| Summary: | Nicaragua faces a crisis of democracy. Daniel Ortega has risen as the newest dictator in Latin America and might well be signaling a new wave of dictatorships in the region. His climb to power has been decades in the making, but between the response to the 2018 protests, to the 2020 pandemic, and his latest ‘election’ in 2021, it has become quite clear that Ortega and his regime represent a rising authoritarian power in Nicaragua. Citizens are facing repression, exile, arrest, and death for even expressing disdain at the administration. Many have become enemies of the state. Several groups are particularly ‘at risk.’ In this paper, the lens is through health service workers who are viewed as ‘oppositional’ to the Ortega regime and are facing severe consequences. Violent repression has become the norm, and Nicaragua's classification as a police state is excessively obvious through data and lived experiences of health care workers. Disloyalty is punished expediently, and many health workers have found themselves under surveillance, fired, forced out of jobs, forced to flee, detained, or killed. Foreign governments and international powers are hesitant to take any formal action against the regime. Nicaragua faces the rising power of authoritarian government as witnessed through repression and quelling of health care professionals and other entities of civil society.
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