The
lack of competent medical care in Guatemala is in dismaying evidence on all
sides. Within the steel-and-glass towers
of downtown Guatemala City one will find the same level of competence in the
medical profession available anywhere in the industrially-developed world,
albeit with somewhat less access to technological aids, but this level of
medical competence is available only to those who can afford it. There is simply no way for ninety percent of
the population of a country which offers a minimum wage of four dollars per
day, and in which subsistence farmers will often earn far less than that
princely sum, to pay even the relatively low fees for visits to U. S.-trained
physicians.
In
the street, you will often meet beggars with limbs which have apparently been
badly broken, and which have been allowed to heal without being properly set,
so that now arms or legs may go off at crazy angles. One beggar I have seen has an arm the bone of which has been
offset, so that his arm, rather than going straight from his elbow to his
wrist, makes two right-angle turns along the way, forming a sort of a Z in the
line of his appendage. This, I find a
little surprising, because even the most remote pueblos have access to
"hueseros" or "compone-huesos," folk-medicine specialists
who will set the bones and treat the muscle aches of humans and animals, and
who will work for payment in hen's eggs, vegetables, clothing, or what have
you. Perhaps many breaks are just
beyond their professional competence.
A
fellow on the bus next to me on one trip had lost one hand at the wrist, and
the other had been almost lost, but had been pinned back on at the wrist with a
steel pin. The trouble was, it had not
been pinned back on in a straight line, but now was attached to his body at a
crooked angle, and with a quarter-turn to the side, too. It was plain to be seen that the hand had
been put back on by means of a steel pin because the steel pin was now
protruding from his skin by a good half-inch.
The ayudante of the bus driver chose to treat him as a cripple, and
would not accept the thirteen-cent fare from him.
There
are, in fact, government-subsidized public health clinics throughout the
country, and they have made some headway in gaining public acceptance, but
there is limited reliance on them by much of the population. People complain that the public health
clinic workers treat them badly and don’t care about them. A common complaint seems to be that the
patient may be told that he or she has an appointment to see a doctor at 8:00
AM, will arrive on time and will sit in the waiting room until 11:30 AM, at
which time he or she will be informed that the clinic is closing until 2:00 PM
for lunch. He or she will then sit in
the waiting room with all the other sick people from 2:00 PM until 6:00, at
which time he or she is told to come back the next day. When he or she finally sees a doctor, he or
she may only be charged 75 cents to $1.30 for the visit, but will receive a
prescription for drugs which he or she will often not have the money to buy
from a pharmacy.
There
is no ambulance service in such towns as San Pedro La Laguna, and since there
is no hospital, either, and the health clinic does not provide emergency
service, a seriously ill person will have to hire a private launch to cross
Lago Atitlan, and then try to find a pickup truck for hire to take him or her
to the hospital in Solola, another 25 minutes away, for a best-possible time to
emergency care of 50 minutes. If he or
she does not have enough money or cannot persuade launch owners or pickup
owners to help on the basis of kindness or of a favor to hopefully be repaid
sometime in the future, he or she may have to wait up to 45 minutes for a
regular launch to depart from San Pedro, and may have to then take the bus
grinding its way slowly up the mountain to the general vicinity of the hospital
in Solola.
It
is largely because of such difficulties in gaining access to mainstream western
medicine that the medicine readily available to much of the population
continues to come from folk practitioners called "curanderos" who, as
surgeon and faculty member of the school of Medical Sciences at the Universidad
de San Carlos de Guatemala Joaquin Acevedo and his co-author Elba Villatoro
have pointed out in an article in Tradicion Popular #74 (1989), fill a role in
the community that has more a magico-religious character than a purely physically-curative
one.
For
example, many sufferers of disease are believed to be the victims of
witchcraft, and it is part of the healing art of the curandero to establish
just who in the community is the witch, or "brujo," responsible for
the illness by means of feeling and interpreting the victim's pulse and by
asking such questions as "How do you feel?" and "When did the
infirmity begin?"
Many
curanderos hold positions of great respect in the community and will deal with
not only physical and mental problems, but also social, moral, and spiritual
problems as well. Regulated by the
ancient Mayan calendar, they work to keep the community in harmony with
"the spirit world," with "holy maize," and with "the
guardians" found on the hilltops near their communities. This will involve rituals performed in front
of the Catholic church, in ancient ruins such as those of Iximche, Tikal, or
Kaminaljuyu, and on the summits of special hilltops.
These
rituals will involve the burning of incense, often in evidence at the entrances
to Guatemalan churches and in cemeteries, the copious burning of candles, and
if I'm not mistaken, based on what I've seen at a ritual site in Kaminaljuyu,
the occasional use of fireworks.
