health but of everything else too. Whether to die from the virus or from hunger is the dilemma facing those millions who live in the planet’s “basement.”
different responsibilities and visions
This differentiation is also expressed in the awareness of the different generations that today coexist on the planet. In Europe there’s a debate about COVID-19 and climate change between the current generation and that of the “baby boomers,” those born after World War II between 1946 and 1964.
To some extent, climate change is the result of actions taken by the baby boomer generation, after their parents made the effort to build a welfare state following the Great Depression of 1929 and then the disasters of World War II.
Venture capitalist Bruce Gibney accuses US baby boomers of looting the country’s economy by cutting taxes for the richest and ignoring climate change, thus ruining previous generations’ legacy of large infrastructure and leading to bankruptcy, which the current generation now has to pay for. Today, while COVID-19 more cruelly attacks third-age people—the baby boomers of yesteryear—the current generation is fighting to protect them and themselves.
In Latin America, the older generations born after 1930 accelerated the expansion of the agricultural frontier as demand for meat grew in the US. Those in the large cities, seeing how forests were being replaced by pasture for cattle, resisted capitalist agribusiness, faced military dictatorships and passed on a deep distrust of the depredating State to generations that followed.
That generation of over-60s, who assured their children’s education without themselves having studied, is now under attack by COVID-19. Today’s generation, while sometimes falling into consumerism and religious or ideological fundamentalism, advocates non-authoritarian societies, defend sustainable agriculture as part of their past, worry about climate change and, far from questioning their grandparents, fight, like their peers in the US, to protect them and themselves.
Home quarantine for everyone?
During the worst years of the Black Death (1347-1353), rich Europeans went to their country homes, while the poor remained terrified and overcrowded in the cities, where they were kept isolated and under surveillance. Today, fear is spread on Facebook, Twitter, the social networks… and people must stay at home, in lockdown, while borders are closed and health systems are overwhelmed.
The compulsory quarantine project assumes that home is a safe and harmonious place and that everyone has a house, which isn’t usually the reality of the cities’ poor neighborhoods and rural communities.
Mandatory confinement assumes that every family has savings or daily income, which isn’t the case for most families in many countries, as they depend on the informal economy and live in rented accommodations. The political class should take a public bus and get off at the last stop where the subterranean city begins… There they should reflect on social and economic policies that could make a difference in the lives of these, the majority of the population.
More than strengthening health systems and providing truthful information about the pandemic, some governments seem interested in taking advantage of it to increase authoritarianism and validate questionable measures. It shouldn’t be forgotten that following the emergency from the 9/11 attacks, the US government effectively legalized torture as a method to combat terrorism.
In the United States, Trump’s government isn’t so much interested in saving the poorest from COVID-19. It is far more interested in saving the large companies that helped create conditions that incubate the plague and, at the same time, threaten Venezuela, where big US and Chinese companies contributed to the conditions that generated COVID-19.
In Brazil, the largest country in Latin America, Bolsonaro’s government is responding to the pandemic with religious fundamentalism and dismissing science’s inputs to stop its spread. The greatest risk is that if those who incubated COVID-19 and will incubate future plagues present themselves as the bearers of solutions, whether directly or mediated by authoritarian governments. We would then be on the verge of a new plundering of public assets, humanity’s common and natural assets.
Brutal austerity imposed by big capital
Big capital is lying in wait behind today’s fears and the authoritarianism of both governments and the market. In The Shock Doctrine: The Rise of Disaster Capitalism (2007), the Canadian author and activist Naomi Klein explains how big capital has taken advantage of natural and social disasters in the last 30 years to dismantle what remains of the welfare State in order to impose the neoliberal model.
Now, with the advent of the pandemic caused by COVID-19, and in a virtual meeting from her home, Klein reflects that we do need to stay home and one of the reasons is because our leaders didn’t heed the warning signs and imposed brutal economic austerity on the public health system, cutting it back to the bare bones and leaving it unable to cope with this kind of situation… After the 2008 financial crisis, Southern Europe was ground zero for the most sadistic austerity policies. Is it surprising that, despite having to provide public medical care, their hospitals are so badly equipped to deal with this crisis?
Naomi Klein also reminds us that the capitalist system has always been willing to sacrifice life on a massive scale for profit.
