About Guatemala

Guatemala is a Central American country bordered by Mexico to the North, El Salvador and Honduras to the south, and with both a Caribbean and Pacific coastline. It covers approximately 109,000 sq km and has a mix of mountainous forest highlands and jungle plains.

Its population totals about thirteen million people and these break up into 57% Ladino (of Spanish-American descent) and 45% indigenous Maya. 60% of the population speaks Spanish and the remainder speaks twenty-one different Mayan languages.

The people of Guatemala are a strong, stoic and willing people who have been burdened by decades of civil war. They live in an unequal society where very few have very much and the rest struggle to survive. The reasons for this imbalance go back to the Spanish Conquest of 1524. Since that time Mayans have been dominated by dictatorial governance, political conflict and civil war that have stifled social growth. Today most indigenous people continue to live in miserable conditions without access to drinking water, electricity, schools or healthcare services.

Impoverished conditions abound throughout Guatemala, but the civil war which ended in 1996, ravaged lives. An estimated 200,000 people were killed or disappeared, 440 villages razed to the ground, and more than a million uprooted and forced to seek refuge in other departments or countries. The majority of those affected during the thirty six conflict were indigenous people and for much of this time the world knew nothing of their plight. Not until 1983, when an indigenous Mayan woman called Rigoberta Menchu, published her memoir I Rigoberta Menchu did the stories of the atrocities and human right violations start surfacing.

With the 1996 Peace Accord the killing ended and changes are happening but it takes time to rebuild a country whose imbalance goes back nearly five hundred years. Indigenous people continue to be marginalized and in places prejudice is only thinly veiled Living conditions of the Maya remain much as those of their pre-contact ancestors. In truth though Guatemala is now a democracy for the Maya little has changed.

Even though these people do what they can to improve their lives their efforts are often in vain. They live in a country which has precious little to give to the poor and even less to the indigenous. If hospitals exist they are under-staffed, under-equipped and under-funded. Many were built in the 1980s with foreign aid but have no equipment of staff and remain virtually unused. Even the National Hospitals are only partially used and are notoriously short of funds. What healthcare exists is largely for emergencies, and even then only if you are lucky.

Guatemala is receiving foreign aid for medical care under the terms of the Peace Accord, but only some of it used where it was meant to go. Improvements are painfully slow and often under-thought. For example the maternal and infant mortality rates in Guatemala are horrendous. In order to try and improve these, programs have been set up to address this issue. Even if there were enough money, the problem goes deeper than funding, staffing and equipping existing buildings. There are many cultural reasons why women do not seek medical care during pregnancy and labor. These are sensitive issues and for any maternal and infant mortality program to succeed these hurdles need to be addressed - which is no easy task as they cross into long established cultural beliefs and feelings of fear and distrust.

When it comes to the general health of the population and those needing elective surgery, there is little good news for there is very little elective surgery in Guatemala. What funds are available are directed to maternity and emergencies. If it isn't an emergency then most likely little can be done, and even if it is an emergency it depends on when the patients arrives at the hospital as to what, if any, services can be provided.

Add to this the belief that hospitals are places in which to die, and is it surprising that people suffer for years with treatable conditions? While working in Guatemala we have seen women with cysts the size of water melons, hernias like sacks of worms and prolapsed uteri that hang down to the knees (Yes we know they sound gross but they are all true). And then there are the men, women and children with cleft lips and palates whom we constantly see and who bring heart-wrenching stories of abandonment, rejection and social isolation (see Teodoro's story and Arturo's story). These stories are especially hard to bear knowing the devastation the deformity brings and how easy it is to rectify it.

We have many more stories to tell but to write them all would take a book. Not all our stories are negative as Guatemalans are wonderful people who give back so much. They are soft spoken and shy and have no anger at their situation. They believe that life goes in cycles and although it may be hard now the next cycle will be good. They give us so much more than they will ever know. They are patient and accept life as it is. They expect nothing and thus are not disappointed. They work hard and make do with what they have. They do not constantly strive for more and complain about what they do not have. And so if you ask us why we work in Guatemala, it is because there is so much that needs to be done, but it is because of the people themselves.

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