Tortilla con Sal, October 10th 2018
Interview with Dr. Judith Lejarza, Director of León’s “Oscar Danilo Rosales Argüello” Hospital and with Dr. Marcelino Blanco Rodriguez, Director of León’s Integral Local Health Authority (SILAIS).
Tortilla con Sal: What was the impact of the failed coup attempt on your work here in León in the “Oscar Danilo Rosales Argüello” Hospital and in the Integral Local Health Authority (SILAIS)?
Dra. Judith Lejarza : The period of the coup attempt in our country was a very difficult time for all health workers because as well as guaranteeing our own security we had to maintain free heath care for all the population of our León. It’s undeniable that people were fearful, however they continued arriving for care in our hospital which we kept open 1005 of the time giving free health care to the whole population regardless of any difference of political opinion, sexual orientation or religious belief.
We never received orders to close our doors. Saying we did is false. All our health workers guaranteed care, for people who were wounded, for pregnant mothers for children. Everyone who sought medical care received it. We saw how our health workers had various difficulties getting around, as a result of barricades. threats, including efforts to violate their rights when trying to get through roadblocks, especially our nurses. Even so and despite the distances involved, they always set out to deliver care to our population.
The hospital was under threat on different occasions. On three occasions it was attacked by the people who were causing the street violence and threatening and putting at risk the lives of our patients and health workers. However, we organized ourselves as the Ministry of Health to ensure care for the whole population, guarantee the security of our health workers and maintain the benefits of our government for the welfare of the population, the right to free health care with all the benefits that brings.
Dr. Marcelino Blanco Rodríguez: The SILAIS León was badly affected by the events during the months of the coup attempt since we in effect have three health sectors, namely a primary hospital, a regional hospital and ten health centers. In effect, with the roadblocks and the difficulties our ambulances had not being able to get around freely in a normal way we had serious problems. Because they also stole our ambulances, even ordering patients out of the ambulances just so they could get hold of the ambulance.
They kidnapped many of our health workers. They destroyed our ambulances. They set fire and burnt out one of the hospital ambulances. They totally destroyed an ambulance from the Telica health center They smashed the windows of the ambulance in the Malpaisillo health center. They machine gunned the front of the ambulance from the Jicaral health center. In sum, what the roadblocks caused us was sheer terror for our health workers who with great dignity with a complete spirit of service arrived and transported patients, at great risk to themselves. They risked their lives because some of them were even kidnapped for periods of time.
We couldn’t transfer patients to hospital because the coup we were practically imprisoned. The roadblocks prevented us getting to the hospital here and we had to travel to other SILAIS, like the SILAIS in Estelí or the SILAIS in Chinandega who opened their doors to us to take our patients given the problems caused by the coup attempt which seriously affected our health care system, above all parts of the infrastructure and our health workers themselves.
Dra. Judith Lejarza : Annd in that regard too one should bear in mind that it was not just the ability to move personnel and vehicles but also supplies to the hospital were blocked. We had problems to get medicines in, to get food in because everything was held up by the opposition thugs who didn’t let them through either to the hospitl or to the other health care units out in the municipalities. That’s why Dr. Blanco mentions the moments when the SILAIS of other departments had to help us out.
Because, as a result of the roadblocks, the most direct way to a hospital was to go to the hospital in Chinandega or to the hospital in Estelí, given the blockade of free movement of the freedom of movement to which our people have a right. And as well as impeding the entry of patients to the hospital here they also blocked transfers of patients to better resourced hospitals in Managua, putting at risk the well being of seriously ill patients. But thankfully God was on our side and despite all the limitations from one moment to the next we managed to give those patients the care they needed.
TcS: Did the coup activists invade the hospital at all?
Dra. Judith Lejarza : They tried to get into the hospital on three occasions. Thanks be to God, thanks to the solidarity of some comrades, thanks to our health workers, patients realitves and even some patients themselves, we managed to defend the hospital so they could not get in. We guarded the different hospital entrances, both on the north side by Emergencies and the entrance on the University side and we managed to deny entry to any of those criminals who attacked, threatened and violated our rights with stones and clubs, disregarding the calm needed by our patients since in a hospital we have to respect the need for quiet of someone who is sick.
Thanks be to God and the comradeship that prevailed in those days we managed to prevent them entering and we didn’t have more serious difficulties as they did in other hospitals like the Hospital Alemán in Managua where their rights were violated and their workers threatened with firearms. The hospital in Masaya also suffered that aggression. Thanks be to God, here our health workers, patients and relatives of patients defended the hospital.
Dr. Marcelino Blanco Rodríguez : In some of the health units, like the case of Nagarote they did in fact invade the pharmacy. They stole property of the health center. Those criminals even invaded the maternity care unit as well and they set about destroying and stealing the equipment there, aggressively threatening our health workers and demanding that they hand over the ambulance. They took the Nagarote health center ambulance and they used it for a long time, before wrecking it.
TcS : One of the most common accusations against MINSA is that there were orders not to attend patients who sympathized with the opposition coup promoters…
Dra. Judith Lejarza : That is false. At no time did our authorities nor our good government give orders to deny care to any patient. To the contrary, the order was to ensure car and security to all these patients. To the extent that while legally we are obliged to inform the police of any wound caused by firearm or sharp weapon or of any traffic accident that puts a patient’s life at risk. But during this period we did none of that beyond ensuring medical care, ensuring patients’ health and ensuring all that was necessary to give them good care.