The first victim is the truth
Today, big capital could be calculating how to frighten our societies in order to divert our attention from neoliberalism’s nefarious effects, which attract the pandemic and lay the groundwork for wealth accumulation through dispossessing lands and resources; making States invest public resources to improve public health systems that are later privatized at ridiculous prices; promoting laws that reduce or exempt the wealthy from taxes; eliminating laws that limit the extraction of natural resources; and imposing and steamrolling investment projects in indigenous territories, always under the principle that the rich are “development’s driving force.”
In revealing the lies with which the United States made war on Iraq, Julian Assange said: “The first victim of war is the truth.” It’s possible that truth is also the first victim of the “war” against COVID-19.
Where’s the “invisible hand” today?
In Latin America today, there’s disinformation, fear, pastors and priests who repeat that the pandemic is a sign of the “end of days” and propose prayers as a spiritual shield. They have done this for centuries and in the face of every disaster… although it’s also true that we are dusting off science and venerating virologists, reluctantly in Trump’s case and clumsily in Bolsonaro’s.
There’s also some civic awareness in our countries, questioning the powerful laws of the world market and the state institutions that have yielded to those laws for many years and imposed the normality of the capitalist system on us. COVID-19 is laying bare today’s world: without leadership or world coordination. It is showing us that the neoliberal emperor has no clothes. Can anyone tell us where the market’s “invisible hand” is coordinating actions against this pandemic?
Perhaps it’s behind the philanthropists who are distributing food in Europe and the US to prevent looting for food, just as USAID did in Central America in 2001, when coffee prices plummeted. It took food to big coffee plantations to keep hungry workers from going out to the highways to demand help from drivers. We’re waking up to the idea that the “developed” countries are really not so developed.
A new awareness
for post COVID-19
Awareness is also growing in this other “underdeveloped” world that COVID-19 can be tackled with coordinated human action: hygiene, solidarity, responsibility, physical distancing, rapid virus-detection testing, scientific information backed by virtual technology…
In Latin America, as in the rest of the world, we are in transition that goes beyond COVID-19: the virus arrived in a context of economic conflict between the US and China over global markets and natural resources, with Europe scarcely out of the Brexit crisis and Latin America divided and constantly besieged by the greed of big capital.
Despite the uncertain economic future and the possibility of an economic depression similar to that of 1929, and with equally uncertain expressions about ongoing climate change, now is the time for our societies—as represented by their different cooperatives, associations, social companies, community organizations, diverse social movements, etc.—along with the very weakened capitalist reformist forces to emerge strengthened. Will the link between the different community organizations and social movements and the capitalist reformist forces (politicians, certain international cooperation agencies, some international organizations) have real potential to alter post COVID-19 trends? It could be. It is this awareness that we are gradually awakening to, like the sun that humanity and all other living things arise to every morning.
The firewall of an
Faced with the crisis of institutional legitimacy and with big capital “lying in wait,” socially legitimate organizations and institutions, including the churches, could make a difference to their members and their communities by providing truthful health information and preaching responsibility and calm through example.
In his book Sapiens: A Brief History of Humankind, the Israeli historian Yuval Noah Harari states that humans have the advantage of being able to share information across borders. Korea can advise us on how to deal with COVID-19, something viruses can’t do with each other. Local organizations are the first firewall against the coronavirus in the work of sharing information. Harari says that a motivated and well-informed population is usually much more powerful and effective than an ignorant one under surveillance.
By mobilizing their communities, local organizations and institutions can build a firewall against the coronavirus and future epidemics. The vaccine is a short-term technical solution, exclusively for this virus, not for other, imminent pandemics. If the world continues looking only in one direction like a blinkered horse, responding only technically to COVID-19, we will be left midway.
We must mobilize as an informed public so the responses governments give to the coronavirus don’t facilitate big capital accumulating wealth through dispossession, as happened in the 2008 financial crisis. In that case substantial resources from society were given to the financial system despite it having generated the real estate bubble and causing a world food crisis. Or, as has happened on so many other occasions, when capitalism was resuscitated again and again, stripping societies of their assets: land, water, trees, minerals, public assets, etc.
…of a mobilized public…
In addition to preventing vaccines being handled as commodities, we can’t allow capitalism to continue producing the current immoral black hole of inequality where 1% of the population appropriates 80% of the planet’s wealth and continues intensifying the terrible climate change that is the factory for COVID-19 and those that will follow.
As a mobilized public we must promote fairer tax systems, demanding more taxes from big capital, the driving force behind the neoliberal development model. We must further demand that those taxes be used to improve the capacity of public health systems in every country; that health and education be outside the laws of the market; that health also be accessible to impoverished families; that health systems be multicultural; and that governments strive to save lives regardless of any utilitarian calculation about the economic consequences of doing so.
