HISTORY, A DETERMINANT OF HEALTH: A Focus on Indigenous Guatemala

Around the world, various indigenous communities face health inequities and experience poor health outcomes due to fractured healthcare systems and inadequate health frameworks. For Guatemala, where an estimated 40 percent of the population is indigenous, access to quality care and resources remains a persistent challenge. From environmental to socioeconomic factors, many confounding variables have made access to basic healthcare highly difficult for Indigenous Guatemalans. In this week’s blog, we are going to spend some time learning about the prevailing historical events that led to the initial marginalization of Indigenous Guatemala. We will then explore the evolution of the Guatemala’s healthcare system in the next blog post and learn how the current system came to be. I must warn you, Guatemala’s history is very long, but to fully understand the context of her healthcare system, we must first examine her history and her defining moments, even if its going to take an extra paragraph or two. So, buckle up!

Before Guatemala was colonized by Spain in the 16th century, its population was predominantly made up of various Mayan groups that spanned the entire nation. Once the nation was colonized, many of these groups lost their land and ruling power. When Guatemala finally gained independence in 1821, the nation formed an alliance with several other Central American states and became the United Provinces of Central America until its dissolution in 1839. This dissolution led Guatemala into a long duration of transitioning between authoritarian rulers throughout the 19th century. Although there were periods of peace and prosperity, the growing presence of the United States in Guatemala is what eventually led the nation into political chaos.

By the start of the 20th century, the United States had formed a strong export partnership with much of Latin America. Its economy became largely dependent on authoritarian governments that allowed foreign investment and it gradually became Latin America’s strongest economic influence. In 1901, America established the United Fruit Company (UFCO) in Guatemala and was given farmlands that belonged to Indigenous Mayan groups. In 1931, Jorge Ubico became president and further displaced the Indigenous population by giving more landownership to the UFCO. However, in 1944, the country began to go through political unrest and experienced a liberal revolution. This caused Jorge Ubico to flee the country and in turn, Juan Jose Arevalo became Guatemala’s first democratically elected President.

During his rule, Juan Jose Arevalo made several reforms in labor rights, education, and landownership. His goal was to give land back to the Indigenous population and give aid to the middle and lower classes. His successor, Jacobo Arbenz, was elected in 1951 and doubled down on his ideas by implementing a program that allowed indigenous Guatemalans to buy their land back and receive full ownership rights and protection. In addition to this, Jacobo Arbenz attempted to nationalize the UFCO, but he was faced with American opposition and labelled a communist threat for failing to back American capitalist interests in the country. By 1954, with help from the United States, Colonel Carlos Castillo Armas, seized power from the Arbenz government and was declared the new president of Guatemala. Carlos Castillo Armas reversed all land reforms and policies that had benefited the indigenous population and the rest of the lower class, and then proceeded to revoke the voting rights of illiterate Guatemalans (most of which were indigenous).

From 1960 to 1996, Guatemala went through four long decades of “political unrest, social instability, and structural violence”. The country went through frequent changes in leadership, and with each succession, more reforms were overturned and the indigenous population lost even more land. It is believed that during this time, 99.6% of the land that had been given back to the indigenous population under the leadership of Jacobo Arbenz, was returned to the UFCO. All of this led to the underground rise of multiple socially organized political parties and rebel factions. To suppress any opposition, the government, in conjunction with the military, began a movement of violent campaigns that resulted in the assassinations, torture, and massacres of these groups. The movement was largely supported by the United States and they declared it as part of their effort in putting an end to Communist policies. They provided “training, resources, and in some cases even manpower to ensure the failure of the revolution.”

Indigenous involvement in the revolution rapidly grew in the mid 1970s after government backed armed forces openly fired into the crowd of over 100 people that was peacefully protesting against the eviction of Indigenous Guatemalans from Kekchi land in Alta Verapaz, a province in central Guatemala. The outcry of the Indigenous population grew further in 1980, after a group of indigenous workers from the province of Quiché went to the Spanish Embassy in Guatemala City to protest and demand intervention to the ongoing violence. They were answered with brutality and were burnt alive in the embassy building.

After General José Efraín Ríos Montt came into power in 1982, the violence became overwhelming and the violation of human rights became severe. This transition in power triggered one of the bloodiest revolutions in Latin America and began what is now recognized as the Mayan genocide or the Silent Holocaust. Under this government, “Operation Sophia“, a program that targeted the Mayan population and rebel forces, over 600 villages were destroyed, 200,000+ Guatemalans were killed, and one-eight of the entire population was internally displaced, with many as 150,000 fleeing to Mexico for refuge. During Montt’s rule, people would often disappear and were found killed and buried in unmarked graves. A scorched earth policy was also implemented and it resulted in the destruction and burning of crops, the slaughter of livestock, contamination of water supplies and the violation of sacred places and cultural symbols.

It was later concluded, in 1999, that during José Efraín Ríos Montt’s rule, the government had committed genocide against four specific Mayan groups: the Ixil Mayas; the Q’anjob’al and Chuj Mayas; the K’iche’ Mayas of Joyabaj, Zacualpa and Chiché; and the Achi Mayas.

From the Commission of Historical Clarification (CEH) under the United Nations, in their report,
“Guatemala: Memory of Silence”

After his rule, José Efraín Ríos Montt was succeeded by Vinicio Cerezo, and even though he attempted to stop the violence and restore peace, his government still ended up committing several human rights violations. His rule was followed by a series of democratically elected leaders, “some of whom made attempts at improving relations with the indigenous and eliminating corrupt officials from the government“. Although Guatemala’s political unrest did not stop with these democratically elected leaders, it was seen as the beginning of a transition towards peace and reconciliation. In 1989, after almost 36 years of violence, the Guatemalan government formed the National Reconciliation Commission (CNR) in an effort to restore stability to the nation and give its citizens a platform to report the atrocities they had faced. The CNR entered a series of negotiations and talks with the primary revolutionary party and signed a document that would later lead to a peace negotiation. By the end of 1996, “the parties had agreed upon 11 total accords“, and efforts were made to reconcile the armed forces and the rebel groups. In addition to this, several plans were made to address social and structural issues, including a plan for a revised health care system. On paper, these plans were going to help the poor and marginalized populations, and provide better access to health care for all who had been displaced by the violence.

In the next part of our series, we are going to find out why some of these plans feel through and how traces of government’s violent past became a barrier for change in the health of Indigenous Guatemala.

To find out more information on the Silent Holocaust, please visit the following pages:

• https://hmh.org/library/research/genocide-in-guatemala-guide/
• https://theconversation.com/guatemalas-history-of-genocide-hurts-mayan-communities-to-this-day-97796
• https://cja.org/where-we-work/guatemala/

Together we can make an impact on the health of the nations and the generations to come.

The mission of WHEF is to increase accessibility to medications and supplies for healthcare facilities in Guatemala and Grenada. If you are interested in hearing more about the work we are doing, or in connecting with us, you can visit our website, check out our instagram or facebook, or sign up to receive our newletters. If you would like to support us in our work, please donate here.

The mission of WHEF is to increase accessibility to medications and supplies for healthcare facilities in Guatemala and Grenada. If you are interested in hearing more about the work we are doing, or in connecting with us, you can visit our website, check out our instagram or facebook, or sign up to receive our newletters. If you would like to support us in our work, please donate here.