Nicaragua is one of the poorest nations in the Western Hemisphere. The
health of the population suffers as a result of poor nutrition, epide
mic diseases, natural and manmade disasters, sporadic violence, urban
industrial growth, and inadequate government funding for even basic me
dical equipment and supplies. Within this environment, emergency servi
ces development has been recognized as an important and cost-effective
public health intervention. In recent years, government and nongovern
mental agencies working together have had a dramatic positive impact o
n the quality of emergency care provided.