…and of mindful and
We must also create another firewall of interconnected localities to respond to the causes generating plagues and putting Planet Earth at risk.
We must reflect in an organized way on how social inequality and environmental deterioration favored the arrival of this virus and on how to increase cooperation between communities; expand small production practices, diversified production systems that respect the environment, urban gardens and allotments… Reflect on the urgency of making dietary changes, choosing products that come from sustainable agriculture and breed free range fowl and cattle.
We must promote critical thinking and not repeat traditional religious or other beliefs: “Only God can save us,” “Private always works better,” “Only the rich give us work,” “More agrochemicals mean more food,”… Now is the time for those who are below to organize and make themselves felt, so that those in the “basement” and those on the “first floor” (peasantry, indigenous peoples, laborers…), those who maintain the structure of humanity, are recognized and protected from “savage capitalism.”
It’s the time of small-scale production, which usually maintains most of the population in every country but lacks social security and is the markets’ victim from the weighing stations to the credit they receive from money-lenders, to the prices their produce is valued at. It’s time to build societies that care for our common home, for people and the many ways they organize.
“We’re in a better
position than in 2008″
Naomi Klein says the Earth’s habitability is being sacrificed to our profound ecological crisis, to climate change. We must think what kind of response we’re going to demand. It will have to be based on the principles of a truly regenerative economy, based on care and repair…
She says the good news is that we’re in a better position than in 2008 and 2009. During these years we’ve worked hard in social movements to create platforms of people… She says she’s hopeful because of the ways people are collaborating in the pandemic. It’s ironic: we’ve never been so physically distant and perhaps it’s because of that distance we are so determined to reach out to each other.
The firewall of democratic organizations
The fourth firewall is associative organizations and local institutions working at being democratic, at improving their social fund’s policies—social redistribution of their surpluses—so as to tackle pandemics, organize information backed by technology and be transparent with their members.
We must learn to organize information using cutting-edge technology and at the same time prevent governments from using it to subordinate societies. Organizations in specific zones must learn to coordinate with each other about health, food and climate change challenges, so as to practice participatory and representative democracy and not obedience and an authoritarian mentality, which the Korean philosopher Byung-Chul Han says Asian cultures have used to deal with COVID-19.
With the redistribution of surplus, transparency of information, inclusion of women and men of all ages, and different organizations coordinating, we will be able to stop the conflagration of plagues and of savage capitalism and the elites who, with virtual technology, are trying to subordinate societies, with a mere click.
We need a change that
changes the future
In the midst of the current uncertainty and insecurity due to the pandemic and its unpredictable economic, social and political consequences, including whether the US hegemony will be replaced by China or by multipolarity, the only certainty in our societies should be, as Franz Hinkelammert said: I am if you are.
Staying home and in the communities stops the virus in the short term and helps nature regenerate, but we need more than that: a long-term and far-reaching change that changes the future.
It’s time for associative organizations and other institutions to take over leadership of the communities, promoting these four firewalls in the communities to reinvent our societies and their institutions: giving truthful information, preventing capitalism from strengthening itself with the pandemic, reversing the conditions that create viruses by building different futures, and being coherent—democratic, transparent and equitable.
Let’s avoid going back to pre-COVID-19 normality; let’s allow capitalism to die so other futures can be born. The virus won’t defeat capitalism; no virus will make revolution. But as the Slovenian philosopher Slavoj Žižek says, COVID-19 carries an ideological virus, “the virus of thinking about an alternative society, a society beyond the nation-State, a society that actualizes itself in the form of solidarity and global cooperation.”
It’s we human beings who must rethink and hatch new futures, against the totalitarian vigilance that countries will try to import from China.
These four firewalls are possible if instead of nationalist isolation we express global solidarity in many ways. Working together for solutions will make our differences small by comparison.
Let’s not be ruled by the fear of death. Fear is a more damaging emotion in times of crisis because it creates hysteria and paralyzes action. Yes, COVID-19 is an adversity, but as Benjamin Franklin said: Out of adversity comes opportunity.
Let’s try to see behind the adversity and envision various alternative futures to neoliberalism. They will be possible if, in addition to “I am if you are,” we adopt another principle: “We are if the communities where we live are.”
René Mendoza Vidaurre is a researcher who collaborates with the Minnesota-based Winds of Peace Foundation and accompanies rural organizations of Central America. His son, Inti Gabriel Mendoza Estrada, is a student at Austria’s Graz University of Technology.
