From: rastern@sol.racsa.co.cr Date: Sat, 21 Mar 1998 09:10:35 -0600 (CST) Subject: AIDS IN NICARAGUA IN NICARAGUA, PEOPLE WITH AIDS ARE EXCLUDED FROM MEDICAL ATTENTION by Guillermo Murillo and Richard Stern A short fact finding visit to Nicaragua has revealed the terrible plight of People who live with AIDS in this Central American nation of 4 million inhabitants. Basically, people with AIDS in Nicaragua have little hope of receiving treatment for their opportunistic infections, let alone the newer anti-retroviral medications that, while not a cure, offer hope for recovery. In Nicaragua you live as long as you can without medical intervention, as if all the medical advances that have occurred in the last 15 years have not yet penetrated the Nicaraguan border. What medical attention is available is through private non-governmental organizations such as the Xochiquetzal Foundation. Agency director Hazel Fonseca said that Xochiquetzal tries to buy medicines for opportunistic infections, using fees it collects from the few patients who have the ability to pay for services. But in all of 1997, just $7,000 was collected for this program. There is a support group for patients who come to Xochiquetzal, attended by about a dozen persons, two of whom had died the week before we arrived. The Nicaraguan government´s own AIDS Department Coordinator Dr. Roberto Pao, openly acknowledged that the government will not treat with anybody with AIDS, even if they are paid up members of the National Health insurance program. AIDS is a on a list of conditions that are excluded from government medical attention. A person with AIDS may try to get medical attention for an infection, but must try to hide from health the authorities the fact that they have the AIDS virus. This is not so difficult since the government does not have the "reactives" necessary to test for the presence of the virus. There are only 170 officially diagnosed cases here, but almost everyone agrees that there are hundreds of cases that have never been officially reported. Many Nicaraguans leave the country to work in other parts of Central America, where the rates of infections are much higher. When they return, infected, there is little help available for them. Nicaragua shares borders with Honduras, which has 10,000 cases and Costa Rica which has 1,300. Paradoxically, a very progressive law has recently been passed by the Nicaraguan leglislature which guarantees the rights of Nicaraguan People Living with AIDS, but the law appears to have little impact on improving conditions for people with AIDS. Discrimination and misinformation are rampant. There is no hospice for men who have AIDS although a small program has recently been opened which houses 4 women. Nicaragua has been thrashed for the last 30 year by natural disasters, war and political upheaval. The recently elected government of Arnoldo Aleman appears to be trying to stimulate international investment and privatize many government Agencies, including the health care system. It would appear that any relief for Nicaraguans living with AIDS must come from initiatives that would have to be taken by the International Community. Leaders of both ONG´s as well as Dr. Pao, were strongly critical of the lack of participation of the United Nacions organization for AIDS, UNAIDS, in Nicaragua. The world health organization and Panamian Health organization did spend $159,500 there in 1995 for a seminar for leaders of the Nicaraguan religious sector held in the beachfront luxury resort of Montelimar. Rita Arauz of Fundacion Nimehuatzin attended one of the sessions and said that it was led by bible thumping religious fanatics urging chastity. For direct contact with Nicaraguan ONG´s: Fundación Xochiquetzal P.O. Box N° 112, Managua, Nicaragua tel: (505) 249-05-85 fax. (505) 249-13-46 e-mail: quetzal@ops.org.ni Fundación Nimehuatzin A,P. A-262, Managua Nicaragua tel. (505) 278-00-28 fax. (505) 278-65-34 e-mail: nimehua@ns.ops.org Guillermo Murillo/Richard Stern Asociacion Triangulo Rosa Apartado 366-2200 Coronado, Costa Rica Tel: 506-433-8522 506-234-2411 Fax: 506-234-2411 e-mail: rastern@sol.racsa.co.cr luasovih@sol.racsa.co.cr