Sir.—Having just returned from an international medical conference in Nicaragua, I would like to share some information on the health of children there and also call attention to the growing number of United States physicians who are becoming interested in the medical conditions of our nearby neighbors in Central America and who are increasingly disturbed by what they find.
Nicaragua is a country at war. Since 1983, they have lost over 2,000 people who died from attacks across their borders. Most of these dead have been civilian noncombatants. Many of them were children. Present heavy defense expenditures are largely being taken from the social services budget. In spite of this, intelligent and effectively implemented public health measures have accomplished dramatic improvements in the well-being of Nicaragua's children. Vaccination campaigns aimed at the entire population, both rich and poor alike, have reduced reported cases of measles from over 4,000 in