The Nicaraguan government has been harshly criticized internationally for its lack of response to COVID-19, including not implementing social distancing measures. Keeping schools open is one example of them. On May 25 the Government released a White Paper associating criticism of its COVID-19 response to attempts of “coup supporters” to destabilize the economy. This article gives a glimpse into the impact of the virus on the educational system, and the decisions that parents are facing in light of the virus and government policy.
“If the school year is going to be lost, then lose it”, the reality of thousands of Nica children in the face of COVID-19
Losing the right to education or taking the risk that your children be infected with COVID-19. This is the dilemma that parents face in light of the decision of the Ministry of Education to continue classes in spite of the fact that the pandemic is in the phase of exponential expansion.
For some people the home has been turned into a school, while others are already resigned to repeating the school year, because the Ministry of Education decided not to suspend classes for public schools, which is why many students had to quit attending classes to avoid being infected with COVID-19.
He is just a five year old boy, and he was beginning to get used to getting up early, doing homework, having a teacher and classmates, but now he asks, why am I not going to school? Tania Muñoz, former political prisoner from Masaya and an opponent to the regime of Daniel Ortega and Rosario Murillo, told La Prensa that for more than a month one of her grandsons, “the youngest”, had to quit school to ensure his health.
Muñoz explained that, after the first case of COVID-19 was announced in Nicaragua in March 2020, she began to talk to her daughters and sons that were still going to class, so that they would quit going or quit sending her grandchildren.
One of the youngest grandchildren of Muñoz quit going to class in the Benito Juárez Public School, where he was in third level of preschool, because his relatives said that “they were not giving us options there to continue classes from home.”
The former political prisoner stated that, when she spoke with her daughter, she told her that she did not want “to be bitterly crying over the death of one of her grandkids just so he wouldn´t lose a year of school. I told her that if the boy was going to lose the year, let him lose it, but we are not going to expose him to being infected” with COVID-19.
Now, in the afternoon and sometimes into the evening, the Muñoz home is turned into “the school”, because her grandchildren and children work on studying the guides that they receive from the private schools where they go, while the youngest who was pulled out of the public school works on coloring and getting to know numbers and letters, until he can safely return to school.
The situation of Muñoz´s grandson is not unique in Nicaragua. According to statistics offered by the Vice President of the Ortega regime, Rosario Murillo, at the beginning of the school year there were a total of 1,800,000 students in different schools in the country.
According to Murillo, in preschool the registration was 280,558 children. In primary school, 890,932 children, including distance primary school in the countryside, while there were 390,569 students registered in secondary school, including distance secondary school in the countryside.
The presidential advisor on educational issues, Salvador Vanegas, in an interview on Channel 10 at the end of April 2020, after more than 3 weeks of the announcement of the first COVID-19 case in the country, recognized that 50% of the students in “the more urban” public schools quit going to school.
“The fall in attendance varies from one municipality to another. In more urban municipalities like Managua, absenteeism was larger. The farther the schools are from the urban areas the more they are operating practically with normal attendance of between 88-92%. In the more urban schools, it has dropped to approximately 50%”, said Vanegas.
Juana Palacios, who had one of her sons studying in a public school in the capital, recognized that certainly part of that percentage of absenteeism was due to the absences of her son, because she says that since the report of the first case of COVID-19 in the country, she began to send him in a staggered way, and protected with a mask.
The son of Palacios is 14 years-old and was in the third year of high school in a school in the capital. His mother states that she sent him in a staggered way at least for a week and a half with the hope that the Ministry of Education “would do something.” The mother was hoping, at least, that they would allow her son to receive guides from his teachers once a week, but that they would not make him be exposed. Nevertheless, that did not happen, and she decided to quit sending him.
The third-year students in addition informed his mother that, during those days that he had to attend in a staggered way, he noticed that only between 8-10 of his classmates were showing up, when in his section there are more than 20 students.
Palacios recognized that even though classes were not suspended, they decided to put a sink for hand washing at the principal entrance to the school, but she thinks that this “was not enough.”
The mother tried to talk with the teachers and reach an agreement, so that her son would not quit exercising his right to education, but it was not possible because the order was clear, they had to keep attending classes.
“I spoke with the teachers, I told him that I was going to quit sending him because of the situation, and he said to me that I should do what I thought was helpful”, commented the mother of the secondary student.
