Guatemala

Guatemala is the most populous nation in Central America. It was once the core of the Mayan civilization, and many Maya reside there today.

Learn more about Guatemala

*This information was paraphrased from Bernhardson, Wayne (1995). Moon Handbooks: Guatemala. Avalon Travel Publishing: Emeryville, CA. 1-48:

The Mayan civilization reached its peak from 100-900 A.D., which is referred to by scholars as the Classic Period. Agricultural advances and subsequent surpluses provided the foundation for the rise of the Mayan Empire. At its height, the Mayan Empire had enormous citystates with soaring temples and sprawling acropolises.

The Mayan Civilization at this time was a hierarchical, literate society that built enormous stepped, pyramid-shaped temples and carved stone tablets (stelae) to record their legacies. The Mayans were known for their advanced mathematics and astronomy as well as the development of their unique calendar system, which has allowed scholars to decipher texts and reconstruct events of Mayan history with amazing accuracy.

By the end of the 15th century, the Mayan Empire was crumbling due to the infighting of the various citystates and “an unfortunate combination of growing population, environmental degradation, political intrigue, internal dissension, regional warfare, and collapsing trade networks.”

Colonialism

*This information was paraphrased from Bernhardson, Wayne (1995). Moon Handbooks: Guatemala. Avalon Travel Publishing: Emeryville, CA. 1-48:

The first incursion of Spanish explorers came in 1523 and was led by Pedro del Alvarado to the area now known as Chiapas in southern Mexico. The following year, expeditionary forces penetrated the highlands of present day Guatemala. In the ensuing years, more Spanish forces came in pursuit of conquest, some seeking riches of the devastated indigenous civilizations, while others were seeking religious conversion of the native inhabitants. Conquered lands were under the dominion of the Spanish Crown, who required the indigenous people to sign the requerimiemento: a document that forced people to accept Spanish authority and Catholicism or risk military suppression. Although the Spanish armies certainly had superior weaponry over the indigenous population, academics now recognize the effect that diseases may have contributed to the decimation of the native inhabitants. The Spaniards brought with them diseases for which the natives had no built up any immunities. Diseases such as typhus, small pox, and measles, which were relatively innocuous for the Spaniards, exacted a catastrophic toll on the native population. By the end of the war,“more than three quarters of Guatemala’s two million inhabitants died in the first 30 year following Spanish contact, reaching its lowest point of 128,000 in 1625.”

Civil War

*This information was paraphrased from Bernhardson, Wayne (1995). Moon Handbooks: Guatemala. Avalon Travel Publishing: Emeryville, CA. 1-48:

Guatemala achieved independence from Spain and was recognized as a separate country in the mid-19th century. Since that time, the political leadership of the country has been dominated by military dictatorships. The country’s political history has been characterized by a succession of revolutionary coups and counter-coups. The first democratically elected leader was Juan Arevalo, who was elected in 1945. He was followed by Jacobo Arbenez, who was overwhelmingly elected based on his political stances on educational reform and redistribution of wealth in the country. His reforms challenged the Guatemalan elite and foreign landowners, particularly the American-owned United Fruit Company, which owned huge portions of land throughout Central America. In the context of the growing cold war paranoia of the 1950’s, Arbenez’s radical leftist ideas and suspected affiliation with communist organizations raised “red-flags” with the U.S. Central Intelligence Agency. In response, the CIA backed a revolutionary coup, which dispossessed Arbenez and instituted the formerly exiled military officer Carlos Arnas (whose political ideologies were solidly pro-business and favored the rich). Devoted adherents of Arbenez along with the disenfranchised poor sparked a 30 year civil war which resulted in more 100,000 deaths. The civil war pitted the military forces of the President supported by the powerful elite against scattered guerrilla forces made up of academics and the poor Guatemalans. The grass-roots effort of the guerrilla forces contrasted starkly with the U.S. backed, and consequently well-funded, forces of the ruling military party.

The war was a long and bloody endeavor characterized by horrific atrocities on both sides. Several guerrilla movements gained notoriety for executing several infamous landowners. However, the conflict reached its apex in 1980 when a peaceful occupation of indigenous peasants of the Spanish embassy in Guatemala City turned tragic. The national police stunned the world by barring the doors and burning the embassy to the ground, killing everyone inside.

