Having visited Nicaragua and spent some time with the locals of the poor class, Nicaragua’s health care system is of interest to me. Looking back I wish I would have asked more questions as to the state of healthcare, especially now that I know a little more about the country.
Nicaragua, as well as most of the world’s poorest countries, went to the World Bank and IMF for assistance. They were advised to strengthen privet sectors by lowering spending in non profit areas. This resulted in a cut to healthcare funding. I understand where the World Bank and IMF were coming from in a way. It makes since, if you want to increase your economy, put money into areas that will produce the goods and encourage the growth of economy. However I don’t think that you should be forced to cut health care funding in order to adhere to the conditions set out by the World Bank and IMF. Adding this cut of healthcare to the already unequal health care system and many people will have to go with out the basic care they need to survive.
Inequality is very prevalent in the Nicaraguan health care system, which has three tiers. The upper class of Nicaragua receives their healthcare privately, and what care they cannot receive in their own country, they will receive in others. The working class, comprising about eight percent of the population and only includes those working for the government and industries, receives their health care through The Nicaraguan Social Security Institute, which they and their employers pay into, and is similar to insurance. This “insurance” is mainly government funded and the majority of the government health care budget. The Nicaraguan Social Security Institute provides for basic medical care including medications and care for the spouse and young children of the family.
The rest of the Nicaraguan population, about ninety percent, the poorest receive public healthcare that is poor and mismanaged at best. There are public clinics for these people to go to, but many of these clinics lack the resources need to be helpful. In addition to the poor quality of these clinics, many of these services are only offered in the larger cities, and the majority in the capital city of Managua. This is leaving the majority of the country without health care services at all, simply because there aren’t any around. If the poor are fortunate enough to receive care, they may not be able to afford it or the medicine. One medical visit could cost several days wages, if they have a job, and several days without food. Is it better to receive medical care than eat?
I have witnessed the dilemma these people are in. While I was in Nicaragua I saw a family whose father was ill but in order for him to receive care he would have to travel to the city, the cost of traveling alone would cost several days pay and they needed that money for food. I also spent a good deal of time with a three year old girl. She had a stomach ailment and her family had taken her to a local clinic, but the resources at this clinic were poor and they could not figure out what was wrong. Her family wanted her to get better but they could afford neither the care nor the cost of traveling it would take to maybe make this little girl better. And so she suffered, this little girl who should have been smiling and happy toddler was sullen and sad.
I see the health care problem in Nicaragua as one with multiple causes. One being that the government cannot fund the care needed for the entire country. Another is that the resources needed for healthcare are not available, this includes the number of doctors and nurses available to serve. Even if these two causes were fixed and there was enough funding and resources I see the last cause as the one that will continue the problem. The people can barely afford food and as long as they are in a state of struggling to nourish themselves, day by day, they will not be able to have the health care they need.
Works Cited:
http://www.jhc-cdca.org/health.html
http://www.access2insulin.org/html/nicaragua_s_health_system.html
http://www.tortillaconsal.com/health_nicaragua.html
http://www.mapsofworld.com/nicaragua/healthcare/
http://countrystudies.us/nicaragua/27.htm
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