Int J Health Serv
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In July 1979, a coalition of social forces in Nicaragua, under the leadership of the Sandinistas, toppled the discredited 43-year Somoza dictatorship. In addition to revolutionary Nicaragua's own substantial efforts, since 1979 international forces and developments have had profound impacts on the nation's ambitious social programs. This article investigates the impact of foreign nations and international organizations on Nicaragua's health conditions since 1979. ⋯ Since 1981, counter-revolutionary guerilla forces, known as contras, have fought the Nicaraguan government troops in a disastrous conflict, involving substantial international assistance for each side. The United States and several other nations have provided some form of aid to the contras. The war in Nicaragua has resulted in enormous human and material losses, and, of course, has adversely affected health conditions.
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Corporatization of health care is dramatically transforming the medical workplace and profoundly altering the everyday work of the doctor. In this article, the authors discuss recent changes in U. S. health care and their impact on doctoring, and outline the major theoretical explanations of the social transformation of medical work under advanced capitalism. ⋯ S. experience, no country or health system can be considered immune. Indeed, U. S. experience may be instructive for doctors and health care researchers in other national settings as to what they may expect.