A Lost Opportunity? Collective Demands and Migrant Farmworkers in Costa Rica during the Pandemic

The COVID-19 pandemic induced an overexposure of migrant farmworkers' poor working and living conditions in Costa Rica's northern border area and underscored the country's dependence on migrant labor. This created a unique opportunity to position pro-migrant concerns and demand actions from the state. In this article, we assess if and to what extent the actions of the Costa Rican state were influenced by migrant demands, or whether other priorities guided policy. Based on a novel database on protest and collective action (Protestas-IIS) that is fed with national and local newspaper articles, we analyze the demands made by migrants, the private sector and NIMBY movements, and state responses. Our findings suggest that the latter prioritized market concerns and antiimmigrant interests, thereby underscoring lessons from the literature that migrants are among the politically most disenfranchised in society. Their demands were only partially responded to by the state, and only concerning issues that aligned directly with public concerns, in this case related to health.

The Long Game: The Opposition Wins in Honduras

Opposition parties in competitive authoritarian regimes rarely win elections by a landslide, especially where poverty, repressive security forces, and clientelism abound. Yet in November 2021, Honduras's opposition defeated the incumbent National Party against the odds. This essay argues that the opposition succeeded by "playing the long game": 1) building a mass-party organization, 2) continually participating in elections, and 3) forging unity through power-sharing. Paradoxically, the Honduran opposition's lack of international support incentivized these choices and became a blessing in disguise. Whether Xiomara Castro will rebuild democracy remains uncertain, but her coalition's route to power yields lessons for oppositions elsewhere.

Kidney Replacement Therapy in Latin America, 2020 Data

Introduction: The Latin American Dialysis and Renal Transplantation Registry (LADRTR), founded in 1991, has collected data and reports on patients receiving kidney replacement therapy (KRT) since 1993. The main goals of the LADRTR is to promote the development of national registries, consolidate a data system for KRT in Latin America (LA), return the data provided by nephrologist to the different stakeholders that participate in the decision making process, while contributing to the universal knowledge of prevention, incidence and evolution of the disease in the region. This summarizes the registry data for 2020. Method(s): Participating countries complete an annual survey collecting aggregated data on incident and prevalent patients on KRT in all modalities. The different treatment modalities considered were hemodialysis (HD), peritoneal dialysis (PD) and living functioning kidney graft (LFG). National gross domestic product per capita (GDP, expressed in US dollars) and life expectancy at birth (LEB) corresponding to the year 2020 were collected from the World Bank Data Bank. Prevalence and incidence were compared with previous years and were also correlated with GDP and LEB. Result(s): On 31 December 2020 the prevalence of KRT in LA was 848 per million population (pmp), which shows a drop in the rate compared to the previous year (Figure 1). The prevalence ranged from 2129 pmp in Puerto Rico to 111 pmp in Nicaragua. Eight countries had a rate >700 pmp (Argentina, Brazil, Chile, Colombia, Ecuador, Panama, Puerto Rico and Uruguay). The states of Mexico, Jalisco and Aguas Calientes, also had a rate >700 pmp (Figure 2). Regarding treatment modality, 67,0% of the prevalent patients were treated with HD (n= 290 099) and 9.3% with PD (n= 40 450) while 23,6% of the patients had an LFG (n= 102772). The total unadjusted incidence rate of patients that started KRT was 158 pmp. The majority of the patients started KRT with HD modality, while only 6,08% used PD, varying the rate of incidence from 477 pmp in Jalisco and Aguas Calientes to 2 pmp in Bolivia. The kidney transplant rate in the region was 15 pmp, showing a drop from the previous year, and 89% of KT were from a deceased donor (Figure 3). The total prevalence of KRT correlated positively with GDP per capita (r 2 = 0.6, P < 0.01) and LEB (r 2 = 0.27, P < 0.05). The overall unadjusted mortality rate was 18%, cardiac disease was the leading cause of death (31%), followed by infectious diseases (21%) and other causes (16%). [Formula presented] [Formula presented] [Formula presented] Conclusion(s): For the first time in the last decade the overall prevalence and kidney transplant rate decreased, being this associated with COVID-19 pandemic. Although the incidence and prevalence of KRT in the LA region have increased over the years, there is still a need to improve accessibility to KRT, develop programs that facilitate better control of risk factors, early diagnosis and the treatment of chronic kidney disease, as well as the implementation of an effective kidney transplant program, to reduce the gap that exists between the countries of LA. No conflict of interestCopyright © 2023