Turkeys and roosters will be sacrificed, and the ritual consumption of
aguardiente will accompany efforts at divination by the use of special
beans. By these means, the appropriate
dates for various community activities such as weddings, for example, will be
determined. This appears to be a
continuation in the modern day of the function of the ancient Mayan
priesthood. The force of tradition,
then, is the other reason for the continued reliance on the curandero´s art.
Dr.
Acevedo has recorded the following treatment for inflamed testicles practiced
by a particular curandero in Todos Santos Cuchumatan which will provide more
insight into the curandero's approach to treating physical ailments. To cure this malady, the testicles of a
calf, available in butcher shops in any populated locality, are to be rubbed on
the affected area along with cooking oil, following which the patient is to
retire to a sweat lodge for a vapor bath.
Throughout this process, prayers are recited to God in solicitation of
the rapid recovery of the patient's health.
Should
this not prove efficacious, a further treatment by the bank of the river may
alleviate symptoms. This will consist
of a ceremony which will require thirty-two white paraffin candles, two ounces
of incense, an octavo of aguardiente, and the blood of a turkey. Sixteen of the candles will be burned for
the life of the patient, and the other sixteen will be offered to the river as
recompense for the ceremony's being realized in that place. The incense likewise will be divided between
the river and the patient. Exactly who
drinks the aguardiente is unclear, but the rest of the goods are burned while
special prayers are recited.
But
what I find most striking in a casual survey of the literature on the subject
is the enumeration by Francisco Rodriguez Rouanet, writing in Tradiciones de
Guatemala #1 (1968), of serious and in some cases life-threatening childhood
ailments as described by curanderos. Here are the four major illnesses which
may affect children in the first, most vulnerable years of life according to
the practitioners of folk medicine:
1. THE EVIL
EYE
This
malady is the result of an invisible force that emanates from certain
individuals and celestial bodies. The
evil eye force is capable of affecting young children, animals, and persons of
a weak or debilitated spiritual character.
It may be transmitted through the blood or the bodily "humor"
of certain persons, or through their stare.
The same effect may be received by a child exposed to the light of the
sun under certain special circumstances, by children exposed to the light of
the moon, especially the full moon, and most certainly by children exposed to
the effects of solar or lunar eclipses.
The
effects of the evil eye may be warded off in many cases by red caps for babies'
heads which may at times be pulled down over their eyes; by a red handkerchief
knotted in a special manner over the child's head; by little red bags
containing various diverse contents, especially printed prayers; and by various
amulets of coral, witches' beans, wooden crosses, fangs of tigers, sharks, or
lizards, or red poker chips.
Should
said safeguards be breached, the most common symptoms of the disease are a
general decrease of activity on the part of the child, irritability, vomiting,
diarrhea, anorexia, and a lack of energy.
In the most serious cases, cutaneous lesions will also appear, and the
life of the child will be in serious danger.
Pediatrician
Juan Jose Hurtado Vega surveyed 238 cases of the evil eye in communities
throughout Guatemala, including such relatively urbanized areas as Guatemala
City and Antigua Guatemala. He was able
to personally examine "a good number" of the victims of the disease,
and reports that according to the concepts of western medicine, they appeared to
be suffering from varying degrees of malnutrition, acute gastrointestinitis
generally of an infectious origin, and skin lesions corresponding to various
types of dermatitis. But never mind
that.
The
curandero may use various means to diagnose the illness. He or she may, for example, pass nine chiles
over the entire body of the child, repeatedly making the sign of the cross with
the chiles while reciting special prayers.
Later, the chiles will be tossed on a brasier, and if they are observed
to burst from the heat, this will indicate the presence of the evil eye.
Another
diagnostic technique is to pass a hen's egg or a duck's egg over the child's
body in the same manner, to then crack open the egg and to deposit the contents
in a dish with some water. This is then
placed under the child's bed overnight, and if a change in the color of the egg
is noted the next morning, it will provide a positive indication of the evil
eye.
The
cure for the evil eye sounds relatively simple. A duck is passed over the entire body of the child to absorb the
noxious energy of the evil eye, and is then released into water to bathe
itself. A duck's propensity for bathing
is the reason the duck is the only bird that can be used in this cure, for if
the bird fails to bathe, it will die of the heat of the evil eye within itself. Moreover, the water washes away the
infirmity from the duck.
2. THE FRIGHT
Children
are thought to be quite susceptible to this disease which is the impression
received from another person or from an animal. The cure will depend on which person or animal gave the fright to
the child. In the case in which the
child took a fright from a cow, for example, a pinch of hair is to be taken
from the animal. Some of this will be
burned along with rosemary leaves, and the child made to absorb the smoke. Later, a small figure of wood or of wax will
be formed to represent the child, and to this figure the rest of the cow's hair
will be stuck. The figure will then be
carried, preferably to the spot in which the fright occurred, where it will be
beaten with a hand, a paddle, or a handful of straw. When the figure is then buried, the fright will be cured.
