After a 7 hour microbus journey from Rabinal to Chimaltenango, we finally arrived at ASECSA Chimaltenango on Tuesday afternoon. We dropped our bags off in a dormitory building up the street from the site of the conference and headed out to check out the town of Chimaltengango.
Off the bat, I realized that we weren’t in Rabinal anymore (sorry Todo). Chimaltenango has a very different feel than Rabinal. In Rabinal, you greet everyone you walk by with a “Buenos Dias” or “Buenas Tardes.” I suppose Chimaltenango is a more of an urban setting (as evidenced by the fact that they have multiple traffic lights, whereas Rabinal has none). Regardless we explored the centro and walked by giggling high schoolers (terecero basico en Guatemala) and chatted with a few locals. We also met up with Bron and Eric Anders, 2 doctors from San Diego that would be helping us with the planning of the health fairs. Bron has been heavily involved with the Department of Community Pediatrics at UCSD, and she and her husband have some great perspective on international medical projects.
When we arrived back at the dormitory, we realized that each room held about 14 people in a relatively tight space. That made for 28 women in close quarters. Let me clarify, 28 women and one bathroom! Many of our roommates were health promoters and comadronas (midwives) from different regions of Guatemala, while others were some of the women that we interact with on a regular basis from ASECSA Rabinal.
Wednesday morning at 2am, we were all loudly awoken by conversations going on in the 2 women’s rooms. Both the power and water were not functioning, and we had all planned on going to a traditional Mayan ceremony at 4am that day. After getting ready, we walked over to the site of the traditional Mayan initiation ceremony. We walked through a garden during the dark of early morning and followed the sounds of traditional Marimba music to an opening in the greenery where the ceremony had just begun. In the center the guías, or spiritual leaders of the ceremony, had arranged a circle of rocks about 5 feet in diameter in which they placed kindling material, lenia (cedar firewood), sugar, bread, corn husks and many other offerings and kindling material.
The purpose of the ceremony was to celebrate 30 years of ASECSA, initiate the ASECSA conference, and ask ancestors for their blessings on this auspicious occasion. The guías emphasized 3 main topics during the conference. They emphasized (1) respecting the earth and all of the gifts it provides us with, (2) solidarity and equality amongst all human beings, and (3) praising the ancestors for their continuing guidance and contributions. The ceremony lasted about 5 hours and ended with some group sharing about the experience.
After the ceremony, we walked through the garden and across the street to the ASECSA Conference. The first day of the conference gave us a good overview of the history of ASECSA. We heard from a couple of the main founders of ASECSA, Maria Zuñiga and Armando Cáceres. They outlined that 2 main needs in the Guatemalan health care system in the 1970’s were (1) low cost medications and (2) training of health promoters. Over 80% of patients receive primary care from health promoters and comadronas in their homes, and only 20% of patients go to local clinics or doctors for medical care. From its inception, ASECSA has been training health promoters in the community to provide care for fellow community members. ASECSA has also concentrated on being conscious of natural resources and traditional Mayan remedies. The organization incorporates these concepts into the health promoter trainings. The first day of the conference was a good introduction to the history and objectives of ASECSA. Later that evening we were treated to a traditional Mayan dance performance and music.
Day 2 of the ASECSA conference started off with a panel discussion about (1) the rights of indigenous women, (2) youth in the community, and (3) the new Mayan Cosmovision. I especially enjoyed learning about the Mayan Cosmovision which emphasized a unifying energy, unity and synergy, and the concept of dynamic equilibrium.
My favorite part of the whole conference was the afternoon session on Day 2. The topic was “Health for All: an undeniable right.” The highlight of the panel discussion was the presence and comments of Nobel Prize winner, Rigoberta Menchu. I read Rigoberta Menchu’s autobiography in college in an anthropology class that focused on the struggles of indigenous societies in Latin America. Menchu’s autobiography details the tragedies, violence, and injustices she, her family, and the Qui’che Mayans faced during the time of the Civil War in Guatemala. Some other group members have been reading her autobiography on the trip, so we were all very excited to hear her comments.
The panel began with a history of statistics presented by Dr. Rigoberto of OPS. We learned that there is approximately 1 doctor per 1,000 people in Guatemala. The Guatemalan government spends 1.2% of the GDP on health care in comparison to 7.5% in Spain. He emphasized that the worst part of the Guatemalan health care system (similar to problems in the US system) is that people are forced to spend an exorbitant amount of money at the time that they become ill. He emphasized that the state has an obligation to guarantee the right to health to each citizen.
Next Rigoberta Menchu described many of the issues her Qui’che population face with the current medical care system. She emphasized the distrust between doctors and the indigenous people due to language barriers, cultural barriers, and racism. She urged people to fight for their health. She described a need for a movement fighting for life, for equal access to health care. She praised ASECSA’s efforts in reaching out to the most distant communities and training health promoters there.
Finally, Maria Zuñiga spoke about the People’s Health Assembly. She discussed that the main cause of disease and illness is the structure of injustice within a society. She denounced privatized water, clearly stating that clean, running water should be accessible to all without additional cost. She also spoke against genetically modified corn, which would harm the businesses of traditional farmers by making them dependent on a commercial product.
Then, the fun part! We got to ask questions. Three members of our group asked 10 of the questions that were presented to the panelists. I asked if the panelists thought that the medical education system needed to change so that doctors and health promoters could develop mutual respect as they worked towards the same goal. Mike Bakal referenced Menchu’s book and a disconnect between doctors and the attitude of people in the local aldeas here in Rabinal about opinions on health care. Mike McGuirk asked how the government could separate the economic interests of pharmaceutical companies from providing necessary medications to the population. We got some interesting responses to our questions from each of the panelists. They emphasized the importance of having indigenous doctors in the communities and the need for a scholarship program to train such doctors. They also agreed that doctors and comadronas need to have mutual respect and work together instead of against each other to provide medical care.
After Day 2, we left for a group trip to Lake Atitlan. The ASECSA conference overall, was a great learning experience. We will definitely be incorporating some of the ideas we learned into future Voces y Manos plans.