Nicaragua: Daniel Ortega loses his primary care physician

Q24N (Nicaragua) Co-president of Nicaragua and wife of Daniel Ortega, Rosario Murillo, ordered the arrest of her husband’s doctor despite his critical condition.

The dictator reappeared in public after a 66-day absence, accompanied by Rosario Murillo at a ceremony honoring Carlos Fonseca; he has never looked as physically unwell as he does now, yet the “co-president” dismissed his personal physician of many years, Julio César Paladino, who is also a commissioner general and headed the Carlos Roberto Huembes Police Hospital.

Paladino is now accused of corruption. The medical center was one of the repressive institution’s flagship services and was used to funnel millions of córdobas.

According to Nicaragua Investiga, the Carlos Roberto Huembes hospital will continue serving police officers and their families, but the National Police will no longer manage it directly. The change follows independent reports of an audit and alleged financial misconduct at the facility.

The Nicaraguan Social Security Institute, known as INSS, formalized the transfer of management and administration of the Carlos Roberto Huembes Teaching Hospital to Specialized Medical Services, or SERMESA, effective November 10, 2026.

The hospital has long been associated with the National Police and has served officers, their families, pensioners, and other covered patients. Under the new arrangement, it will no longer be run by the police.

In a statement described by the online media, INSS said the decision followed a review and validation of the services the hospital provided to police personnel and their families.

The official explanation focuses on continuity of care. The circumstances surrounding the transfer raise a separate question: why was the police force removed from direct control of a hospital so closely tied to its personnel?

Nicaragua Investiga reports that independent journalists had previously described an intervention by the Attorney General’s Office connected to an audit that allegedly found diverted funds, extra salary payments and other unauthorized acts of corruption.

It also reports that senior hospital officials were detained or placed under house arrest in early November.

Analysis

The distinction between access and control is central to this decision. INSS says police families will retain their connection to the hospital. What changes is who directs it. That gives the social security institute, through SERMESA, authority over a facility that had been an important part of the police force’s medical and operational structure.

The transfer could give INSS more direct oversight of hospital administration. Whether it improves care, addresses the reported financial concerns or changes services for patients remains to be seen. For now, the confirmed shift is institutional: the police keep a hospital dedicated to their care, but lose direct management of it.

What happens to Daniel Ortega’s medical care now?

There’s no confirmed change to Daniel Ortega’s medical care. What changed on November 10 was the management of Carlos Roberto Huembes Hospital.

The uncertainty is significant because Ortega has reportedly used a private room at that hospital. DIVERGENTES reported that he went there for a specialist evaluation on October 30, was discharged that night, and remained under medical supervision.

So Ortega may still receive care at Huembes, at home, or through a different physician. No reporting we could verify establishes which arrangement is now in place.

In 2026, Ortega’s public appearances have fallen to less than half the number recorded in previous years. According to an analysis by Confidencial Digital, Ortega made a total of 264 public appearances between January 2018 and November 2026. The findings show that since the April 2018 uprising, his public appearances have declined year after year, while an increasing number of historic commemorations have been dropped from the dictator’s already limited schedule.