Still, the country remains the second poorest in the Western Hemisphere, with a per capita GDP of $817. Nearly one-half of the population lives on less than $1 a day, while one-third of children suffer from severe malnutrition and other chronic health problems. In addition, the national education system ranks weakest in Central America. The majority of adults do not have stable formal employment, with many generations sharing one family home.

In 1972, Food for the Hungry assisted with earthquake relief efforts in Nicaragua, and began its long-term holistic development work in 1994. In this disaster-prone country, FH has had two major relief operations in the past nine years, as well as other small responses. The 1998 Hurricane Mitch response involved food, shelter and home and church reconstruction efforts. This year’s category 5 Hurricane Felix and the multiple effects of two months of heavy rain have again required significant intervention.

In September 2007, FH responded on Nicaragua's Atlantic Coast with a multifaceted approach that included funds for food and housing reconstruction, $2.7 million worth of medicines, and counseling for the survivors and their families. Current efforts are ongoing in the western region of Chinandega, which are related to a serious epidemic of leptospirosis and crop destruction from a tornado.