It’s a smear that the coup promoters who tried to take over the government used to try and convince our population of that lie. But our population maintained their confidence in our hospitals and came to seek care. The most seriously ill came here to this hospital. Thanks be to God we had no deaths caused by the problems of ensuring health care. For everyone who came here seeking medical care we guaranteed their health and they left this hospital in excellent condition.
TcS : They also accuse MINSA of having taken repressive administrative measure against meical personnel that gave care to opposition sympathizers and activists…
Dra. Judith Lejarza : We, as the Health Ministry at no time have carried out repressive measures against any health worker. We have always respected their beliefs, their ideology, their decisions so long as they ensure the health of our population. But abandoning their posts or mistreatment of patients or abuse of our work colleagues are things we cannot permit. And that is why those people were withdrawn from our institutions because it was proved that they mistreated patients, relatives of patients, fellow workers and colleagues and abandoned their work posts putting at risk the lives of patients who came seeking health care.
They abandoned their work posts at different moments. We passed a long time with the attempted coup. But even after there were no barricades and no direct aggression, even then we found ourselves threatened, besieged by hostile news media who supported the coup attempt and encouraged the population here to come and create chaos in the health institutions. These people left there places of work, even denied care to patients in different ways and that is not attitude or behavior the health Ministry can tolerate.
Because one of the orders of our good government is to guarantee free health care to our population and the right to life that all of us have. So with the mere fact of abandoning our work area, for example if I am supposed to be in surgery and I go to pathology or if I should be in the pediatric areaadn I go off to the University, that is abandoningand putting t risk the life of a patient who may be in a critical state without the quality of care they need to save their life.
TcS : What have been the effects on your health workers of their experience of the coup attempt?
Dra. Judith Lejarza : With regard to the psychological impact we have many fellow workers who are afraid when they go out in the street or if they here the home made mortars… patients too, when they heard a mortar go off they’d try and get out of the hospital because at that time they were afraid it could be invaded.
We are addressing all of that. We have a specialized area of psycho-social care here where care is free and people can come during the day for therapy, relaxation therapy, therapies with psychologists and psychiatrists. If one of these patients presents a more serious anxiety or depressive trauma we have the medical care to give them support.
With regard to our fellow health workers the psychological damage is serious. There are male and female fellow workers who were threatened and searched at the barricades and they are afraid of crowds, they are afraid if someone creates a scene or a scandal. One can see the anxiety in their face and we are working hard on that with them We have relaxation work, therapy with psychologists.
But its something we all have to be open to, to accept we have a problem so as to be able to accept the help we need. There are still people in denial who don’t accept that what happened happened, but they have indeed been affected psychologically and we as MINSA and as the health authorities are engaged in helping all our fellow health workers.
Dr. Marcelino Blanco Rodríguez : A group was also created of psychologists and psychiatrists who are attending directly relatives of people who died and people who were wounded. Some of these receive this attention in their homes so it’s possible to see what their home environment is and give them the psychological and psychiatric care possible with continuous organized routine visits and in that way we are helping the population, because the psychological is working with impact of the attempted coup was also very strong. Having to deal with the roadblocks, with threats, with those deaths caused by the coup activists among our population, all that also caused a lot of psychological distress and that is why this program is working with people who suffered these problems directly.
TcS: And how do you see MINSA’s work after the attempted coup?
Dr. Marcelino Blanco Rodríguez : After having had around 770 barricades in León we are gradually getting back to stability and tranquility where people can move around normally without difficulty, with no one threatening them, where they can carry out their normal activities and go to work in tranquility. I think this is essential. And what the government has done in effect is make freedom of movement possible, a return to normality so we can all continue working together to carry Ncaragua forward as a single people, that is essential. Gradually one can feel again the stability that Nicaragau needs so much to be able to get ahead.
Dra. Judith Lejarza : As Dr. Blanco has said we are returning to normal. How can we see this? We see it in our population walk the streets in tranquility, they are doing activities at night time that before were practically abolished. Nobody could go out after 3.00pm because the coup activists on the barricades threatened them, threatened to kill people out after 3.00 in the afternoon. But not now. Now we see our young people, our students who had also had their classes stopped and now we are seeing students in the hospitals, students in the university returning to normal and the recreational activities at night time.
The people, the population go out in peace and tranquility and with security because our police force is minding the streets. That was something this attempted coup tried to steal from us and thanks be to God we now have it back. The police make it secure for us to move around and go about our normal work and our different activities. There are workers in the Free Trade Areas and these at three or four in the morning had to make their way through the barricades and roadblocks where they were threatened, searched and robbed of their personal things and belongings, their food. Similarly on their way back home if the coup activists hadn’t got anything they charged money to people so they could pass trhough those places.
But now our population is returning to normality. We are seeing tourists. We are seeing confidence returning in our people. León as a university and tourist city is returning to normality. It’s engaging in its day to day activities, the students are going to their classes, people who need to go to a health care unit have free access to all areas without threats. It has been a hard process and it will take time to repair the damage the coup promoters caused to our economy and our international image because Nicaragua was one of the main tourist countries. León along with Masaya and Granada were tourist spots and this attempted coup tried to change that image. But really we as a population, as a people are making the greatest of efforts to return and recover all that our good government achieved during such along period of time and that the coup promoters wanted to trash in recent months.
Dr. Marcelino Blanco Rodríguez : Citizen security is essential. The work the police are doing to make people feel secure again is tremendous. León is again able to move around. there is more activity at night time and the police are keeping watch. In the end that security the police provide is really great because ti allows people to do their routine activities as normal, which is essential.