by Laura Ruch, WCAS 2012, biology and science in human culture major, global health minor
Dr. Paul Farmer once said, at a keynote address for the 2010 Northwestern GlobeMed Summit, “There are no first, second, third worlds. There is one world.” That line has stuck with me since I first heard it, and I think it offers a wonderful model for thinking about issues related to poverty, access to resources and health inequality. We are all living in the 21st century, a time of seemingly endless technological capacities, and as members of one world, it strikes me as unacceptable that some communities continue to remain cut off from the resources and inventions that the “developed” world has at its fingertips.
I recently had the chance to spend a week in El Petén, Guatemala, working with an NGO called SewHope, based out of Toledo, Ohio (my hometown). I’ve traveled to Guatemala five times before, but this trip rattled me even more so than the others, perhaps because I am older, but also, I think, because the organization has developed strong relationships with the people in Pueblo Nuevo. The small village has only about 60 families, and working among them, it felt like we were their extended family, their friends, rather than outsiders with our own agenda. SewHope is a multifaceted organization comprised of physicians, teachers, farmers, and students, both from the US and Guatemala. While the American doctors have expertise in diagnosing and treating illnesses, the organization would be nothing without the inside knowledge and connections of the Guatemalans who work there. When we must board a flight back to the US, patients can return to the clinic for follow up visits and medication refills, the education programs continue to run, and the gardens and tilapia farms we helped to create aid in improving nutrition and bringing in extra cash for the community. It seems intuitive that an organization working in community development and health care simply cannot be effective if it runs stop and go programs, dependent upon the travel schedules of foreigners.
Many incredible moments came out of my week in Pueblo Nuevo, but I’ll limit myself to sharing three of the most poignant stories. Firstly, while taking a medical history of a young woman, I commented on her baby’s lovely knitted red hat, and asked her why she used it in the middle of the summer. As it turned out, the hat was not for sun protection so much as for protection from “El Ojo”, or the Evil Eye. The woman explained to me that the year before one of her other children had begun vomiting a green fluid after a man she had an argument with gave it “the look.” The baby died suddenly. After hearing this, I began to notice that almost all the babies had something red on them – a shirt, a blanket, a simple bracelet. Beliefs surrounding Evil eye date back to Spanish folk religion, and children, especially infants, are believed to be most susceptible. In a setting where many infants die of malaria, diarrhea, malnutrition, and other preventable illnesses, it makes sense that such beliefs are ubiquitous. Rationalizing “stupid deaths” (another Paul Farmer phrase) by ascribing them to uncontrollable forces of evil is a much easier pill to swallow then recognizing that one’s child has been the victim of an unfair world, where some are simply cut off from basic healthcare, sanitation, and clean water. Many women also continue to believe that their health care catastrophes are the results of the “susto”. Susto is what happens when you experience a terrible “fright.” One woman described seeing a large snake in her home that terrified her while she was pregnant, and her baby immediately died. Another woman witnessed a murder and afterwards began experiencing chronic back pain. Of course, these are not conscious things – the mothers have not had the privilege of learning about the mechanisms of disease and malnutrition, and they are not trying to replace science with non science-based cultural beliefs. However, one can see how believing in the Evil Eye or “susto” might serve as a sort of coping mechanism for painful losses.
Also on the trip, I saw first hand the importance of a community feeling empowered and being able to collaborate to work toward big goals. The day after I arrived in Guatemala, we drove into the village in a van and found all of the kids and some of the community leaders gathered outside the school and looking forlorn. As it turned out, the school’s principal, Concepcion, had locked the gates to keep the students and teachers out. From what I understood, he felt angry at the way parents had been pushing him to create new education programs, and he thought that the new spirit of empowering women and children would undermine his authority. He is frequently absent (the school was only open 1 day the week before for no apparent reason). Concepcion has been pulling these sorts of stunts for years, but the community had decided once and for all they had had enough, and one of the leaders went off in search of something to break the lock with. When he came back with a huge set of bolt-cutters, he spoke for a few minutes on camera about the unfairness of the situation, and then forcefully broke the lock while everyone clapped and cheered. On July 1, a group of the villagers went to the Human Rights Commission, the Ministry of Education, and the newspaper (Prensa Libre) with the information, with the hopes of removing Concepcion from his position. They were able to inform the authorities who have promised to replace Concepcion. It was really cool to see the people of Pueblo Nuevo standing up for themselves and taking the initiative to demand a higher standard of education for their children.
Finally, a very surprising event that we were privileged to take part in was the excavation of the body of the husband of one of the women in the village. The man and his friend were the victims of random killings during Guatemala’s 36 year civil war (1960-1996), arguably the most brutal civil war in the history of Latin America. More than 200,000 people were killed, about 83% of Mayan descent, and the U.N. Commission for Historical Clarification has issued a report showing that state forces and military groups inflicted the vast majority of human rights violations. Now the government has started a program to offer some solace to families of those who have suffered the loss of loved ones. A team of two archaeologists, two forensic scientists, a psychologist, numerous policemen and others led the exhumation of the husband and his friend. The story was featured on the Guatemalan news for the Petén region. The community eagerly included us in the very special event and even invited us into the area sectioned off for family members. Our friend Orfe initiated the process, and she has also established a cemetery in Pueblo Nuevo. For a community with very strong religious beliefs, having a proper place to bury and visit those who have passed away is very important.
It took me a full day of traveling to make it back to Chicago, and, as always, it was a somewhat surreal experience to step into an American airport and have limitless restaurants, amenities, and services offered to me. The week in Guatemala truly flew by, and I’m eagerly looking forward to my next trip there. In the meantime, there are lots of things to mull over. I can only imagine what sort of changes will take place in Pueblo Nuevo in the next couple of years and beyond the people are given the chance to make their lives better.