There was no doubt, he said, that the case was one of demonic possession.

“The devil exists. Demons exist,” he said, declaring them responsible for many of society's problems.

For psychiatrist José Miguel Salmerón, who has followed the Vilma Trujillo case closely, this is an instance of what he calls “a dangerous understanding of the world that dates back to the Middle Ages”.

He says that though no-one can diagnose Vilma posthumously, her symptoms - including talking about the devil - are common in hospitals for mentally ill people.

“The majority of the Nicaraguan population is not interested in mental health. People prefer supernatural explanations,” he says.

“The key to change is more education in schools. More biology and life sciences. We need to create space for critical reasoning and secular thinking. We need to separate religion from our interpretations of the world around us.”