During the civil war more than 100,000 Mayans fled across the border to Mexico with many living in refugee camps. In an ironic attempt to thwart communist uprisings, the government relocated entire villages to “model communities” which were essentially government sponsored communes, so that they could be more easily monitored. Many indigenous communities are still concentrated in these highland communities, which has been one way that many Mayan cultural practices and languages have been preserved.

Dwindling resources, the withdrawal of U.S. aid, and increasing political unrest set the stage for the peace process, which was finally reached in Guatemala on December 26, 1996. However the tragic vestiges of the war remain in the hearts and minds of the Guatemalan people to this day. Indeed, “the war had left perhaps 200,000 dead, a million displaced internally, and more than 40,000 missing or ‘displaced,’ to use the euphemism that gained currency in South America during the 1970s” (p. 32).

Experiences in the United States

*The following quotes are extracted from an interview with Julio Chohoy,an immigration expert for the Northwest Division of the Guatemalan Consulate in the United States:

“I want to share something personal about my experiences with the mobile consulate, which was something that occurred in California, which is that many of the laborers are coming here [to Oregon]. Many of these laborers have a low educational background. I say this with much respect, but also with some sadness, that most of these people do not know how to read or write. You can see that despite their lack of schooling, they are still the ones generating income and sending it back to Guatemala. From what I’ve seen in my work, I can see that the money being sent back to Guatemala is used to take care of the family’s basic needs. This money also is going to provide for the education and health services for the family. When they send back, say $200 from the U.S., is first prioritized for education. Even though education is free in Guatemala, there are still some costs associated with education. The next priority is food and the third priority is construction. In the study I conducted, I looked at income generation and the different proportions of expenses [for Guatemalan families]. For every $100 they make in the U.S. for work for laborers in California, for example, 89% goes to rent, food, feed and other equipment. In these purchases, they are helping the economy of California by paying taxes for the items they are buying. At the same time they are experiencing the physical wear and tear resulting from their labor.”

[Question: What is the cost for this immigration?]

“Answer: That’s a big question, but I will get right to the point. The cost is for the family. The families are disintegrated and dispersed. I’m going to give one example of the conditions of people in Guatemala. When someone dies in Guatemala, it is important for the family to spend the last night with the person, so that they can see that the full cycle of life continues. A few years ago a neighbor of ours died, and then we called the family. When the family member realized that he could not go to Guatemala for the funeral and return to the United States, even though he was 31 years old and spent most of his life in the United States, it became one the biggest tragedies of his life, because if he left he knew he could not return. And even if he did go back to Guatemala, he could not return to the place he grew up. This speaks to what we have accomplished as a society. But I have faith that the human race will one day be able to look at immigration with justice and with human eyes. In the end let’s say that Guatemala has some proof of change, but that change is slow. And Guatemala has been characterized by discrimination, and exclusion, exploitation, and a bit of indifference. It’s about time we share the world’s riches, using U.S. capital and things that you get from Guatemala that you should be able to share with all.”

Culture

Perceptions of Healthcare

In a recent interview with a member of the Northwest Division of the Guatemalan Consulate, Julio Cochoy provides an account of current healthcare practices in Guatemala as well as healthcare perspectives for Guatemalans living in the United States.

“There are two types of healthcare systems in Guatemala: private healthcare and public healthcare. Access to private healthcare is primarily available for the rich, who account for only 20% of Guatemala's population. Private facilities are well equipped and they have systems in place to help people prevent themselves from getting sick. These are special hospitals that have a lot of money and resources.”

“The public system is used by the majority of the population (80%) who are mainly poor. The national budget for the entire Guatemalan healthcare system is roughly 2,000,000,000 quetzales (which equates to approximately 270,000 U.S. dollars). In the public system there is very little preventative medicine services. In general, the services are very limited, because there is too much demand. On any given day, you will see patients lining the hallways waiting for services even for the most serious conditions. Epidemics such as AIDs have gone largely untreated because it would cost the government over 5 million quetezales a year to treat these patients.”

