Letter to the Editor: The Nicaragua Example

Lori Hanson

In Lies, Damned Lies, and “Official Statistics” authors Maria Gargiulo and Megan Price offer an important reminder of the inherent difficulty and potential danger in collecting data and providing information to the public during a pandemic, using examples from both authoritarian right-wing and authoritarian ‘left’ regimes in Latin America. They propose similarities to the work of collecting data in conflict situations.

The story behind at least one of their examples of such danger – Nicaragua – is a story of both the pandemic and ongoing conflict. As I wrote in Health and Human Rights in August 2018, the persecution of health workers in Nicaragua became a “side effect” of conflict that erupted after a student-led uprising was brutally crushed by state and paramilitary forces. Ongoing repression of civil society has only intensified as November’s national election nears with the Ortega-Murrillo regime exhibiting increasing obsession with eliminating any possible opposition or threat to their rule. The country’s slide into dictatorship is already present. This current context is the background needed to understand the dangers to scientists during this pandemic. And those dangers have just deepened.

On Wednesday, July 28, deputies of the Nicaraguan FSLN-led assembly voted to annul the legal status of 24 more NGOs operating in the country, 15 of which were medical associations that had allegedly criticized the government’s pandemic management. Among them were professional associations of nephrology, diabetology, pneumology, urology, leukemia, dermatology, infectious disease, and psychology. Professionals in these organizations included clinicians who worked with the COVID-19 Citizen Observatory, and/or who had signed a petition in June 2020 asking the Nicaraguan Ministry of Health (MINSA) to follow WHO preventive guidelines and requesting PPE. Among them were senior clinicians who had been fired from positions in MINSA even prior to the latest round of NGO annulments.

While one Ortega-supporting commentator relentlessly attempts to discredit the Citizen Observatory, accusing it of exaggerating and fomenting civil discontent, most reasoned critics of all political stripes agree with international condemnation for the government’s obfuscation of COVID-19 facts. The true data is not publicly released.

Gargiulo and Price optimistically conclude: “COVID-19 is not the first crisis where governments have attempted to lie with statistics, and it may not be the last, but it provides an opportunity to establish precedents to ensure that there are consequences when science is jeopardized by the state.” But who will ensure such consequences? While statistics can lie, truth is always the first victim of conflict. It is only the end of the emergent dictatorship in Nicaragua which might lift the veil on the empirical story of COVID-19. I’m not sure when that opportunity will emerge.

Lori Hanson, MSc, PhD, Professor, Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Canada.