Reality Check
By Robert Terenzi, Jr.
On my third day in León, Nicaragua, I made a spectacular find in the local market. Weaving my way through stands overflowing with bright papayas, mangos, and watermelon, I was eagerly greeted by most of the merchants. As a gringo, my white skin, not yet tan, attracted quite a bit of attention. I enjoy walking through local markets, the pace is bustling, and the energy of the people there is contagious. I still remember the first time I saw Mercedes; sitting on a small stool at the end of a long, dark, and dusty row of fruit stands. An elderly, overweight woman, she had an air of authority and solemnity. Her stand was more crowded than the others, and as I approached, I saw her earnestly trying to keep up with her eager customers, methodically ladling various fresh juices into small plastic bags with ice. Her fingers tied off each expertly, and passed them on in exchange for a few cordobas.
I got excited. Call me a sheep, looking for a flock to follow, but when I saw the crowd around the little stand, I knew I needed to try some of that juice. I walked up and ordered a serving of cantaloupe juice. As I took my first sip, I knew I was in love. I came back to Mercedes’ stand everyday from that point on, and she got to know me, and got to know what I liked. I told her one day that I liked cinnamon. The next day, as I approached her stand, brushing past all the other vendors vying for my attention, she proudly produced a bag of juice, which she had prepared specially for me, “with extra cinnamon.”
To be honest, it became not only a ritual, but a highlight, of my day. Everyday, at noon, I would leave the office and seek out my little plastic bag of ambrosia. As I came to the stand this past Monday, a short guy, of about sixteen or eighteen was sitting on her customary stool. I asked where Mercedes was, because she had also failed to show up on the previous Thursday and Friday. The kid informed that he was her son, and that Mercedes had died on Friday.
A diabetic, Mercedes went into a sugar induced shock, and was brought to the hospital by her four children. She needed an insulin shot to rebalance her sugar level. If she could get an insulin shot, she would be all right. Mercedes waited in line at the hospital for six hours, and passed away still waiting to be seen.
Stories such as Mercedes’ are not uncommon at all. The medical community has been on strike since mid-November, demanding a pay increase. While doctors and nurses continue to work in private clinics, only a small percentage of the population can afford to visit these clinics. The average waiting time in the public hospital is at about five and a half hours, and that is only if your case is judged as an extreme emergency.
Who is to blame? The answer to that is not so simple. It would be easy to criticize the medical community because of its lack of compassion and dedication to their patients. But the fact is, that in Nicaragua, general practitioners earn approximately $200 a month and those with specialties around $350, while their colleagues in other Central American countries earn anywhere from three to five times that.
Perhaps the Nicaraguan government should shoulder the blame. They refuse to grant any concessions to the medical community and, after four months, seem to be praying for some blind miracle to get the doctors, nurses, and other medical workers back to their jobs.
It seems as if ultimately, it is the International Monetary Fund and World Bank, which need to account for the loss of life and decline in health in the country by authorizing only a paltry 15% raise for medical workers, still leaving them the worst paid (by far) workers in Central America.
By overseeing, and directing the budget of Nicaragua, the IMF and World Bank has put severe limitations on the government’s ability to manage its own affairs. They have taken the reigns of control out of the hands of the people and its representatives at the threat of a cut in aid. Already the third poorest country in the world, Nicaragua can hardly bear to lose any more aid. So, wrangled from the people by use of threat, the political and economic control of the country is in the hands of a faceless (and apparently heartless) multibillion dollar system of banking. What does the IMF care if thousands of people die in rural communities for lack of the simplest of medical needs, so long as their agenda of free trade and neo-liberalism is advanced? Mercedes’ death serves as a harsh reminder of the travesties a country must endure if it subjugates the fulfilment of its needs to the authoritarian rule of the IMF and World Bank.