4 de abril 2020
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On June 26, 2018, a Nicaraguan official from the Pan-American Health Organization (PAHO) took the floor, during an assembly held at its headquarters in Washington DC, to denounce his own organization and its director, Dr. Carisa Etienne, from the island of Dominica.
The Communication and Knowledge Management official, Oswaldo Leon-Fariello, an expert in international relations with eight years of professional service at PAHO, was closely following the Nicaraguan crisis as a result of the outbreak of the April 2018 civic protest, and the repression used by the health system to deny care to the victims.
Leon-Fariello called for a PAHO statement on violations of Nicaraguans’ health rights, while other members of the institution, between April 18 and May 18, 2018, sent more than 40 messages to the PAHO director in Washington urging her to declare an emergency regarding the crisis in Nicaragua.
Etienne took her time to respond to the urgent request and rather reinforced her unconditional support for the Ortega-Murillo regime and the Minister of Health, Sonia Castro, who in June 2019 was sanctioned by the United States Treasury Department, accused of serious violations to human rights.
On June 26, 2018, Leon-Fariello said a very important event would take place at the PAHO headquarters. “I knew they I would not be granted the favor of the microphone. I used the force of my voice. I took out the Nicaraguan flag and shouted a few words that I had meditated that morning: This organization that Mrs. Etienne represents didn’t have the dignity to dedicate a minute of silence to those three hundred persons murdered. That is inhuman. That is unacceptable. I speak on behalf of Nicaragua so that he (the dictator) be condemned,” said Leon-Fariello, until staff linked to the human resources office evicted him from the auditorium.
Oswaldo Leon-Fariello. “They were students not delinquents”
Oswaldo, you were fired from your position as a PAHO official in Washington, after you spoke at a public event to talk about the Nicaraguan crisis in June 2018. What was your demand to PAHO?
Oswaldo Leon-Fariello: Indeed, on June 26, 2018, I took the floor at an event that PAHO had organized for the staff in Washington and for the 27 representations that PAHO has throughout Latin America and the Caribbean. I demanded that the director Carissa Etienne apologize to the mothers of all the young people who had been killed up to that moment.
In the operating rooms of hospitals (they denied care) on orders from the authorities of the Ministry of Health. It was a subject of PAHO’s mandate, and the responsibility of this director. I felt that she had the duty to apologize to the Nicaraguan people for not having condemned, and not even showing her concern with the Nicaraguan people.
A few months ago, in that same room, the same director had asked us to keep a minute of silence for Ebola victims in Africa, for “our brothers and sisters,” she said, but for the mothers of Nicaragua, she did not have that courtesy.
The second demand was for the director to end her political alignment that, since the beginning of her tenure in 2013, she had demonstrated towards the Government of Daniel Ortega. It is not usual for a director of a health agency, a technical agency like PAHO, to politicize health. That is not correct, and it is not healthy from any point of view.
Did the director of PAHO, Carissa Etienne, in the exchanges you had with her, before and after the public event, provide any justification for not recognizing the emergency in Nicaragua and the anti-humanitarian action of the country’s health authorities in denying treatment?
No, she did not provide any statement or justification. On the contrary, what has always reigned is absolute silence. A silence that becomes complicity and a communication that we know exists, directly, between not only the PAHO representative in Managua and Rosario Murillo, but directly between PAHO here in Washington with Rosario Murillo.
Murillo said so in one of her daily litanies, that she had spoken directly with Dr. Etienne and, well, that she had praised so many things about the Nicaraguan health system. That day when I spoke, I gave the director a folder with documents, copies, photos and evidence about corruption and workplace harassments that she had done nothing about. I have all that evidence and I am going to use it now.
In January of this year, the World Health Organization declared the coronavirus a pandemic and counselled all countries to avoid (physical) contact and massive crowds. However, in Nicaragua the Government has done the opposite, and the delegate of PAHO in Managua has praised the Government actions, and says that what they are doing is correct. Can the regional organization, in this case PAHO, contradict the WHO?
It should not do so, because although PAHO is affiliated to the WHO and is its regional representative in Latin America; it is nevertheless, independent as an organization. However, at no time should it contradict the indications with the WHO’s observations because these derive from agreements. And in this concrete case, they come from the International Health Regulations, which is a legal instrument recognized by all states, including Nicaragua, and which PAHO and WHO must promote and ensure compliance. So, the answer is no: no, it should not contradict it.
However, what has happened in the relationship of the representative in Managua with the Government, is an orientation and the result of politicization.
Carissa Etienne (2nd from the left), director of the PAHO in Washington, along with the former Nicaraguan health minister, Sonia Castro (2nd from the right) Photo: OPS
What is being said is that the PAHO representation in Managua does not have autonomy to represent it and fulfill its mandate, does it act more as a projection of the Government of Nicaragua?
Yes, it is acting as a projection of the Government of Nicaragua, but with the complacency and the permission of the director of PAHO, who is Carissa Etienne. She has not hidden her sympathies with Daniel Ortega, with Maduro, and the support has been constant. So, this behavior of the representative is not a coincidence but responds to a direct guidance of Carissa Etienne here in Washington and her interests. She comes from (Dominica), one of the ALBA countries, controlled by the left of Nicolas Maduro, Hugo Chavez, and Ralph Gonsalves, who are still tied to those dreams of the past.
PAHO published on its website that there are six positive cases of coronavirus in Nicaragua and not two as maintained by the Government. But a few hours later, almost at midnight, the representative comes out at a press conference saying that a typing error had occurred, and she offered excuses to the Government of Nicaragua.
Does PAHO keeps its own statistics on the health situation, or is it limited to supporting what the Government says?
Statistics in any international organization are not independent. They have to be a combination of two things, and it is the same in this case. It is a combination of what the government provides and other studies.
However, I think that in this case there was a mistake, it could be in typing, especially because I know the environment. But also because of the way the quantity was presented, because a statistic presented in an Excel table is not something to be trusted too much. I think it was a mistake, but what is strange is the representative’s conduct to make a kind of humiliation before Daniel Ortega and Rosario Murillo, which is absurd.
Does PAHO have in its mandate any obligation to Nicaraguan civil society, beyond the Government? In Nicaragua, representatives of the private sector and civil society organizations have demanded that PAHO contact them to coordinate preventive actions against the coronavirus. However, there has been no response. Why?
PAHO is a member of the United Nations system, therefore, it has a mandate to work with civil society that is very broad. For more than 30 years ago it has gone from being a paradigm, to a daily work approach, the same for the OAS. PAHO responds to the OAS, it is part of the Inter-American system. So, it has a mandate to work with civil society, especially in what are social determinants of health.
That said, this lady (the PAHO director) does not have a very inclusive concept of civil society, and I do not think that she is of the idea that there has to be dialogue and that participation must be taken into account. PAHO has not fulfilled its responsibility to enforce what the International Health Regulations includes in these pandemic cases. They have not complied at all with any of the guidelines stipulated in this regulation.