High Co-circulation of Influenza and Severe Acute Respiratory Syndrome Coronavirus 2.

In the first 2 years of the coronavirus disease 2019 pandemic, influenza transmission decreased substantially worldwide, meaning that health systems were not faced with simultaneous respiratory epidemics. In 2022, however, substantial influenza transmission returned to Nicaragua where it co-circulated with severe acute respiratory syndrome coronavirus 2, causing substantial disease burden.

Telehealth in Latin America: Progress, Challenges, and Opportunities in the Face of COVID-19

The COVID-19 pandemic has accelerated the use and importance of telehealth and telemedicine globally. In industrialized countries, stay-at-home measures and changes to government regulations regarding telehealth resulted in an over 100-fold increase in demand within weeks. The COVID-19 has raged across Latin America for most of 2020, with associated high rates of illness and death. The objective of this article is to review some of the successes and challenges of telehealth in Latin America and highlight opportunities for action within the context of COVID-19. We identify several positive trends in telehealth adoption across the region as well as some promising case studies on the use of telehealth platforms for delivering care when needed. We also identify barriers that have limited the scale of telehealth in Latin America during the current phase of the pandemic. Limiting factors include inadequacies in long-term evolution telecommunication availability and access to digital trainings for healthcare workers. In addition, political commitment, legislation, and regulation have yet to catch up with demand. Finally, we present opportunities to more effectively scale these technologies, across Latin America for the current emergency, as well as reducing or controlling healthcare costs, addressing health disparities, and providing improved health care, especially in rural areas.

Nicaragua puzzles over space plans amid socio-political turmoil

Speed read Government of Nicaragua approves plans for a Secretariat for Outer Space Meanwhile, science community denounces persecution and loss of university autonomy Government plays down COVID-19, but charges for tests to enter the country The Nicaraguan government has created a National Secretariat for Outer Space, Moon and other Celestial Bodies, to the astonishment of the country’s scientific community, besieged by budget cuts and ideological persecution. The government-funded secretariat “is a late ratification of international instruments, in a country that is barely in a position to pay for basic care in the health system,” Dora Maria Tellez, a former health minister, tells SciDev.Net. SciDev.Netreceived no responses to interview requests with legislators, or representatives from the Ministry of Health and the Nicaraguan Council for Science and Technology about the new space agency and national science policies.

COVID-19 and the state: Nicaragua case study

Unlike Latin American peers, and contrary to World Health Organization recommendations, Nicaragua eschewed lockdowns and other common strategies to mitigate the spread of COVID-19. Analysts have since demonstrated how Nicaraguan authorities dramatically under-reported the number of deaths and infections that resulted (though a dearth of data complicates cross-country comparisons). Questions remain about the government's decision to pursue a hands-off strategy in the first place. This paper argues that rather than optimizing for fewer cases and deaths, the authoritarian government of President Daniel Ortega instead attuned its pandemic response to other, political and economic, variables. In the context of a pre-existing sociopolitical crisis that threatened the regime's legitimacy and territorial control, policy-makers were primarily interested in safeguarding macroeconomic indicators and fomenting a sense of normalcy among the populace. For related reasons, they restricted public health information and criminalized citizen-led public health efforts. In the Nicaraguan case, government and leadership mattered more than state capacity in determining the public health response.