Now the adolescent passes the time closed up at home and from time to time – on learning about the topics that are being taught in the school – works on reviewing them with the help of his older sister, but not always, because the teachers are not providing guides to the children who withdrew out of fear of infection from COVID-19.
“I cannot expose him. If he has to lose the school year, let him lose it, because here we are only in the hands of God,” said the mother of the student.
The family of Palacios survives on a minimum salary, and the contribution that now her older daughter provides, who is now working, nevertheless, this is not enough to put the adolescent in a private school, which is why they have the hope that – once the pandemic passes or they can control it – the student can return to classes in a public school and with all the assurances of safety for his health.
Up to now according to the government in Nicaragua a total of 279 positive cases of COVID-19 have been reported, 17 have died, 199 have recovered and the rest are active cases.
They violate the right to education
The high number of absences in public schools, according to experts on educational issues, could have been avoided if the Ministry of Education would have complied with its task of providing options to the student community to continue safely exercising their right to education.
Ernesto Medina, the president of the Eduquemos Forum, stated that the first thing that the authorities of the country had to have was the “political will to help the poorest find a solution, and unfortunately so far we have not seen this, because they have not suspended classes and are not providing an alternative to those who report that they are going to quit sending their children to protect them from COVID-19.”
The expert stated that it is critical that the authorities “seek out a humane solution, because the solution cannot be to expose some children to the danger or threaten them with losing the school year for defending the right to life.”
On his part, Jorge Mendoza, the Director of the Forum on Education and Human Development, recalled that in times of emergencies “the creation of alternative programs is justifiable, they should even be already prepared,” which is why he states that for all those children who have not gone to school because their parents want to protect their right to life, it is critical that MINED ensure they have safe access, with options that would reassure their parents and not allow that the younger ones lose the school year.
In addition, he recommended that the Ministry of Education “suspend classes immediately” and adopt measures that would be adapted to the economic reality of the students and the capacities of the teachers.
The experts agree that MINED, in the case that it would decide to suspend in person classes, should consider the use of means like television, radio or cell phones themselves to teach “essential content”, and in this way the students might be able to continue learning from home and exposing themselves to less risk of contracting COVID-19.
The following pronouncement appeared as a paid advertisement in the Saturday, May 9, 2020 edition of La Prensa. The next day, six former Nicaraguan Ministers of Health sent a joint letter to the WHO and the PAHO warning about the lack of response on the part of the government to the pandemic; and COSEP issued a statement in support of this pronouncement of Health Care professionals. In addition, the Nicaraguan Medical Association reports 60 confirmed COVID-19 cases among health care professionals, and have denounced this past week that fact that several doctors were fired for reporting on infected cases in state hospitals. It has been five days since the government has released statistics on the incidence of coronavirus in the country.
Pronouncement from Health Professionals in the face of the COVID-19 Pandemic in Nicaragua
This past March 11, 2020 the World Health Organization (WHO) declared that the outbreak of a new Coronavirus (SARS-CoV-2), started in Wuhan, China in November 2019, had become a global pandemic. As a consequence of this outbreak, the WHO advised the implementation of national contention and mitigation plans for the epidemic, for the purpose of attaining its control. The lessons learned in China, the European countries and America have taught us that the late implementation of these recommendations has given rise to the collapse of health systems in many countries, with the subsequent rise in the mortality rate and enormous social and economic impact.
We health care professionals, in the face of the expectation that the Nicaraguan government would follow the guidelines of the WHO – like the rest of the Latin American countries – placing priority on the common health and wellbeing of the people, at the expense of great economic sacrifices, still hoped that the health authorities would develop and implement a national plan with basic measures of preparation in the face of the imminent threat of SARS-CoV-2, such as:
Contention Measures, through:
Identifying location, follow up and isolation of cases and contacts of COVID-19
Appropriate sampling of the population for the identification of suspected cases.
Partial or complete closure of land and air borders.
Training, preparation and supply of appropriate means for all the health personnel for self- protection, and adequate treatment in private as well as public health unit.
Development of treatment and case management protocols for cases diagnosed with COVID-19.
Increase in the perception of risk and education of the most vulnerable populations in the country, like the elderly, people with multiple comorbidities, and immune-compromised patients.
Mitigation measures, like:
Physical distancing, restriction on mobility and mass concentrations, as well as quarantine and isolation of affected populations.
Hygienic-sanitary measures, like frequent hand washing.
Use of masks for the general population in places where people congregate with the risk of transmission of the infection.
