Throughout the year in Nicaragua, MSF provided medical and mental health care to victims of traumatic episodes of violence experienced during armed unrest or while detained. We offered mental healthcare to patients and their relatives, most of whom were suffering from depression, anxiety and post-traumatic stress disorder. In addition to running basic medical services, MSF facilitated access to specialised care, such as physiotherapy and neurology and treatment for sexual violence. The teams strengthened their activities in the capital, Managua, and in Masaya, Jinotepe, León, Estelí, Jinotega and Matagalpa. 

Until September, MSF staff also treated Nicaraguan patients who had crossed the border into Costa Rica to request asylum. According to the UN refugee agency, UNHCR, Costa Rica has received more than 68,000 of the estimated 82,000 Nicaraguans who have fled the country since April 2018. Our teams there offered medical and psychological care and organised referrals to specialist services.

In both countries, MSF provided training in basic mental healthcare, psychological first aid and self-help to community leaders, groups and educators to enable them to give psychological support to others in crisis situations. After collaborating with other groups and organisations, the teams were able to extend these activities. At the end of the year, we handed over all services and referred patients to these organisations.