Santiago, Atítlan: “Waaaaaaa!” “Waaaaaaa!” The newborn wailed so loudly we could hear her in our meeting upstairs at the rural Mayan health clinic. Her cry was universal while our meeting was being held in Spanish, English and Tzutújil (pronounced tsu-too-heel), a Mayan language. This joyful event explained why the coordinator of the community health advocates had abruptly left our gathering earlier—to assist in the birth.That morning, three of us, representing an international philanthropy, had sailed across Lake Atítlan in a small commercial boat to reach the clinic. After disembarking, we walked along dirt roads past many local produce vendors to the health clinic, Rxiin Tnamet, (meaning For the Community) whose innovative programs we had come to learn about. The small clinic was bustling. In one room, someone was leaning back in a slanted chair looking up at a white-frocked dentist. In another, women of all ages were sitting in rows of benches, facing a teacher. Another room hosted men sitting in a circle talking.
Although 23 different Mayan peoples live in Guatemala, of which the Tzutujiles are one group, the government provides health services and education only in Spanish. With nearly 60 percent of the population here living in extreme poverty, life is hard for everyone, but women and girls are especially discriminated against and disproportionately illiterate. The clinic is an antidote to the dearth of services in maternal health and the lack of education specific to women and girls in their own language.
For this reason, the clinic has trained 150 mothers to share information orally. With pamphlets using mainly graphics, they learn about female health, HIV/AIDS, sex education and family planning, and teach other villagers what they learn. The local health advocates are trained to handle straightforward health problems as well, like helping a mother treat her child’s stomach problem or assisting an elder cope with the effects of aging.
Francisca Akchivan, returned to our meeting, after finishing the day’s stint as a midwife. “From the moment a girl is born, she faces limitations. Now that women are learning their rights, they are finally asking about their own health care. And they are asking for more text in the pamphlets so their daughters can learn to read.”
“They have overcome many of the objections men raised when women first got involved in the training,” she continued. Some men even beat their wives for going to the classes. “But once women had a taste of learning, they kept insisting on attending the health lessons. Eventually, most of the men grew to understand the benefits of women leaving their homes for training.” And the clinic came to realize how important it is to educate the men as well. For example, treating STDs in teen-age girls is necessary, but preventing STDs is vital. Prevention requires that migrant men understand how STDs are transmitted. Since being trained by the clinic, 50 male health promoters have returned to their communities to educate other young men.
The director of the clinic, Leticia Toj Umul, explained how much their institution values integral health care. This means using both pharmaceuticals and native plants. “There is no need to abandon the medicinal applications of native herbs and plants,” she said, “because they serve as palliatives and curatives for various conditions and we can also take advantage of modern medicine that can save lives and improve general health.” Later that day we met with a native herbalist on the western side of the lake who easily ticked off 15 different plants and their uses. She was growing all of them in her small backyard.
Ms. Umul also explained the inherent democracy in clinic structure and how it contributed to improvements in community health care. Every six months the trained health advocates participate in voting on the action plans and budget. They elect representatives from each village to the General Assembly. The majority of the board of directors is Mayan, mostly women.
On our way out, the coordinator took us to see the family with the newborn. We congratulated them, showing our enthusiasm on the birth of their baby girl. The family wasn’t celebratory. Age-old prejudice cannot be washed away in an instant. But now that the family is connected to the clinic, perhaps the attitudes of prejudice borne by the men and internalized by the women, will succumb to the understanding that when a woman cares for herself, she improves the lives of everyone in the family.
As we sailed back to the other shore, the soft mirror of volcanic peaks in the lake gave our transit an air of mystery. Gliding across the water, cradled by mountains long revered by the ancients, I felt hopeful that one day, a family giving birth to a baby girl in the shadow of Mount Toliman, will jump for joy.
©Leanne A. Grossman