The commemorations of the 50th anniversary of the death in combat of Carlos Fonseca Amador offer an opportunity to reflect on the importance of two fundamental rights which have always accompanied the history of the Sandinista Revolution: health care and education.
More precisely, the founding father of the FSLN considered literacy, access to culture and the improvement of living conditions of the majority class to be essential elements of national liberation. In his integral vision of the country’s reality, the Matagalpa-born intellectual and guerrilla linked the struggle for the liberation of Somocismo to a project of national rebirth based its people’s social and cultural emancipation. So his political and cultural legacy deserve an essential review so as to reflect on the results achieved and the extent to which his teachings figure in the revolutionary government programs in their different stages.
Revolution – when health care becomes a right
Before the triumph of the Sandinista Revolution, Nicaragua was marked by very profound social inequalities, accompanied by mindless, cruel repression. Structural backwardness was widespread, especially in rural areas and, especially in the most isolated communities, where access to health services was limited and access to education practically non-existent.
Poverty, malnutrition, lack of schools, shortage of hospitals and clinics and too few qualified medical personnel negatively conditioned the life of a considerable part of the population, deeply mortgaging not only their development, but even their own survival.
With the triumph of the Revolution, health became a public policy priority. The aim was to overcome a system in which the possibilities of receiving medical care largely depended on economic status and place of residence. Vaccination campaigns, maternal health and child care programs, training of health personnel and preventive medicine initiatives were promoted. Special attention was paid to rural areas, where the presence of health centers had historically been insufficient.
This revolutionary process was interrupted by 16 years of successive liberal governments which destabilized Nicaragua and returned it to a situation in which education and health care depended directly on private wealth. A two-way system prevailed in which rights advanced at two speeds: a delayed one for the people and a faster one for the elites.
The return of Sandinismo to government, in January 2007, changed the rules of the game once more and again placed both issues, education and health care, at the center of the government’s agenda.
Investment in infrastructure, personnel and technologies in both sectors during these years have led Nicaragua to achieve a level of satisfaction of these two rights in accordance with a country that respects itself.
Self-evidently, this is directly related to the broader fight against poverty and, at the same time, its logical result. To demonstrate this, it is helpful to use the Gini index, the coefficient chosen by the United Nations to measure the degree of a country’s development based on the level of satisfaction of its population’s fundamental rights.
The index, developed by Italian statistician and demographer Corrado Gini in 1912, is a statistical measure evaluating levels of inequality in distribution of income, wealth and consumption of a given population.
It is measured by the Lorenz Curve, which compares the area of effective inequality with a hypothetical equity line in the distribution. The curve, developed by the economist Max O. Lorenz in 1905, measures inequality of income and wealth distribution.
Both coefficients are standard formal references for most important international organizations and fully apply in Sandinista Nicaragua. This is also why the policies promoted, both in education and health care, since the FSLN’s return to office in 2007, give reason for pride on the part of the country’s Government of Reconciliation and National Unity.
In the health care field, the main public health indicators have been completely transformed, both in quantitative and qualitative terms, as recognized too by the Pan American Health Organization (PAHO), which speaks of «significant results» testifying to the advances made in primary health care.
In its 2025 report, PAHO pointed out precisely the interventions aimed at strengthening diagnostic capacities, improving health care infrastructure, digitizing medical records and developing care for people with disabilities. Nicaragua’s health care model is based on free provision of medical attention and locally organized preventive care. Everything is supported by a hospital network of 80 hospitals including 43 newly built during the last 19 years.
The new construction includes primary hospitals distributed between the local communities, as well as new departmental hospitals and also highly specialized national reference centers. The system even deploys mobile clinics, reaching patients who are unable reach their health center and, in this way, fulfill an important part of the cycle of prevention and cure. To this must be added specific highly specialized interventions, such as cardiology services, four lineal accelerators for cancer treatment and a national hemodialysis network.