3. THE VAPORS
This
disease is produced by the emanations of animals which are about to give birth
or who are in the process of giving birth.
It results in recurrent cycles of swelling in the body of the affected
child until a sort of profound anemia is reached which will finally result in
death.
The
disease may also be caused by a woman giving birth, or by her clothing being
carried to the river to be washed by the midwife, and passing near a
child. It is said this disease is
sometimes intentionally caused when the midwife is told to deliberately pass by
a certain child.
It
may also be caused when a person carries fresh jutes, freshwater mollusks in
the form of snails, home, and passes near a child.
Symptoms
depend on from which creature the vapors were received. In the case of the vapors of a cow, for
example, the diseased child will lose weight to an alarming extent, and the
child's hair will fall out. In this
case, the cure will involve the application of fresh cow manure to the head of
the child, which will then be wrapped in linen. After a few hours of this treatment, the child is to be bathed in
hot water.
In
the case of the vapors of jute, the victim will form dry boogers in the
nose. This may be cured by obtaining a
special sort of jute from the vicinity of Coban, mashing it thoroughly and
using it to prepare a drink which is to be given to the victim. The child may also receive baths with the
water prepared with this jute.
Generally,
the infirmity of vapors is cured by means of baths in cow manure mixed with
special herbs. These baths are to be
taken every two days in a place in which the sun is shining fully. In the case of a cloudy day, it will be
necessary to wait for a patch of sunshine to come through into the place in
which the bath is to be taken, for it is the object of these baths to dissipate
the vapor, for which the direct sunlight is necessary. It is necessary to take care during these
baths that in order to avoid contagion, other children do not breathe the
vapors being released from the affected child's body.
In
addition to the baths, the affected child is given drinks prepared from special
wild plants.
4. THE SECRET
"The
secret" is an infirmity received by a child while still in the womb of its
mother as the result of an impression involuntarily received by her. Thus, a desire unfulfilled in her may
produce in her child "the secret."
For example, in the case of a future mother who has a desire to eat pork
rinds, but who is unable to fulfill this desire, her child will be born with a
disease which will develop into what is called "the pork rind
secret," which will consist of the child's development of scabs on the head
in the shape of pork rinds.
In
the case of the mother's having unsatisfied cravings for a hard-boiled egg, her
child will be born with an abscess in some part of the body. If she desires a pineapple but can't obtain
one, her child will be born with or will eventually develop a tongue that is
chapped and cracked. If the pregnant
mother were to take a fright from, say, a worm, surely the child will be born
with a fright, also, or will move with motions similar to those of a worm. If the mother sees another person with a
physical defect of some sort, or feels an antipathy to any particular person,
her child will be born with the defects of those other persons.
Cures
vary according to causes. In the case
of the pork rind secret, the cure will entail grinding up pork rinds and
throwing them in water with which to bathe the child, at the same time giving
the child some of the pork rind water to drink. This treatment is to be carried out daily until the child is completely
healthy.
Bibliography:
Acevedo,
Joaquin, and Elba Villatoro. "Vida
y obra de los curanderos de Todos Santos Cuchumatan, Huehuetenango,"
Guatemala city: Tradicion Popular #74, 1989, pp. 1 - 12.
Aguilar,
German. "Creencias populares y
medicina tradicional en el municipio de San Martin Jilotepeque, Chimaltenango,
Guatemala," Guatemala City: Tradiciones de Guatemala #49, 1998, pp. 229 -
235.
Cholotio,
Pedro Guillermo. "Curacion de
enfermos," Technicas del Lago Atitlan. Quetzaltenango: CAEL / MUNI-K'AT,
1999, pp. 223 - 224.
Hurtado
Vega, Juan Jose. "El Ojo:
creencias y practicas medica populares en Guatemala," Guatemala city:
Tradiciones de Guatemala #1, 1968, pp. 13 - 25.
Middleton,
John. Magic, Witchcraft, and
Curing. Austin: University of Texas
Press, 1967.
Rodriguez
Rouanet, Francisco. "Ojeo, susto,
hijillo y acuas, enfermidades del indigena kekchi," Guatemala City:
Tradiciones de Guatemala #1, 1968, pp. 43 - 46.
Tuy
Navichoc, Saqiiq'-Felipe de J., with Naan Jesus Iiyoom - Rosaria Quiacan
Televario. "El arte de ser
comadrona," Technicas del Lago Atitlan. Quetzaltenango: CAEL / MUNI-K'AT,
1999, pp. 185 - 192.
Villatoro,
Elba Marina. "Practicas y
creencias medicas en una comunidad indigena de Guatemala," Guatemala City:
Tradiciones de Guatemala #28, 1987, pp. 31 - 38.