Nicaraguan authorities have withheld life-saving treatment from a pregnant cancer patient because it could harm the foetus and violate a total ban on abortion. [1]

A state-run hospital has monitored the cancer spreading in the body of the 27-year-old named only as Amalia since her admission on February 12 but has not offered chemotherapy, radiotherapy or a therapeutic abortion, citing the law.

The decision has ignited furious protests from relatives and campaigners who say the woman, who has a 10-year-old daughter and is 10 weeks pregnant, will die unless treated. The cancer is suspected to have spread to her brain, lungs and breasts. They have petitioned the courts, government and the pan-regional Inter-American Commission on Human Rights [2] to intervene.

The case has revived controversy over the 2007 law which made Nicaragua [3] one of the few countries to prohibit abortion under any circumstances. Girls and women who seek an abortion, and health professionals who provide health services associated with abortion, face jail.

“Amalia’s situation demonstrates the urgent need to repeal this draconian ban which prevents the delivery of timely care and impedes sound medical judgment,” said Esther Major, central America researcher at Amnesty International. “Each day is critical for Amalia’s chances of survival.”

The ruling Sandinistas, who once boasted feminist credentials, supported the measure to curry favour with the Catholic church.

Amalia is being monitored at a hospital in Leon, the second-largest city in the impoverished central American country. The hospital director, Ricardo Cuadra, said the case had been referred to a government-run medical commission which is due to issue a recommendation next Monday.

Campaigners accused the authorities of dragging their feet despite the patient’s deteriorating condition. “The doctors say because she is pregnant and since abortion is banned they cannot do anything,” Bertha Sánchez, of a local feminist advocacy group, told La Prensa. [4]

A group picketed the hospital with a banner reading: “Doctors we support you, save the life of Amalia.”

Since publicising the case last week, Amalia’s sister has been supported by two advocacy groups. Oscar Flores, a doctor with the Strategic Group against the Criminalisation of Therapeutic Abortion and the Nicaraguan, said Amalia suffered from “metastasized cancer that has spread throughout (her) body, a problem exacerbated by the pregnancy”.

The Nicaraguan human rights centre, Cenidh, described the case as “dramatic and painful”. Both groups have lobbied the supreme court and the Inter-American Commission on Human Rights to intervene.

The government said it would make an announcement after the medical commission reported. “We will comment on this case in due time,” said the health minister, Guillermo Gonzalez.

In apparent reference to the authorities’ frequent clashes with non-governmental organisations, he added: “Unfortunately, it seems that there are political interests behind this.”

As Marxist rebels in the 1970s and as a revolutionary government in the 1980s, the Sandinistas championed women’s rights – including limited abortion rights.

After losing power in 1990 their veteran leader, Daniel Ortega, embraced Catholicism [5]. When making a comeback in a tight 2006 election he joined conservative foes in backing a church-led iniative for a total abortion ban. There are no exceptions for rape, incest or health risks to the mother. Even an anencephalic or ectopic pregnancy, which are incompatible with life, must be carried to term.

An Amnesty International report last year said the ban had led to a spike in maternal deaths. [6]

Rory Carroll