“We will build a better, stronger, more diverse Guatemala.”
An Interview with Anne Kraemer Diaz — Patzún, Guatemala. Article 25 & Wuqu’ Kawoq
For over 7 years I have been working with Wuqu’ Kawoq – Maya Health Alliance and I feel lucky to be a part of this very exciting movement that is providing innovative solutions to persistent health problems for Guatemala’s poor, underserved and indigenous communities.
I work daily to develop and lead our programs while planning for the future and thinking strategically about how to be sustainable and grow the organization. Fundraising and locating resources are very important daily tasks that help to keep the organization in motion.
One aspect I enjoy is collaborating with other organizations and discovering how partnerships with other organizations and the government can create better health care solutions. I also enjoy logistically challenging issues for our team, patients, or moving medications or supplies from one region to another efficiently and using little resources.
My favorite thing to do is work with and develop our incredible team.
Our team is creating incredible healthy futures for Guatemalans, one where rural Guatemalans are no longer forced to choose between their culture and health, financial security and health, our team is access world-class health care in their own language.
What does the name Wuqu’ Kawoq mean?
We chose our name to follow the traditional Maya custom of naming an organization based on the day in the Mayan calendar on which it started. Wuqu’ Kawoq formally began on January 1, 2007 which was the day Wuqu’ Kawoq (7 Kawoq) in the 260-day Cholq’ij or Mayan sacred calendar. The name Kawoq has significance for our work, as it is typically associated with health care and midwifery.
Where did you grow up? Were you always intent on working on issues of rural community health?
I was born and raised in suburban Cincinnati, Ohio. Growing up as the youngest in a family of six children greatly influenced my worldview about resources, sharing and collaboration. It also provided the need to be an individual and take my own path. As a young child, indigenous cultures, archaeology, and the ancient Maya intrigued me.
In junior high, my father provided me the opportunity to meet leaders of the Shawnee Native American nation.
When one of the older men asked me what I wanted to do when I grew up and I replied archaeologist, he looked at me and said, just never forget how we feel when you excavate our past and interpret our histories, do not leave us out of our own past.
This theme permeated my worldview of indigenous populations’ relationships with the rest of the world and guided my path of study in the university in anthropology, history and Native American rights and advocacy.
During my undergraduate, I participated in creating a fully collaborative ethnography with the African American community in Muncie, Indiana. This led to the creation of the book, The Otherside of Middletown, which championed the themes of marginalized populations, the power of collaboration, and utilizing resources and technical assistance to empower marginalized communities, along with the unique methodology of ethnography for deeply understanding others in their context.
Graduate school opened the door to visiting Guatemala and learning Kaqchikel Maya at the University of Kansas. During my first trip to Guatemala, I lived in the home of my Kaqchikel professor and his family. It was here that my intellectual engagement with indigenous rights and marginalized communities suddenly became a daily reality as I observed first hand the difficulties that many of my new friends faced, not only because they were poor or rural, but also simply for the fact that they were indigenous and spoke a Mayan language. I knew from my studies that this kind of systematic marginalization and bias can only be overcome by empowering the disenfranchised. Observing and thinking about how best to do that was through health care, because without good health, it is hard to do almost anything else.
The challenges and barriers of providing quality healthcare in rural Guatemala seem overwhelming, from language barriers to lack of infrastructure — like clean water and sanitation — to lack of hospitals, physicians, and basic health services. I’ve read some of your articles on the many barriers indigenous Guatemalans face when it comes to healthcare. Rural indigenous populations so often face the largest burden of inequity and poorest health outcomes, all across the world. Why do you think this? How do the people you support in central Guatemala describe this inequity?
Great question with a short and long answer…In Guatemala, lingering state-sponsored violence against its indigenous Maya majority, which peaked in the civil war in the 1980s, has resulted in an indigenous population that has been systematically demoralized, demotivated and disenfranchised.
This is directly connected to the near assassination of the Maya cultural identity and language by state and foreign actors who have deemed them unimportant and as non-factors in development.
The 1996 Peace Accords provided hopes for indigenous communities by protecting human rights and officially recognizing indigenous languages with the language law, however life for a majority of indigenous Guatemalans remains similar if not worse to life during the civil war.
Structural racism and inequality, discrimination, corruption and violence compound the fact that a majority of indigenous communities have little foundation to build on. Maya have also remained largely disengaged and marginalized from national civic life due in part to the absence of services, health care, and mass media in Mayan languages.
Even with more than 15,000 NGOS, human development indices remain extremely low, some of the lowest in the hemisphere and have not significantly improved in decades despite intensive development investments. Guatemala has one of the highest rates of childhood stunting in the world, and the highest rate of chronic childhood malnutrition in Latin America. The rates of extreme poverty and chronic malnutrition for rural indigenous communities are nearly twice those of urban nonindigenous communities and indigenous communities suffer an infant mortality rate that is four times the national average.
Many NGOs support the status quo and real change stagnates because grassroots organizations are considered ineffective. The indigenous people of Guatemala do not benefit from failed developmental aid. Indigenous people identify language barriers and a disregard for indigenous culture as major factors impeding access to education, health, and economic advancement. Their lives are marked by poor health outcomes, lower social status and higher poverty.
Real, systematic change for a majority of the Guatemalan population will not occur if language and culture are ignored. Although Mayan languages have co-official status with Spanish in the areas where they are spoken, in practice government services are rarely offered in Mayan languages, and this includes the government-run healthcare system.
It is necessary to leave strategies that insist minority languages and being indigenous are problems and eradicate the social disadvantages which speaking Mayan languages constitute. This means building a system, which allows the use of Maya language and culture in a wide range of public spaces. If speaking a minority language prevents someone from engaging meaningfully with a physician, then the only viable long-term solution is to insist on building a health care system that provides services in minority languages.