“For Guatemalans in the United States, most of whom are illegal immigrants, there is a general fear about seeking medical treatment. People who are here illegally, the majority of whom are laborers, do not have insurance are afraid to seek medical attention. If they get hurt while they are on the job, they won't make a claim because they are afraid they will be fired or sent back to Guatemala. Since they have no insurance, if they get treated they will have a huge bill. If they get sick or hurt they may not take medication, because the prescriptions are too expensive without insurance. Women will often neglect to tell their employers that they are pregnant for fear that they will be fired. So they won't get any pre-natal care. They may not even go to the hospital to have their children because they have to pay for the birth. In general, people will leave chronic conditions, such as back pain, untreated because either they don't have insurance or they don't know about health insurance. In general, people who are here illegally don't believe that they have any rights.”

Attitudes About Disability

The incidence rate of people in Guatemala diagnosed with a disability is 12% to 20%.Factors such as malnutrition, poor sanitation, and limited access to health services likely contribute to this higher than average incidence rate. Special education services in Guatemala are evolving out of the private sector through the efforts of charitable organizations. Generally speaking, there are very few special educational or rehabilitative services offered through Guatemala’s education or medical system. However, schools and hospitals are increasingly instituting programs for people with special needs, including new services at public hospitals, an increasing number of military rehabilitation hospitals, and a growing push for special education programs in schools.

A qualitative research study by Couch, Goetz, and Baud (1992), investigated the life-styles, services, and employment opportunities for people with disabilities in Guatemala. They found that families tended to view the person’s disability as the responsibility of the family. Families in Guatemala tend to be close knit, so people with disabilities will often spend the rest of their lives with their family who will provide for their basic needs. In the study, some parents reported feeling “overprotective” of their child. Members of Guatemalan society are likely to view people with disabilities as “objects of pity, a source of shame, and not a part of mainstream society.” The concept of rehabilitation is not highly valued in Guatemalan culture, presumably because most Guatemalans have never been exposed to such services.

Language

The official language of Guatemala is Spanish. This is the language of the elite and the language of commerce. Since the end of the civil war, through the efforts of the Academy of Maya Languages, indigenous languages are increasing. Some schools are even beginning to provide bilingual education. There are over 20 different Mayan languages that are currently used in Guatemala today. The most widely spoken Maya language is K’iche,’ which has nearly one million speakers.Kaqchikel, which is related to the K’iche’ language, has approximately 405,000 speakers. The next most commonly spoken Mayan language is Mam, which has nearly 700,000 speakers. Many Guatemalans are multilingual, most of whom speak Spanish in addition to their native language. However those living in primarily indigenous communities are more likely to be monolingual speakers of Mayan languages.

Implications for the SLP

Therapy Perceptions

According to Mr. Chochoy,the concept of Speech Language therapy essentially does not exist within the medical or educational systems of Guatemala. He attributes this to a lack of financial resources within a healthcare system, which does not have enough money or staff to attend to people's basic needs, much less have enough money leftover for rehabilative or preventative care. Therefore, many Guatemalans may be unaware that speech and language therapy services exist. He recommends that therapists explain to patients or parents about what services SLPs provide. Clinicians should also give a thorough explanation of the insurance or financial repercussions for receiving services. For children receiving services in the school, Mr. Chochoy recommends that therapists reassure parents that the services their children will be receiving are free and to further explain the rights that they have under the law.

Note for SLPs: Because of these prevailing perceptions, SLPs should consider the following when working with many Guatemalan families who may be unaware of services and rights available to them.

• Be sure to explain to the family that the services are free (if in a school setting) or what services are available to them given their insurance coverage.

• Be sure to explain the family's rights under IDEA and the Americans with Disabilities Act. Families who are unaccustomed to exercising their personal/civil rights may need to have the concepts of due process explicitly explained to them. Clinican's may also want to explain to families the importance of active family participation in American culture.

• Reassure families that their participation in their family member's therapy is desired and will not result in any negative consequences. Some families may be afraid to seek services because they are afraid they will be deported or “get in trouble.” Guatemala's history is characterized by subjugation and authoritarian leadership, therefore may Guatemalans may be understandably wary of “causing trouble” or voicing their opinions or concerns. Therefore, clinicans may need to explain to families that their opinions or even outright disagreement is welcome and will not result in repercussions.