2020 American Community Survey: Use with Caution, An Analysis of the Undercount in the 2020 ACS Data Used to Derive Estimates of the Undocumented Population

This paper analyzes and provides estimates of the undercount of the foreign-born in the US Census Bureau’s 2020 American Community Survey (ACS). It confirms that a differential undercount occurred in the 2020 ACS. In particular, noncitizens that arrived from Central American countries after 1981 had undercount rates of 15–25 percent, but undercount of noncitizens that arrived from European countries in the same period was not detectable by the methods described in this paper. The Center for Migration Studies of New York (CMS) and others use ACS data to derive annual estimates of the US undocumented population. The Census Bureau recently reported that the total population count for the 2020 Census was consistent with the count for recent censuses, despite the Covid-19 pandemic and the Trump administration’s interference in the 2020 Census. Nonetheless, the accuracy of 2020 ACS data for the noncitizen population that arrived after 1981 remains a major concern given the fear generated by the Trump administration’s abusive rhetoric and anti-immigrant policies. The estimates set forth in this paper were derived by analyzing trends in annual ACS data for 2016–2020 compiled from the IPUMS website (Ruggles et al. 2021). Decennial census data cannot be used for this purpose because data on country of birth, citizenship, and year of immigration are not collected in the census. However, it is reasonable to believe that the 2020 census and the 2020 ACS experienced similar challenges because they were conducted under comparable conditions. The patterns of undercount of noncitizens described here for the 2020 ACS are likely mirrored in the 2020 census and will reduce federal funding and representation to affected cities and states for the next decade.

ENVIRONMENTAL EQUITY AND RACIAL JUSTICE

Afro-descendant peoples of the Americas are disproportionately affected by overlapping crises such as climate change, the loss of biodiversity, ecological degradation, the Covid-19 pandemic, the public health crisis, extreme socioeconomic inequality, structural racism and the increase in violence against social leaders. Although the communities in what we have named the Black/Afro-descendant Natural Belt of the Americas (ANBA) have a crucial role to play in an integrated response to these crisis, and in spite of the wealth of experiences and good practices at the local and national level, not enough importance has been attributed to the central role they play in the planetary socio-ecological transition needed to overcome the climate and biodiversity crises. This article, among other topics, debates the importance of Afro-descendant communities in the implementation of a range of natural climate solutions, in the region and at a global level, in the territories that are conceptually part of this belt.

Informality, Social Citizenship, and Wellbeing among Migrant Workers in Costa Rica in the Context of COVID-19.

Costa Rica is home to 557,000 migrants, whose disproportionate exposure to precarious, dangerous, and informal work has resulted in persistent inequities in health and wellbeing in the midst of the COVID-19 pandemic. We used a novel multimodal grounded approach synthesizing documentary film, experiential education, and academic research to explore socioecological wellbeing among Nicaraguan migrant workers in Costa Rica. Participants pointed to the COVID-19 pandemic as exacerbating the underlying conditions of vulnerability, such as precarity and informality, dangerous working conditions, social and systemic discrimination, and additional burdens faced by women. However, the narrative that emerged most consistently in shaping migrants' experience of marginalization were challenges in obtaining documentation-both in the form of legal residency and health insurance coverage. Our results demonstrate that, in spite of Costa Rica's acclaimed social welfare policies, migrant workers continue to face exclusion due to administrative, social, and financial barriers. These findings paint a rich picture of how multiple intersections of precarious, informal, and dangerous working conditions; social and systemic discrimination; gendered occupational challenges; and access to legal residency and health insurance coverage combine to prevent the full achievement of a shared minimum standard of social and economic security for migrant workers in Costa Rica.

