State health centres are almost non-existent in rural Guatemala. In an emergency – and even for a minor illness – sick people have to travel in terrible conditions for up to five hours until they reach a hospital. Among the indigenous population, women have six children on average and infant mortality, maternal health problems and malnutrition are high.
Tecpán was once the capital of Guatemala and the city itself has hospitals. But the 40,000 inhabitants living in the 28 rural communities within its municipal jurisdiction did not even have a health centre.
The population was aware of this need, but they did not think it was possible to do anything about it. The Ministry of Health had told them that it would only build health centres in cities. Another barrier was the joint negotiation required between the 28
affected communities, because everyone wanted their own health centre.
‘We have talked about health for 25 years, but nothing had been done. Do we have to wait another 30, 40 or 100 years?’ said pastor Joel Socop Cumez. ‘We believe in God and in our community; that is why we organised ourselves to meet this need.
‘One of our biggest problems was maternal deaths and diseases in children. It was around these problems that we started to join ideas.’
Members of churches and communities did not see their access to health as a right.
So evangelical pastors worked together with the people and the local COCODE (Community Councils of Development) to influence the public authorities of the capital. After much discussion, the Community of Paquiq was chosen as the site for the health centre because of its ‘strategic location in comparison with the other villages and hamlets’.
In 2011, Tearfund's partner organisation, Asociación Vida, began to plan advocacy actions and trained and empowered the evangelical leaders of Técpan. These advocacy strategies included marches to Guatemala City and meetings with friends of political leaders to connect them with the Minister of Health. They were persistent in their demands and, almost a year after the start of their campaign, the Ministry of Health gave permission for the construction of a new health centre.
The perseverance and insistence of the community and its church leaders had borne good fruit. However, although the health centre came with a budget for equipment and three nurses, it did not provide for doctors and ambulances.
The perseverance and insistence of the community and its church leaders had borne good fruit.
As a result of continued campaigning between 2012 and 2016, the health centre currently has one permanent doctor paid for by the state; a team of four professional nurses who attend the health centre and visit the 28 communities for their health campaigns; two ambulances to transport the wounded and sick; and medicines kept in a pharmacy.
‘Here in Guatemala, no importance is given to rural areas and they even say that the rural population are parasites. But now, thank God and according to what a deputy told us in congress, Paquiq is the number one village in the country for its health centre,’ said Pastor José Mendez Toj. How was it achieved? ‘With the effort, unity and harmony of the community and with the blessing of God.’
In the process of gaining their first health centre, the church and community leaders learnt many things, but these seven things were critical to their success:
- knowing and understanding the laws of participation in Guatemala
- re-reading the Bible’s teaching on integral mission and political advocacy
- negotiating with others in ecumenical spaces
- realising that the problems of the community are the problems of the church
- learning that decision makers are not unreachable
- understanding that the advocacy proposal must be constantly reviewed and updated to see who the people are you have to influence
- knowing that achievements are brought about with unity and cooperation
Pastor José sums up: ‘Finally, if you have to manage a project like this, first you have to ask God and then pray that you do not get tired of managing it. Communities have to organise themselves to be taken care of; if there is no organisation you will not witness these achievements.’