• Given that many families are reticent to speak out, clinicians will need to be especially cognizant of subtle signals the family are sending to let her know how they are responding to their family member's therapy.

• Given the country's history of military dictatorships and that many people are in this country illegally, it is not surprising that many Guatemalans do not have a strong trust in the governmental system. Consequently, families may actively avoid seeking services available to them. SLPs will need to be especially vigilant in identifying patients who may require services.

10 Things to Remember

Some Tips for Working with Guatemalan Families

1. Don’t assume that the family speaks Spanish. Before calling an interpreter, be sure to find out if the family speaks an indigenous language and what language they speak.

2. Don’t expect an instant response. “Time in the tropics” is a common phrase used in Guatemala to describe the pace of activity. Guatemalans families may need additional time to respond to requests for information. Guatemalans, in general, are very family and community-oriented. Families may need additional time to discuss their decisions with others.

3. Silence should not be interpreted as a sign of implicit agreement. Guatemalans are generally very socially conservative, especially to people outside their familial/social community. For Guatemalans, it may be rude to disagree or make direct statements.

4. Explain your role as well as the family’s rights under the law. Guatemala has a long history of social and cultural suppression. Families may be cautious or skeptical of services they are not accustomed to receiving.

5. Discuss the family’s role/involvement in therapy. Guatemala is a highly stratified culture, with a high disparity between rich and poor. This causes an unequal distribution of power. Families from a lower SES background may not expect to be actively involved in their child’s therapy.

6. Be sure to review the phonological and language structures of the family’s language to ensure that the articulatory/phonological processes observed are not due to language differences. For a review of these differences, please visit the following reviews of Spanish and Mayan languages.

7. Because of the social and economic circumstances of Guatemalans coming to the U.S., clinicians should be aware that these families may not have had access to education or reading materials. Therefore, the clinician should determine the family’s level of previous education and literacy in a respectful manner. Furthermore, clinicians should take care to ensure that the behaviors observed in assessment are not the result of a lack of exposure versus a true language disorder or delay.

8. Many families may have experienced traumatic events in their lives. The political and economic turmoil of Guatemala may have had a traumatic impact in the lives of families now living in the U.S. In Guatemalan culture, these atrocities are generally considered a “taboo” conversational topic. If the clinician feels this has a significant bearing on therapy, she should collaborate with a qualified psychologist.

9. Building social rapport is important in Guatemalan culture. In Guatemala it is customary to engage in “social talk” before beginning business. To start a meeting or session abruptly may be considered rude.

10. In many indigenous cultures of Guatemala, averting one’s eyes is a sign of respect. This is especially true for students’ interactions with their teachers. Therefore, a lack of eye contact should not be construed as a pragmatic impairment.

Recipe

Guatemalan Style Ceviché

Ingredients 1 ½ pound of jumbo shrimp (de-tailed) 1 small white onion (finely diced) 1/3 bundle of fresh cilantro (remove from stem and finely chopped) 1 cucumber (peeled, de-seeded, and diced) 1 ripe mango (peeled and diced) 1 cup of ketchup 1-2 tablespoons of hot sauce (flavor to taste) 1 ripe lime (juice)

Thaw pre-cooked shrimp and remove tails. Mix together onion, cilantro (about 1/3 of a bundle), cucumber, and mango with the shrimp. Stir in ketchup, hot sauce, and lime juice to the mixture. If desired, add a little salt (or soy sauce). Refrigerate for at least one hour before serving, but 4-6 hours is optimal.

Variations:

• • Instead of shrimp: try raw white fish, but be sure to add more lime juice and let sit over night (the acid of the lime juice and ketchup will essentially “cook” the fish).

  • Instead of white onion: try ½ of a red onion

  • Instead cucumber: try Jimaca

  • Instead of mango: try avocado or pineapple

  • Instead of lime juice: try blood orange juice

Original Contributor: Laura Kane, Winter 2007

Thanks to Julio Chochoy and other members of the Guatemalan Consulate for taking the time to meet with me to share their thoughts and expertise.