Nicaragua has a stupidity problem.

Wall Street Journal

LATIN AMERICA

In Nicaragua, Doctors Who Spoke Up About Covid-19 Also Lost Their Jobs

Physicians say the country’s authoritarian government is retaliating against them for signing public letters urging virus-containment measures and protective equipment.

By José de Córdoba

July 27, 2020

MEXICO CITY—Carlos Quant, an infectious-disease specialist at a Managua public hospital, was fired in early June after he organized a group of like-minded colleagues to tell Nicaraguans how to protect themselves from the new coronavirus.

Since then, at least an additional 21 doctors in Nicaragua—the second-poorest country in the Western Hemisphere, after Haiti—have been purged, losing their jobs in public hospitals across the country, according to testimony from doctors and medical associations. Two others resigned.

Doctors say the firings are retaliation by Nicaragua’s authoritarian president, Daniel Ortega, and his wife, Vice President Rosario Murillo, for calling attention to the pandemic. Nearly all of the fired doctors, including Dr. Quant, signed public letters asking the government to confront the coronavirus threat and calling for protective equipment for health-care workers.

“The crime is raising your voice, calling for measures to contain the virus, and helping doctors to get protective equipment,” says Dr. Quant, who was fired June 4 from the Roberto Calderón Hospital.

Human-rights groups such as Amnesty International, Human Rights Watch and the Office of the United Nations High Commissioner for Human Rights have protested the firings. Ninety writers, artists and intellectuals led by the Peruvian Nobel Prize winner Mario Vargas Llosa, wrote a letter to Mr. Ortega protesting the firings. “It’s a crime to politicize medicine, especially in the middle of this terrible pandemic,” the letter said.

The government has ignored the criticism. Neither Ms. Murillo, who serves as the spokeswoman for the government, nor Nicaragua’s health ministry responded to requests seeking comment.

The offensive against doctors is only part of the Nicaraguan government’s broader approach to the pandemic that health experts say has been secretive and erratic. Nicaragua didn’t shut down, and the country didn’t implement social-distancing measures. Its public schools and universities never closed—except for an extended midyear vacation. They reopened last week.

Officials in the governing Sandinista National Liberation Front party eschewed masks. And instead of banning mass gatherings, the government continued to promote festivals, sporting events and political rallies, including one in March called “Love in the Time of Covid-19,” during which thousands of Sandinista supporters walked more than a mile on one of Managua’s principal avenues under their movement’s black-and-red flags.

Since then, even as coronavirus cases and deaths have risen, the government has actively covered up the extent of the pandemic, and gone after those who try to counter its narrative, according to local doctors and health experts.

As of July 21, the Nicaraguan health ministry had reported 3,439 coronavirus infections and 108 deaths for the country of 6.5 million people. Doctors say the death figure is absurdly low. “I personally know 10 people who have died of Covid,” says Dr. Leonel Argüello, an epidemiologist in Managua, referring to Covid-19, the disease caused by the new virus.

An independent organization, the Citizens’ Covid-19 Observatory, made up of doctors and health workers, has kept its own tally from the records of hospitals and doctors. As of July 22, it listed 8,755 cases of suspected infection, and 2,487 deaths—roughly 23 times the official number of deaths. That would put Nicaragua’s per capita death toll at 38 per 100,000 people, the 13th-highest in the world, just after Brazil.

Nicaragua hasn’t allowed doctors from the Pan American Health Organization, the U.N.-affiliated regional health organization, to access the country’s hospitals. And it provides no information on the results of the tests it gives, making it impossible for health specialists or Nicaraguans to have a clear idea of the state and path of the pandemic.

“We continue to be very concerned about Nicaragua’s response to the coronavirus, including testing, contact tracing and reporting of cases and deaths,” the organization said.

For weeks in May and June, hospitals were overwhelmed. Nicaraguan cities became the scene of what are known as express funerals, in which bodies of Covid-19 victims were rushed to cemeteries in the middle of the night for quick, sparsely attended funerals.

During the past few weeks, the virus’s upward curve appears to have leveled off, but the lack of reliable statistics makes it impossible to get a clear picture of the pandemic, local doctors and international health experts say.

In recent days, Mr. Ortega’s government appears to have made a grudging nod to the grim realities of the coronavirus, which is widely believed to have killed a number of government officials and ruling-party members.

Among the dead Sandinistas are a former mayor of Managua; four national lawmakers; and Edén Pastora, who fought on both sides of Nicaragua’s civil war and ended his days as an Ortega supporter. Death certificates say all the figures died of various other causes, such as pneumonia or heart attacks, but few in Nicaragua believe that.

“They didn’t take it seriously,” says Dora María Téllez, who was once a Sandinista commander but is now an Ortega foe. She estimates as many as 200 government, security and party officials have died from Covid-19.

On July 19, Mr. Ortega wore a mask publicly for the first time since the start of the pandemic, as he presided over an outdoor gathering of about 800 Sandinista youths, who sat in a large circle far away from the leader. The gathering to mark the anniversary of the 1979 triumph over the late dictator Anastasio Somoza was a far cry from previous years, when as many as 300,000 people jammed together for the celebration.

A few days after Dr. Quant was fired in early June, Dr. María Lagos lost her job. Dr. Lagos says she was the only pediatric pulmonary specialist in Estelí, a city in northern Nicaragua that is experiencing a serious outbreak.

From the beginning of the pandemic in March, she distributed hundreds of donated masks and other protective equipment to personnel and patients at her hospital. Because masks were seen by the government as politically incorrect, Dr. Lagos says she was the only doctor at the San Juan de Dios Hospital using one. She says she was eventually fired because she distributed the donated masks.

“They had prohibited the use of surgical masks because they said the virus only went after rich people, and it wasn’t going to enter Nicaragua,” says Dr. Lagos.

In late March, pro-government media ran antimask proclamations. One, in the Sandinista newspaper Barricada, said “The coup plotters have taken off their masks and put on their surgical masks.” A pro-government radio announcer called Covid-19 “the Ebola of the rich and the white. A lot of rich people are dying.”

In May, as deaths surged and criticism mounted, Nicaragua’s government published a white paper accusing its domestic foes, allied with U.S. intelligence agencies, of waging a disinformation campaign to undermine the Ortega government. “They have seen in the pandemic a great opportunity to scare and misinform the people…and corrode confidence in the government,” the white paper said.

It isn’t the first time that doctors have come under fire from the Ortega government. In 2018, more than 400 doctors, nurses and health workers were let go from jobs in public hospitals for taking care of Nicaraguans injured in protests against the Ortegas that at one point threatened to topple the regime. At least 300 people died in the protests, most of them killed by security forces.

“The regime considers the doctors to be coup plotters in white coats,” says Dr. José Antonio Vásquez, a surgeon who was fired in 2018 in the wake of the protests. “They fired them to send a message to other doctors, to terrorize them: If you talk, you will lose your job.”