Factors Associated with Healthy Life Expectancy: An Ecological Analysis of Global Data

Healthy life expectancy (HALE) measures the quality of life a person expects to live. This study aims to find out the most associated factors of HALE at birth globally. The data of 212 countries came from the World Health Organization, Worldometer, World Bank, and United Nations. HALE at birth is considered as the dependent variable;and social, economic, and health factors are considered as the predictors. Descriptive statistics, Pearson’s correlation analysis, and multiple linear regression models were used as the statistical tools to reach the objective. The results revealed that HALE is found lower in Central African Republic and higher in Singapore. The highest death rate due to coronavirus disease 2019 (COVID 19), alcohol consumption rate, human immunodeficiency virus (HIV) prevalence rate, and average household size are found in Nicaragua, Moldova Republic, Eswatini, and Senegal, respectively. And the lowest recovery rate from COVID 19, and universal health coverage (UHC) service index are found in Tajikistan, and Montserrat, respectively. The recovery rate from COVID 19, UHC service index, gross domestic product (GDP), current health expenditure, tuberculosis (TB) incidence, tobacco smoking, HIV prevalence rate and average household size were significantly correlated with the HALE at birth. The multiple linear regression models identified that the UHC service index, alcohol consumption rate, HIV prevalence rate and average household size are the most associate factors of HALE at birth globally. Therefore, the necessary steps should be taken to maximize the UHC service index, and to minimize the alcohol consumption rate, HIV prevalence rate and average household size for increasing the HALE at birth in the world.

Prevalence and risk factors for SARS-CoV-2 infection in children with and without symptoms seeking care in Managua, Nicaragua: results of a cross-sectional survey

ObjectiveThis study aimed to capture key epidemiological data on SARS-CoV-2 infection in Nicaraguan children (≤18 years) seeking medical care, between 6 October and 16 November 2020.DesignIn this cross-sectional study, 418 children were recruited: 319 with symptoms characteristic of COVID-19 and 99 with no symptoms of illness. Children were tested for SARS-CoV-2 RNA using loop-mediated isothermal amplification. A questionnaire was employed to identify symptoms, risk factors, comorbidities and COVID-19 prevention measures.SettingResearch was carried out in four hospitals and two clinics in Managua, Nicaragua, where schools and businesses remained open throughout the COVID-19 pandemic.ParticipantsChildren were enrolled into a possible COVID-19 group if presenting with clinical symptoms. A comparison group included children lacking any COVID-19 symptoms attending routine check-ups or seeking care for issues unrelated to COVID-19.ResultsA high prevalence (43%) of SARS-CoV-2 infection was found, which was relatively equivalent in symptomatic and non-symptomatic children. Age distribution was similar between symptomatic and non-symptomatic children testing positive for SARS-CoV-2. Symptomatic children who tested positive for SARS-CoV-2 were 2.7 times more likely to have diarrhoea (26.7% in positive vs 12.0% in negative;OR=2.7 (95% CI 1.5 to 4.8), p=0.001) and were 2.0 times more likely to have myalgia (17.8% in positive vs 9.8% in negative;OR=2.0 (95% CI 1.0 to 3.8), p=0.04). Children with COVID-19 symptoms, who tested positive for SARS-CoV-2, were more likely to be under age 5 years and to have a pre-existing comorbid condition than children who tested positive but did not have symptoms.ConclusionsThis is the first paediatric study to provide laboratory-confirmed data on SARS-CoV-2 infection in Nicaragua, crucial for paediatric health services planning and a successful COVID-19 response. The high prevalence of the virus suggests widespread and sustained community transmission, underscoring the urgent need for robust data on the true extent of SARS-CoV-2 infection throughout Nicaragua.

Child Neurology Care in Latin America: Challenges and Potential Solutions.

BACKGROUND: The current practice of child neurology in Latin America has been impacted by the waves of sociopolitical unrest that in the last decades have swept the region. METHODS: We searched the available literature referring to the situation of child neurology in Latin America and conditions that specifically impact the region. RESULTS: In lower-middle-income countries, the number of child neurologists is inadequate. Child neurologists working in large public hospitals can only afford to do so on a part-time basis as these institutions are chronically underfunded. Several circumstances are particularly relevant to Latin America: Spanish is the main language spoken, something that limits the opportunity to keep local child neurologists up to date. The structure of health care systems in Latin America varies significantly. Some countries have fragmented systems with inadequate capacity to offer equitable access to medical care. Latin America has been impacted by epidemics of arthropod-borne viruses: zika, chikungunya, and dengue. It stands to reason that the COVID-19 pandemic will affect the distribution of resources for chronic neurological conditions. CONCLUSIONS: The virtual platforms such as Zoom, expanded during the COVID-19 pandemic, are useful not only to improve access to care through telemedicine but also for educational purposes. Collaborative efforts to support educational courses and symposia in Spanish are ongoing. It is necessary to set short- and long-term priorities to improve child neurology care in the region. Immediate priorities should focus on improving the diagnosis of neurological conditions, making emphasis on locally available resources.

