Panama’s Former Leader Manuel Noriega
Panama's former dictator Manuel Noriega is seen next to police officers upon his arrival at Renacer prison, outside Panama City Dec. 11, 2011. Noriega, Panama's drug-running military dictator of the 1980s, was extradited back to the country on Sunday and taken straight to prison to serve a 20-year sentence for the murders of opponents during his rule. Noriega, now 77, was toppled in a U.S. invasion of Panama in 1989 and has spent the last two decades behind bars, first in Florida and then in France after being convicted for drug trafficking and money laundering.

The former dictator of Panama, Manuel Noriega, who was overthrown in 1989 in what was then the largest American military action since the Vietnam War, was moved from his prison cell to a public hospital on Sunday, after suffering from extreme hypertension.

The country's National Police confirmed that Noriega, 77, who is serving a prison sentence for drug trafficking, had possibly suffered a stroke. An Associated Press (AP) report quoted Health Minister Franklin Vergara as saying Noriega had high blood pressure (which could have led to the stroke) and that doctors even saw signs of a possible brain hemorrhage.

The ex-dictator, who was in power from 1983 until 1989, was Panama's Chief of Intelligence for a long time before he worked his way to the top and ran the country using threats and intimidation. He was hugely criticized for all the killings and torture carried out under his regime. Before coming to power, he was an important CIA and DEA asset, actively involved in spying on Colombian drug cartels that allowed passage of cocaine through Panama into the United States.

However, the relationship between the U.S. and Noriega deteriorated after it seemed the latter had turned on the Americans. Prosecutors later alleged Noriega helped the Medellin cocaine cartel ship "tons and tons of a deadly white powder" into the United States.

He was convicted in a Miami court in 1992 on eight counts of drug trafficking, money laundering and racketeering. He spent close to 20 years in prison, in the U.S. and France, and returned to Panama on Dec. 11, 2011. Ever since then, Noriega has been at the El Renacer prison in Panama on a 20-year sentence for convictions from several unexplained deaths and disappearances of Panamanian citizens while he was in power. There could be more cases pending against him.

Noriega, once feared and known for brandishing a machete while delivering impassioned speeches, returned home to a country that had definitely moved on. There was hardly any political impact or reaction from the Panamanians. The country has seen four presidential elections as well as a booming economic upturn amid a $5.25 million expansion plan of the Panama Canal.

Still those who lost their loved ones to his tyrannical rule and fought his regime hope that Panamanians always remember that democracy has come at a heavy cost and should never be taken for granted.