Health and Life in Guatemala
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Community Health and Healthy Women.
Guatemala is Central America’s most populous country, with 14.3 million people, of which about 40% are indigenous descent. Although Guatemala is a lower middle-income country with an average per capita income of $2,700, this figure masks extreme inequalities that reflect the exclusion and disparity that affect indigenous and rural populations. For example, the average time in school among indigenous people is only 3.8 years while it is 6.5 years among the non-indigenous. Almost 75% of indigenous people live in poverty compared with only 36% of the non-indigenous. These large inequalities are also present between rural and urban residents. Guatemala has a national poverty rate exceeding 50% and a rate of extreme poverty of 15%. While 46% of the total population lives in rural areas, 72% of the extremely poor live in rural areas.
Despite its middle income status, Guatemala’s health outcomes compare unfavorably with those of other much poorer countries. The child mortality rate at 42 per 1,000 live births is the highest in Central America and the third highest in the region after Haiti and Bolivia. The maternal mortality ratio of 136 per 100,000 live births is also one of the highest in the region, and the contraceptive prevalence at 54% one of the lowest. The health situation in Guatemala is essentially a tale of two countries. Paralleling the income and education disparities, large differences in health outcomes exist between urban, non-indigenous populations and rural, indigenous groups. Child mortality and malnutrition are 50% higher among rural and indigenous children. Maternal mortality is up to five times higher in some rural areas compared with Guatemala City. Skilled birth attendance among rural and indigenous women is less than half of that for urban and non-indigenous women.
In Guatemala, the face of poverty and hunger is young, indigenous and rural. Guatemala, with the fourth highest rate of chronic malnutrition in the world and the highest in Latin America and the Caribbean, faces a serious challenge to reduce chronic undernutrition, currently at 49.8% among children under 5, 66% for indigenous children. These high malnutrition rates have long term health, education and economic consequences for those who suffer from it. Unfortunately, there has been very little progress in reducing chronic malnutrition. The rate was 55% in 1995 and 54% in 2002.
While most health outcomes remain worse than in other countries in the region, over the last decade Guatemala has made significant progress in narrowing these gaps and improving health disparities. The child mortality rate, currently at 42 per 100 live births, is on track to achieve the Millennium Development Goal (MDG) target of 37. Total fertility fell from 5.0 in 1999 to 3.6 in 2009 with a comparatively greater decrease for indigenous women from 6.2 in 1999 to 4.5 in 2009, contraceptive prevalence increased to 54%; and skilled birth attendance increased to 51%. Prenatal care coverage rates are the same among urban, non-indigenous and rural, indigenous women, and immunization rates are the same for these groups of children. An important contributor to these improvements is the MOH’s extension of coverage (EOC) program instituted in 1998 which contracts Non-Governmental Organizations to provide itinerant health services to communities that otherwise would not have adequate access to health services. In addition, the MOH, with loans from the World Bank and IDB, is rapidly expanding provision of emergency obstetric care in rural areas with 140 additional health centers providing basic extension of coverage in 2010 and 12 additional centers providing comprehensive EOC (C-sections) by 2011.
Medical Teams International (MTI) has established community health programs in the municipalities of San Juan Chamelco, Alta Verapaz and of Chicaman, El Quiché. MTI is focusing on prevention and community case management of malnutrition, acute respiratory infection and diarrhea while simultaneously improving maternal health. In coordination with community, church, and government health officials, MTI is implementing a comprehensive portfolio of results-oriented activities to address these preventable diseases.
To date, MTI has trained and is actively working alongside over 400 community volunteers throughout Gautemala. Through this network of committed volunteers, MTI Guatemala’s staff is able to:
- Conduct monthly growth monitoring and counseling sessions for children.
- Educate families on the identification and treatment of childhood illnesses.
- Improve health through strategic health trainings.
- Build ventilated stoves, water-systems and sanitary latrines.
- Train community midwives to better care for pregnant women and to attend safe births.
- Ensure essential vaccinations are provided; among other activities.
Plans for 2013-2014
MTI will continue the community health and nutrition project in San Juan Chamelco and this year will expand its work to a new municipality – Chicaman – in the department of El Quiche. Medical Teams International will send medical supplies, equipment and pharmaceuticals to help supply rural health posts throughout the region of El Quiche.
MTI will also deploy 23 volunteer teams to support our work in Alta Verapaz and El Quiche. Teams will focus on health training, community health focused work projects and dental health. Through our programs, MTI will directly improve the health of more than 95,000 Guatemalans.
MTI partners in Guatemala
Guatemala Ministry of Health – MTI works closely with the Ministry of Health by providing it with prenatal vitamins, Albendozole (de-worming medicine), basic medical equipment, and health topic trainings for its personnel, as well as collaborating with MOH personnel in training community volunteers.
FUNMAYAN is a non-governmental organization contracted and funded by the Ministry of Health in order to provide prenatal, postnatal and infant care, growth monitoring, vaccination, deworming services, and supplemental nutrients for children 5 and under, vaccination and supplemental foods to women in their childbearing years and training for community health volunteer staff (midwives, health promoters, community facilitators, emergency commissions).
Alianzas – U.S.A.I.D.’s counterpart in Guatemala.
Food for the Hungry began working in Guatemala in 1976. The organization operates innovative development programs in 2 regions and 32 communities, assisting families, leaders and churches in their struggle to overcome poverty.
Agros International began its programs in Latin America in 1982. Agros has helped families in Guatemala, El Salvador, Nicaragua, Honduras, and Chiapas, Mexico build self-sustaining and thriving communities.
Volunteers should familiarize themselves with the security situation in Guatemala by researching various websites: the Overseas Security Advisory Council - http://www.osac.gov, the U.S. Department of State - http://travel.state.gov, Australia’s Smart Traveler’s website - http://smarttraveler.gov.au and the United Kingdom’s Foreign and Common wealth Office website - http://smarttraveler.gov.au. Volunteers should enroll in the U.S. State Department’s Smart Traveler Enrollment Program – STEP (https://step.state.gov) or at the website for the country of their citizenship in order to be assisted if services are required.
Please donate or volunteer to help save lives in Guatemala.