COVID-19: impactos en el medio ambiente y en el cumplimiento de los ODS en América Latina

Los efectos económicos y sociales que la pandemia del COVID-19 y las medidas asociadas para hacerle frente están teniendo en América Latina pueden derivar en serias consecuencias de largo plazo que repercutirían en el logro de los Objetivos de Desarrollo Sostenible (ODS). En este artículo, resultado de la colaboración de economistas ambientales de ocho países de la región, discutimos los posibles efectos de la pandemia en la contaminación del aire, la deforestación y otros aspectos ambientales relevantes relacionados con los ODS. Además de presentar un recuento de algunos de los efectos iniciales de la crisis sanitaria en el medio ambiente, discutimos efectos potenciales en términos de regulaciones ambientales e intervenciones de política pública. Por último, presentamos una agenda sobre nuevos temas de investigación que surgen a raíz de la pandemia o que han cobrado mayor importancia como consecuencia de esta, incluyendo los impactos sobre el logro de los ODS.Alternate : The social and economic effects of the COVID-19 pandemic and the measures to contain it in Latin America could lead to a series of long run consequences that could impact the region’s achievement of the Sustainable Development Goals (SDG). This article is the result of the collaboration of environmental economists from eight of the region’s countries and it discusses the possible pandemic effects on air pollution, deforestation, and other relevant environmental aspects related to the SDG. In addition to reviewing some of the initial effects of the sanitary crisis on the environment, we discuss its potential effects in terms of environmental regulations and public policy interventions. Finally, we discuss a new research agenda with topics derived from the pandemic as well as topics that have recently become more relevant because of it, including its impact on achieving the SDG.

Seroepidemiology of SARS-CoV-2 infections in an urban population-based cohort in León, Nicaragua.

In a Nicaraguan population-based cohort, SARS-CoV-2 seroprevalence reached 28% in the first 6 months of the country's epidemic and reached 35% 6 months later. Immune waning was uncommon. Individuals with a seropositive household member were over three times as likely to be seropositive themselves, suggesting the importance of household transmission.

Nicaraguan Economic Situation Before And After Covid-19

The development of the Nicaraguan economy has been affected by the impact of the global COVID-19 pandemic. Through this study, a diagnosis of the state of the Nicaraguan economy was presented at the time of the arrival of COVID-19 and the estimates of damage that this pandemic has caused to the economy are discussed.