Transparency of information and communications, with clear, brief and precise messages to the general population
Nevertheless, instead of complying with the recommended measures, the Nicaragua Government has promoted mass activities (like the March of Love in Times of COVID, Summer Plan, boxing tournaments, baseball games, Mayo ya welcome parties, etc.), its educational campaign has been extraordinarily timid, with the aggravating factor of exposing health professionals to the risk of infection, with the modalities which have not demonstrated any effectiveness, like the so called house to house visits. Nor have they adequately equipped health units, and health workers lack the basic protective measures to treat the sick population with minimal risk. On the contrary, the use of masks has been discouraged and restricted, and in some cases even prohibited, jeopardizing the health of health care workers.
Likewise, confusing information has been generated on people affected by the infection. This type of communication has created disinformation among the population, blocking the responsible management of the health crisis, becoming instead a factor facilitating the spread of the infection.
For its part, the sampling of suspected cases is extremely insufficient to detect the progression or development of the infection, it is found to be centralized and done under arbitrary and capricious criteria, which pursues the concealment of the status of the epidemic.
It is important to highlight that SICA in their report No. 16 on April 3, 2020, said the following:
“Nicaragua received today the donation of US$1 million on the part of the Republic of China (Taiwan) to face the COVID-19 pandemic, in the framework of the Regional Contingency Plan of SICA: Thanks to this solidarity support, medical inputs and equipment will be increased to treat patients affected by the virus in Nicaragua.”
In the table that summarizes the measures implemented in each one of the country members of SICA, Nicaragua, in contrast to the rest of the countries, did not suspend classes in public and private institutions, nor did it restrict the entry of foreigners into national territory, and did not confirm whether it implemented telecommuting as a measure for the prevention of contagion.
For its part, the Central American Bank for Economic Integration (CABEI) in the first week of April delivered to Nicaragua 26,000 rapid tests for the diagnosis of COVID-19, and in contrast to the rest of the country members of SICA, Nicaragua has not reported on the plan for distribution and testing in the country.
Also the Assistant Director of the Pan-american Health Organization (PAHO), Jarbas Barbosa da Silva, this past April 24, stated that they “cannot do an evaluation” of the situation of the pandemic in Nicaragua, and reiterated that “in Nicaragua the situation is still undetermined”, in other words, data does not exist on “what the situation of the pandemic is at this time.”
We think that as Nicaraguan citizens we have the right to receive quality holistic health care, without discrimination, and it is the inherent obligation of the state to ensure it. In addition to health care being a Constitutional Right, it is a Human Right, and it is the non-transferable responsibility of the State of Nicaragua to ensure this right.
Therefore, we health care professionals, demand and insist that the government of Nicaragua, in the face of the scenario of the natural evolution of this pandemic:
Free up massive testing at the public as well as private levels. Doing universal sampling is fundamental to be able to mitigate the epidemic, and reduce its impact on mortality and the health services of the state and the nation.
Make the pertinent data transparent on the evolution of the epidemic in accordance with international epidemiological standards, using technical and clear language.
Publicly establish their contingency plan in the face of this public health emergency, and immediately implement social distancing measures and the restriction of mass gatherings, as well as the isolation and quarantine of those who merit it.
Ensure adequate protective measures for all health care personnel of public treatment services.
Ensure sufficient existence of diagnostic means, medicines and life support systems (like ventilators) to all COVD-19 patients who need it.
Ensure – like the rest of the SICA countries – policies of reduction or cushioning of damage on the social-economic level (freezing rates for water, light, value added taxes and bank debts, support funds, etc.) that would allow for relief in the face of the health crisis for health care workers and the citizenry in general, as well as ensure the effectiveness of human rights for the most vulnerable part of the population.
In spite of the negligent management of the COVID-19 pandemic in our country, and that economic stability has taken primacy over health care and the common good of the Nicaraguan people, we think that – in the moment of the beginning of the rise in the curve of serious cases – it is still possible to carry out mitigation actions that might reduce the catastrophic impact on the rate of lethality and the health care system.
We acknowledge the health care personnel who – in this health crisis – continue offering treatment to the population without the needed protective resources.
TO THE GENERAL POPULATION, WE URGE YOU TO STAY AT HOME, FOLLOWING ALL THE PERSONAL PROTECTION MEASURES!
[540 signatures from Health Care professionals, General Practitioners, Specialists, Sub-specialists, Odontologists, Bio-analysis Clinics, Psychologists and Nutritionists].