Specifically, Wuqu’ Kawoq is addressing the continued problem of the development paradox: marginalized communities having to choose between health or culture.
Creating local health systems that support community decision making and inclusive participation seem like a faraway ideal given the scale of inequities in power, especially when it comes to health. Do you see this kind of health system in the foreseeable future for Guatemala?
Yes, it is possible. It will take hard work and we have to do it from the inside out, empowering rural Guatemalans to push for change. It is vital to expand the reach to include a diverse spectrum so that all people can capture the absolute importance of Article 25, something that can change the future of this planet, if we will it to happen. One method of expansion is through electronic media, utilizing social media, blogging, radio programs, and citizen journalism through online platforms to promote article 25.
As a transnational accompanier I will work alongside the communities and individuals to help create this change through capacity building and access to knowledge about human rights and protection. Working from the inside, utilizing the language and culture of Guatemala will empower Guatemalans. This groundswell of support within Guatemala can pressure public policy for systemic change.
This growth of indigenous and local citizenship is also a cost-effective solution to reaching minority communities worldwide as well as providing citizen engagement opportunities that scale to a global context.
What are some of the most difficult moments you have faced in this work?
Sadly, there are many. The majority of the most difficult moments involve specific patients and their heartbreaking stories. Listening to their difficult journeys, struggling with increasing debt, worsening symptoms, and often facing horrible discrimination and racism. Patients have told me that when they couldn’t understand the doctor because their Spanish was limited, they were often yelled at, scolded and turned away.
One of the lowest days was when we lost one of our mothers. We knew she had placenta previa, she had ultrasounds with us, she had her paperwork all in order. She was well aware that as soon as her labor began, she needed to get to the hospital to prevent hemorrhaging. She did everything she was told, but the system failed her. Her labor came in the early hours of the morning, about 1am. She arrived at the hospital at 2am. She was told there was no doctor…she would have to return in the morning. She had her baby that night and she passed away.
She died because they would not attend to her, as she was an indigenous woman.
Her baby survived and we make sure he and his family have the resources necessary.
There are also those days, when nothing seems to go right. They seem to occur more often in rural Guatemala than I ever experienced in the USA. Days when there is no Internet, no cell service, the roads are blocked, we can’t get a patient what she needs…but this is the reality that we know and we are working to change.
How do you envision a social movement for the right to health — for Article 25 — can change things? What could a local movement for the right to health in Guatemala start doing?
I envision a movement where access to quality health care is equal for all, no matter his or her language, culture, or belief. Good health is the foundation for a good life. The movement in Guatemala must start by working with the government together with the NGOs and communities. Systemic, scalable, effective change bust be broad-based and accessible, one that the people themselves are willing to fight for and defend.
I asked you about your most difficult moments, I think it’s only fair to balance it out — What are some of the most beautiful moments you have faced in this work?
One of the most beautiful moments is to see a young 12-year-old girl walk and communicate. The day before she met us, she had major seizures and could barely communicate; her parents loved her with all they could. After working with us, they are overjoyed and told us it is like she has “woken up”.
She walks, smiles, laughs and talks.
Another similar story is of a woman, Maria. Sadly, by the time we met Maria, she already had surgery with a North American surgical travel unit two years earlier, but they did not tell her she had cancer, there was no follow-up. She thought she was cured, but the symptoms returned. We took over Maria’s case in early 2013, when her cervical cancer was extremely advanced and not curable. However, in collaboration with the National Cancer Hospital and others, we were able to arrange cancer treatment in Guatemala City to extend Maria’s life and relieve symptoms. She has done amazingly well, and currently, right now; Maria is living a happy, full, and mostly pain-free life at home with her four children. Maria’s life has been extended by more than a year and a half, this is a major victory. Her children say that each day more with their mom is a gift.
Other beautiful moments are those shared with my team. They are incredible. Our quarterly all team-meeting retreats are motivating. There are days when the work is long and hard, but being with these incredible people refreshes me and motivates me to do more than I ever thought I was capable.
This September, world leaders convened at the United Nations to kick off a set of global goal-setting negotiations for a post-2015 development agenda. If you could sit down with Guatemalan leaders that are negotiating these goals, what would you tell them?
Is discussing this question with several team members, we believe while it is important to have goals to meet, it is just as important to create and identify solid steps for how to accomplish the goals. Development goals often sound great but can be obscure and difficult to put into practice.
Secondly, we want to make sure that Guatemalan leaders focus on empowering the Guatemalan people by creating and supporting long term sustainable economic opportunities through investment in infrastructure and job possibilities rather than short term quick fixes of offering cash and food supplies to families.
If the country is going to change, we have to work together and work hard, so I also believe it is vital for Guatemalan leaders to acknowledge that the majority of Guatemalans are indigenous peoples and valuing their culture and language empowers them.
By respecting people and providing them with a platform to express their identity and be who they are, we will build a better, stronger, more diverse Guatemala.
Are there any Guatemalan poems or quotes that you or your staff return to for inspiration?
We have often turned to Rigoberta Menchu Tum:
We are not myths of the past, ruins in the jungle, or zoos. We are people and we want to be respected, not to be victims of intolerance and racism.
This world’s not going to change unless we’re willing to change ourselves.
What I treasure most in life is being able to dream. During my most difficult moments and complex situations I have been able to dream of a more beautiful future.
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For more information about Anne and Wuqu’ Kawoq, email anne@wuqukawoq.org or visit http://www.wuqukawoq.org
For more information about the Article 25 movement, email theteam@join25.org or visit www.join25.org