INTRODUCTION: BRANCHING OUT: NEW RESEARCH ON THE HISTORY OF U.S.-LATIN AMERICAN RELATIONS

Critical or not of the United States, this scholarship has generally cast non-state actors, extra-hemispheric concerns (apart from Soviet ones), and even non-Cold War issues as secondary.1 Since the end of the Cold War, historians have begun to de-center the role of Washington and to consider alternative actors, timelines, and issues.2 One of the richest veins of research in the last generation has turned out to be in non-state actors' impact on international relations, and interAmerican relations has been no exception.3 Graydon Dennison most explicitly mines this non-state ore with his research on U.S.-based non-state actors and the Alliance for Progress, arguably the most prominent ever U.S. aid program to Latin America. Cambridge University Press, 2015);Jonathan C. Brown, Cuba's Revolutionary World (Cambridge, Mass.: Harvard University Press, 2017);Vanessa Walker, Principles in Power: Latin America and the Politics of Human Rights Diplomacy (Ithaca, N.Y.: Cornell University Press, 2020);Thomas C. Field, Stella Krepp, and Vanni Pettina, eds., Latin America and the Global Cold War (Chapel Hill: The University of North Carolina Press, 2020);and Eriz Zolov, The Last Good Neighbor: Mexico in the Global Sixties (Durham, N.C.: Duke University Press, 2020). 3 Jason Colby, The Business of Empire: United Fruit, Race, and U.S. Expansion in Central America (Ithaca, N.Y: Cornell University Press, 2011);Patrick Iber, Neither Peace nor Freedom: The Cultural Cold War in Latin America (Cambridge, Mass.: Harvard University Press, 2015);Teishan Latner, Cuban Revolution in America: Havana and the Making of a United States Left, 1968-1992 (Chapel Hill: The University of North Carolina Press, 2018);Alan McPherson, "Letelier Diplomacy: Non-State Actors and U.S.Chilean Relations," Diplomatic History 43: 3 (June 2019): 445-468;and James P. Woodward, Brazil's Revolution in Commerce: Creating Consumer Capitalism in the American Century (Chapel Hill: The University of North Carolina Press, 2020).

Pneumonia Following Symptomatic Influenza Infection Among Nicaraguan Children Before and After Introduction of the Pneumococcal Conjugate Vaccine.

Influenza is associated with primary viral and secondary bacterial pneumonias; however, the dynamics of this relationship in populations with varied levels of pneumococcal vaccination remain unclear. We conducted nested matched case-control studies in 2 prospective cohorts of Nicaraguan children aged 2-14 years: 1 before pneumococcal conjugate vaccine introduction (2008-2010) and 1 following introduction and near universal adoption (2011-2018). The association between influenza and pneumonia was similar in both cohorts. Participants with influenza (across types/subtypes) had higher odds of developing pneumonia in the month following influenza infection. These findings underscore the importance of considering influenza in interventions to reduce global pneumonia burden.

Immediate impact of COVID-19 pandemic on farming systems in Central America and Mexico.

CONTEXT: The COVID-19 pandemic has affected all sectors and human activities around the World. OBJECTIVE: In this article we present a first attempt to understand the immediate impact of COVID-19 and the sanitary measures taken by governments on farming systems in Central America and Mexico (CAM). METHODS: Through a review of information generated in these initial months of the COVID-19 pandemic (webinars, blogs, electronic publications, media) and 44 interviews with key informants across the region, we have identified the main impacts felt by different types of farming systems in the region. RESULTS AND CONCLUSIONS: From corporate agricultural production systems, to small and medium scale entrepreneurs and smallholder subsistence farm households, all types of farming systems were impacted, more or less severely, by the different measures implemented by governments such as reduced mobility, closure of public and private venues and restrictions in borders. Larger corporate farming systems with vertical market integration and high level of control or coordination within the supply chain, and smallholder or subsistence farming systems with important focus on production for self-consumption and little external input use, were both relatively less impacted and showed greater adaptive capacity than the medium and small entrepreneurial farming systems dependent on agriculture as their primary income and with less control over the upstream and downstream parts of their supply chain. All types of farming systems implemented a series of mechanisms to cope with the COVID-19 pandemic including the development of alternative value chains, food and agricultural products delivery systems and the exponential use of digital means to communicate and maintain the viability of the different agricultural systems. Collective action and organization of farmers also proved to be an important coping mechanism that allowed some farmers to acquire inputs and deliver outputs in the context of restricted mobility, price volatility, and general uncertainty. Some features of the CAM region played an important role in mediating the impact of COVID-19 and associated sanitary measures. We identify as particularly relevant the nature of agricultural exports, the current structure of the agricultural sector, the diversified livelihood strategies of rural households, and the importance of mobility for rural livelihoods. SIGNIFICANCE: The results presented focus only in the immediate effect of COVID-19 pandemic and the mechanisms implemented by farmers in the first months. Whether these impacts and response mechanisms will result in a transformation of the farming systems towards greater resilience and sustainability is still an open question.