[The following interview with Dr. Jean- Michel Krivine, following his recent visit to Nicaragua, appeared in the December 14-20 issue of the French Trotskyist weekly Rouge. The translation is by Intercontinental Press/ Inprecor.]
Question. How did you happen to go to Nicaragua?
Answer. For several months the Sandinistas have stressed their deep concern about the health-care situation in Nicaragua and asked that international aid in this be given top priority. In France and in Europe as a whole there are many people who would like to help but don't know how.
Lists of items that are needed have been circulated, but they are generally of limited use for anyone who does not have the resources of a state. I was sent to Nicaragua by the France-Nicaragua Solidarity Association* to draw up, with the help of the health-care officials there, a short list of urgently needed medical items that could be obtained through the work of European solidarity committees.
Q. What was your overall impression?
A. I was only there a week and had no time to get outside of Managua. So my impressions-on anything other than healthcare-would be extremely superficial.
Q. Did you visit medical establishments?
A. I visited two hospitals and a health center. The health-care center in eastern Managua is the largest in the city; it provides medical attention for 40,000 families. You can spot it a long way off by the crowd in front of it, hundreds of persons standing in line.
When you enter you can see that it is very well organized and that everyone will eventually be examined. Many mothers • are now bringing their children in for vaccination, for there have been four recent cases of diptheria, resulting in two deaths. While there is a sufficient supply of vaccines, the center lacks syringes, antibi-
*Association solidarité franco-nicaraguayenne, 14, rue de Nanteuil, 75015 Paris, France.
otics, and medicine for diarrhea and respiratory infections.
Managua's hospitals have 1,200 beds (for 500,000 inhabitants). The shortage of medication and equipment is such that only urgent cases can be taken care of. In one institution, the Mother and Child Hospital (420 beds, the sole establishment of this type in all of Nicaragua), I saw two children, and at times two women, in each bed.
There are forty to fifty births a day at this hospital—a total for which the facilities are just barely adequate. At times the number of deaths there from nutritionrelated diseases are quite high-as many as nine a day.
At Manolo Morales P. Hospital in eastern Managua, the best equipped hospital in the country, there is no more film for X- rays, lab work has had to be cut in half because of a shortage of litmus paper, there is no more anticoagulant or cortisone in stock, very little in the way of antibiotics-and yet the emergency room receives 400 patients a day.
Q. What effect has international aid had?
A. There have been a lot of promises but little concrete aid apart from that from Cuba and, I think, Sweden. I saw packages of American gauze stamped with the date 1957.
The French government has been hailed on television for having sent two tons of medical supplies. But that amounts to only about four or five cubic meters of supplies-coming from a state it is the equivalent of a coin tossed in a beggar's bowl. France has also promised to help in the construction of a hospital. UNICEF has distributed packets of rehydration salts made available by Sweden, an estremely useful medication for combating infant toxemia. They can be added to babies' formula.
Q. How can the solidarity campaign in Europe be of help?
A. It should focus on the objectives we discussed with representatives of the Ministry of Health in Nicaragua. Essentially what is needed is help with equipping rural health-care centers, for the situation in the country-side is even worse.
There are only thirty-five centers, one for every 20,000 to 30,000 inhabitants. There are also 148 clinics, each covering 2,000 to 10,000 persons. These facilities, which are often rudimentary, are almost totally without supplies. Nonetheless, they constitute the basic health-care unit.
Solidarity committees should undertake to provide for each one of them the following:
• A set of surgical instruments.
• A blood-pressure gauge and stethoscope.
• Portable sterilization equipment, the kind that can be fired either by wood or petroleum-based fuel.
• A small stock of indispensable drugs, such as penicillin, aspirin, and antidiarrhea medicine.
A precise list, with prices, will be issued soon by the France-Nicaragua Solidarity Association, which has undertaken the task of purchasing the items at the best price possible and assuring their delivery.
The packages that are sent will of course bear the names of those who raised the funds for them, and we hope to receive acknowledgement of delivery regularly from Managua, so as to help facilitate the campaign.
Q. Are volunteers being asked for?
A. They have asked us to hold up on this. At present it is impossible to assure volunteers a wage, and there are problems in providing housing and meals. We were promised that the embassy would let us know when these problems are resolved, because doctors, surgeons, dentists, and trained nurses would be of great help.