It is not only a question of building much needed modern facilities in response to national health priorities: the health care system is also dedicated to prevention, specialized medicine, mental health and the presence of qualified personnel even in the most remote communities as well as in urban centers.
The reduction of infant and maternal mortality, the expansion of vaccination campaigns and the development of locally focused care are well-documented results. All these pragmatic policies helped to combat the COVID-19 epidemic, proving to be very effective. Together with the increase in the number of hospital beds, these indicators confirm the relationship between the provision of services and the economic benefits of family well-being, making Nicaragua a leader in Central American health care.
Learning by teaching and teaching by learning
If health represents one of the fundamental aspects of Nicaragua’s social transformation, education is perhaps an even more iconic symbol of the Revolution’s legacy. In 1980, just one year after the fall of the dictatorship, the Sandinista government launched the great National Literacy Crusade.
It was an extraordinary mobilization: tens of thousands of students, teachers and volunteers left the cities to live for months in rural communities, taking books, notebooks and teaching materials even to the most remote villages. Tens of thousands of people set out to teach but, at the same time, to learn. More than 406,000 people learned to read and write in the largest and most tenderly committed transfer of knowledge ever seen.
It wasn’t just about teaching how to decipher the words. The National Literacy Crusade also represented an experience of collective participation, of interaction between the city and the countryside and of recognition of the role of the popular classes in the construction of the country. Beyond spelling and grammar, common sense in its true meaning came into play.
It was a generational transmission of knowledge, a relay by personal witness giving those who had been left out the same chances as those who had been more fortunate. Education was conceived as a tool of emancipation: learning to read meant being able to understand one’s reality, participate in public life and acquire greater opportunities for independence.
Later, in the neoliberal years, the right to study gradually became once more a privilege of the rich and a condemnation of the poor. Nicaragua’s former Education Minister Humberto Belli, a member of Opus Dei, said «it’s pointless to invest in public schools for people who, at most, might aspire to work as taxi drivers.» These words, so revealing of the upper-class and racist nature of that individual (a family flaw, apparently), were, in fact, the purest essence of the neoliberal socioeconomic model.
The third stage of the Revolution, starting in 2007, has progressively expanded access to education, with special attention to primary education, adult education and rural areas. Here too, studying absolutely free of charge, direct support ensuring school supplies and free school meals are an integral part of a model that recognizes the right to education as an essential opportunity for everyone.
In the area of education fundamentals, the quality of teaching, of teacher training, the availability of adequate classroom facilities, continuity of schooling and access to technology are decisive elements to transform overall commitment into practical results. Here, as with health care, careful planning of public spending and appropriate allocation of resources to combat poverty turn out to be fundamental requirements for any system of health care or education.
A good government born from good ideas
Fifty years after the death of Carlos Fonseca, it is true to say that the balance sheet of Nicaragua’s social policies has to read as confirmation of the historical advances achieved. The extent of access to education, like access to health care, depends on the country’s overall spending capacity.
But, in the end, without an ideological program which sees collective growth as the only possible path to truly systemic growth, without a clear strategic orientation prioritizing the nation’s education and health care, there can be no credible development policies. Budgetary commitments would merely serve the banal logic of correct accounting.
In that sense, the application of Sandinista thinking is clear, conceived by Comandante Carlos as a theory uniting socialism and independence as the engines of Nicaragua’s transformation and thus forming the basis of the country’s growth. Investing in the population itself gives the highest and fastest returns for economic development. Every cent invested in health and education multiplies the return and impacts positively on economic growth.
It has always been so. The idea has prevailed that national transformation demands political liberation accompanied by the elimination of ignorance, the eradication of poverty and an end to social exclusion. All this is happening under a Sandinista Revolution which continues to advance by generating progressively greater equality and steadily more inclusive evolution.
50 years after his death, the legacy of Comandante Carlos can be seen in the millions of people who have been able to flourish as protagonists of health care, education and other public services. Every child can get an education, every woman can receive adequate health care. What is this if not revolutionary?