LOOKING AT HEALTH CARE
The public health care system in Nicaragua was once very strong, but in recent years it has suffered from a lack of resources. Private treatment can be very expensive, and people are sometimes required to pay for treatment in advance.

After the 1979 revolution, the Sandinista government made health care a priority. About 80,000 brigadistas (volunteer paramedical health aides) were trained and sent all over the country to provide vaccinations and health education. Over the next few years, life expectancy increased and infant mortality decreased. Many more people had access to quality medical care and information for the first time. In 1983, Nicaragua was declared a "Model Nation in Health Attention" by the World Health Organization.

In the late 1980s, health workers and clinics were the targets of Contra attacks. This meant that there were fewer health care resources at a time when people needed medical treatment for war-related injuries and diseases. War damage cost the government a great deal of money, and Nicaragua was a poor country even before the revolution. There was much less money available for health care by the end of the 1980s. Since then, the health care system has deteriorated.
 
 
  Did you know?
Nearly half of all Nicaraguans are under 15, and more than a quarter are between the ages of 15 and 29. Only a quarter of the population is over 30. Poverty-related diseases and long-term warfare kill many people before they get old.
Most doctors and hospitals in Nicaragua are located in the cities. People in the countryside have access to fewer services than people in the cities. Some Nicaraguans who live in rural areas distrust doctors. Because of the country's history of war and oppression, they are afraid that what a doctor says is an inoculation against disease might be an attempt to infect them or to control them for political purposes.

 Many Nicaraguans use faith healers, herbal medicines and indigenous remedies for common ailments, such as lemon juice and honey for fever.
Safe drinking water is not always available, so illnesses such as dysentery and diarrhea that result from drinking contaminated water are fairly common. Many homes, even in the cities, are not connected to sewer systems. This contributes to the risk of contamination and disease. Malaria is common and many children suffer from malnutrition.