Nicaragua: Medical Clinics Shut Down and Patients Evicted
Affects thousands of Amocsa members
Doctors received orders to immediately stop treating patients; who will care for the members who had contracts with Amocsa?
By Ivan Olivares (Confidencial)
HAVANA TIMES – The sudden closure of the clinics operated by Asistencia Médica de Occidente, S.A. (Amocsa), in the cities of Leon, Chinandega, and Corinto, has left thousands of patients in that part of the country in limbo. Testimonies gathered by Confidencial show that those affected don’t know what will happen to their prescribed medications or their medical records.
“I need to recover my baby’s medical file. They told us that her records would start from scratch, and that’s just not possible,” said Margarita, a single mother who purchased a health insurance policy to ensure her daughter could receive specialized care. Another citizen, who asked to be identified as Andrea, recounted that she was accompanying a relative who was seeking medical attention when the doctors received the order to abandon their patients and hand over medical records.
Stories like these were repeated by the hundreds in the affected cities. According to data in the 2023 Statistical Yearbook (the most recent available online) from Nicaragua’s Social Security Institute (INSS), Amocsa served over 46,000 patients in both Leon and Chinandega.
Founded in the mid-1990s, Amocsa had become the leading private medical provider in the country’s western region. The 2023 Yearbook data shows that it handled 40.7% of INSS-insured patients in Leon. Its dominance was even greater in Chinandega, where it served 61.6% of contributors. Across the western region, Amocsa attended to 49.6% of insured patients receiving care from private providers. Margarita and Andrea were among them.
Amocsa clinics in Leon and Chinandega closed abruptly without providing any explanation to their workers or clients. Local media reported that it may have been a government seizure, but no reason has been made public.
What Will Happen to Margarita’s Baby?
Margarita is a single mother who says she obtained insurance with Amocsa with one goal in mind: to secure specialized medical care for her baby. Normally, she might have only sought medical advice for herself for minor ailments, but that wasn’t enough for her daughter, who had been diagnosed with behavioral issues and a sleep disorder.
“When the government shut down Teletón [in March 2025], it cut off our access to therapies that are far too expensive. No one cares about the health or therapy needs of children with special needs,” she said. Her daughter requires several types of medications “that help with her condition, as she also has a special diet,” she added.
The lack of access to doctors, therapies, and free medication—combined with financial struggles that caused her to miss some insurance payments—meant her daughter went without therapy for several months. Her anxiety grew even more because “with the closure of Amocsa, their agreements with specialists are canceled, and now they’re telling us to request appointments at the hospital, even though it’s likely they won’t be available until next year,” she explained.
Margarita also worries about what will happen to her daughter’s medical records. The file, built over “years of expenses,” is essential for any new doctor to understand her daughter’s diagnosis and continue prescribing the necessary medications.
The Order Was: Everyone Out!
Andrea experienced the Amocsa closure in Chinandega firsthand. She told Confidencial that she was with a relative who was receiving care when, suddenly, doctors were ordered to stop all treatments.
“They came and told us we had to leave the clinic because it had been shut down,” she recalled. Her relative was handed a discharge summary and told to go to the hospital. Even though the patient needed an injection for pain, staff refused to administer it because of the directive they had received. Andrea said the doctors wanted to help but were powerless as they were ordered to surrender patient records.
Since nurses were not allowed to enter, the doctors themselves had to begin decannulation of patients—removing the permanent IV lines used to avoid repeated injections. “Many parents had to carry their children out while they were still cannulated,” Andrea noted.
While she was helping her relative leave, she saw a young woman diagnosed with a threatened miscarriage who was in severe pain. She too was told to go to a hospital. The shutdown happened so suddenly that even patients who already had prescribed medications were denied treatment, Andrea added.
Another act of callousness occurred when the clinic was being shut down. Andrea said she saw people she identified as “government officials” sealing off clinic areas. One of them yelled at several patients that if they needed urgent care, they should go to the hospital.
They didn’t care that people were complaining of pain, dizziness, or simply suffering from age-related ailments. They weren’t there to listen.
First published in Spanish by Confidencial and translated and posted in English by Havana Times.