Nicaragua Struggles to Aid Its Children

Eight years of socially and economically devastating war with U.S.-backed Contra forces--topped off 10 weeks ago by the most destructive hurricane in decades--have sucked much of the substance but not the spirit from Nicaragua’s 3.6 million people.

A few years ago Nicaraguans talked enthusiastically of government campaigns to reduce infant mortality, eradicate malaria, distribute land to the landless and wipe out illiteracy.

For a while great strides were made toward realizing those goals. But today, for the first time since the revolution that overthrew dictator Anastasio Somoza in 1979, children beg on the streets as government officials reluctantly slash health programs that once drew international praise.

In an effort to help hundreds of thousands of Nicaraguan children who have been displaced, wounded, orphaned or otherwise traumatized by the Contra war, the U.S. Congress appropriated $17.7 million. Two days after President Reagan signed the bill on Oct. 1, President Daniel Ortega said Nicaragua would not accept the money.

To Nicaraguans, refusing the aid was a symbol of dignity and national pride. Tied to the legislation was a second bill that provided a similar amount in non-lethal aid to the Contras, the very forces whose attacks on civilian outposts were--and still are--responsible for the misery of many children.

For Nicaragua to have accepted the aid, said Paul Oquist, an adviser to Ortega, would be comparable to the United States having accepted a donation of blood from Japan following the attack on Pearl Harbor.

“If the U.S. wants to help children, lift the trade embargo and stop the war,” he said. “That would stop the production of orphans and allow more (Nicaraguan) resources to deal with the problem ourselves.”

Critics of the Sandinistas say the party’s bungling management of the economy is the real reason for its desperate straights. They accuse the Sandinistas of torpedoing peace efforts with the Contras, suppressing the opposition press, squelching political dissent and endlessly confounding friend and foe alike with contradictory actions.

Nevertheless, representatives of U.S. and foreign relief agencies based here and even mothers who have lost sons in the war say they supported Ortega’s action.

A summary of the immense effects of the war on children appears in a little-publicized report prepared last summer by a team of American health professionals sent to Nicaragua on behalf of the U.S. Agency for International Development to assess children’s needs. Among their findings, gleaned from interviews with 40 humanitarian agencies working here and with the Nicaraguan government:

-- About 500,000 of the nation’s 1.8 million children under age 17 have been directly affected through destruction or disruption of schools and other services, displacement from homes, death of parents, injuries and psychological trauma.

-- At least 455 children under 15 years have been killed and 691 are missing through the end of 1987. Another 1,542 under 15 have been wounded, with an additional 1,865 wounded among youngsters aged 15 through 20. About 1,200 have experienced serious physical handicaps such as amputations and 568 children have lost both parents, while 138 lost mothers and 9,371 lost fathers.

-- As many as 50,000 children have suffered psychological trauma after seeing their villages shot up, parents or neighbors killed and having been forced to resettle in strange areas.

Despite the cease-fire treaty of last spring, attacks on farm cooperatives and killing and wounding of children continue. In October, in the province of Jinotega, a well-marked Red Cross ambulance was shot up by Contras and one passenger was wounded. The Contras also attacked a civilian truck, killing nine civilians, three of them women. Two children injured in the attack later died. Four civilians were killed in an attack in another province that occurred only hours before Hurricane Joan struck on Oct. 22.

Two American physicians, Tim Takaro and Susan Cookson, who have worked for two years in the Jinotega war zone, said $300,000 of the U.S. aid had been slated for treating intestinal parasites in 30,000 children in their region. But conditions imposed by the U.S. Agency for International Development, which administers such aid funding, would have undermined the existing health system in Nicaragua, they said.

AID requires that any private agency receiving federal funds have no connection with the Nicaraguan Health Ministry. Yet Takaro, Cookson and other U.S. health workers here agree that all private agencies working in health cooperate with the government system because that is the most efficient and economical way to get services to the people.

One of the Health Ministry’s goals since the 1979 revolution has been to expand health centers in rural areas. The policy saved many lives during the Contra conflict. Last summer’s report by the American team on the needs of children noted with some surprise that the primary medical and social needs of most war-injured and orphaned children had already been cared for within government facilities. Most who required specialized care not available in Nicaragua were sent to Eastern Bloc countries, it said. Several Health Ministry doctors said there has been great difficulty arranging for specialized care in the United States.

The priority need now, the report said, is for continuing rehabilitation within the children’s own homes.

All U.S. federal aid to Nicaragua was suspended in 1981. Some of the slack has been taken up by U.S. allies, including Canada, Sweden, Holland, Italy, France, Spain and other European countries who have contributed hundreds of millions of dollars in medical supplies and assistance. Health Ministry officials said the severe strains on the economy have forced them to charge for certain health services that were previously free.

Health workers have also been victims of Contra attacks. So far this year, according to Takaro and Cookson, two volunteer Nicaraguan health workers ( brigadistas ) have been killed in Jinotega province alone, eight have been kidnaped and three are missing.

Because brigadistas live in communities where there is usually no doctor or nurse, their services are highly valued.

“They are hard to replace when killed because others become too frightened to volunteer,” Cookson said. “Eight health centers have been attacked by Contras in Jinotega this year. Some were destroyed and the medicine supplies were always destroyed.”

Hurricane Joan added to the general misery because of the destruction of crops, homes, roads, bridges and service centers totaling $828 million, according to the Social Welfare Ministry. Officials predict severe food shortages beginning in the spring as a result of ruined bean and corn crops. The ministry has called for $16.1 million in aid to clothe and feed for six months the 118,000 children whose lives were disrupted by the hurricane.