Many health organizations and medical scholars discuss the problem of high mortality rates in different states. The scientists name the countries with the highest mortality rates and try to determine possible reasons for such high indicators. In fact, high mortality is closely connected to the active spread of some contagious diseases or typical characteristics of the epidemiological profile of the area. However, the reasons can lie deeper in the social structure of society and healthcare organizations. This essay analyzes high mortality rates in Guatemala and demonstrates some possible steps to prevent the worsening of the situation in spite of its complexity.
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In fact, Guatemala is located in Central America between El Salvador and Mexico. Besides these territories, the state borders the North Pacific Ocean and the Gulf of Honduras. Actually, Guatemala occupies an area of 108,889 square km (Central Intelligence Agency, 2016).
According to the statistical data presented by the Central Intelligence Agency (2016), the number of people, who live in Guatemala, is 15,189,958. The following groups represent the ethnical diversity of the state: Mestizo (mixed Amerindian-Spanish, who are also called Latino) and European groups together make 59.4%, K’iche – 9.1%, Kaqchikel – 8.4%, Mam – 7.9%, Q’eqchi – 6.3%, indigenous non-Mayan – 0.2% and other ethnical groups – 0.1%.
The full name of the state is the Republic of Guatemala. The country is the presidential republic, whose president is Jimmy Ernesto Morales Cabrera. In fact, the president is both the chief of the state and the head of the government; he also represents the executive branch of power. The president appoints the Council of Ministers. The unicameral Congress of the Republic represents the legislative branch of power. Actually, the Supreme Court is the head of the judicial branch (Central Intelligence Agency, 2016).
Actually, the economic situation is complicated in Guatemala. “Guatemala is the most populous country in Central America with a GDP per capita roughly half the average for Latin America and the Caribbean” (Central Intelligence Agency, 2016, para. 10). The agricultural sector accounts for more than 13% of GDP. However, the distribution of income is highly unequal in the state because 20% of rich people account for 51% of general consumption. Moreover, the state faces serious fiscal pressure; the origin of pressure lies in the high level of corruption in the country (Central Intelligence Agency, 2016).
The State of Health
Guatemala was chosen for the analysis because the country has high mortality rates and numerous health problems. However, U.S. agency (2015) reports that the state is at the demographic stage of development; the stage is characterized by high levels of fertility and a rapidly growing population that mostly consists of young people and children. “In comparison to the rest of the LAC [Latin American countries] region, Guatemala is heavily burdened by communicable, maternal, neonatal, and nutritional diseases” (U.S. Agency, 2015, p.6). In fact, the state has managed to reduce its under-5 mortality rate significantly from 80 to 31 per 1000 live births by 2013 (U.S. Agency, 2015). However, the problem remains vital. In fact, the main causes of death include cardiovascular, circulatory and low respiratory diseases. The main reasons for child deaths before the age of one represent low-quality delivery services and lack of access to maternal services. The children from three to five years old mostly die because of malnutrition (U.S. Agency, 2015). Therefore, Guatemala is a country with serious problems in healthcare and social sectors.
The issue of accidents and violence is very important for the understanding of the problem of high mortality rates in Guatemala. The number of violent crimes in Guatemala is the highest in Central America: “violent crime is a serious concern due to endemic poverty, an abundance of weapons, a legacy of societal violence, and weak law enforcement and judicial systems” (United States Department, 2015, para.2). In fact, interpersonal violence causes 11% of all the depths in the country (U.S. Agency, 2015). Traffic accidents often transform into violent actions because the participants carry guns. Moreover, the safety of public transport is at a very low level. Unfortunately, school buses often become involved in fatal accidents. The number of work-related accidents is significant because the employees and employers do not follow the elementary rules of production safety (Unites States Department, 2015). Therefore, healthcare issues in Guatemala are complicated due to the problem of violence and accidents in the state.
Culture and Traditional Medicine
The citizens of Guatemala have strong cultural and religious traditions. Actually, 60% of the population speaks Spanish, which is the official language of the state, and the rest of the citizens speak Amerindian languages. Moreover, 23 of Amerindian languages are recognized as official languages (Purnell & Paulanka, 2008). Purnell and Paulanka (2008) state that from 65% to 80% of the Guatemalans are Roman Catholics. The Spanish have brought Christianity to Maya communities and the majority of Maya became Christian; however, some of them still worship the spirits of the sun, wind, earth, and others. The population of Guatemala has a tradition to help the poor and the people in need Purnell and Paulanka (2008). “Family provides Guatemalans with the meaning in their lives” (p. 154). In addition, spirituality helps the Guatemalans to explain the surrounding events. Regardless of religious beliefs, people think that everything in their life happens due to some reason. In fact, the families highly value the children, especially sons. Both the parents and the entire community take an active part in the process of the upbringing of the child. In the case of the disobedience, physical punishments are accepted in the community (Purnell & Paulanka, 2008). Except for some Maya groups, the Guatemalans mostly represent traditional Catholics in their view concerning family, culture, and religion.
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As the Guatemalans dramatically lack medical education and systematic aid, they often apply for traditional medicine. Therefore, the Guatemalans give special attention to special food diets and products. In fact, Maya groups think that corn can provide a person with the power to fight any disease (Purnell & Paulanka, 2008). Moreover, the Latino population thinks that an injection of a corresponding drug represents the proven way to treat an individual from any illness. In order to solve health problems, a Guatemalan will ask for help from an elderly member of the family. If the sick person does not receive help, he/ she will go to a folk healer, who will use herbal treatment or will ask the spirits for help. Actually, people often underestimate the severity of their state. As long as a woman can perform all her duties as a housekeeper and mother and her husband can work and protect his family, they are both considered to be healthy (Purnell & Paulanka, 2008). Therefore, healthcare services are recognized to be ineffective and inaccessible by poor Guatemalans.
Healthcare System and Delivery
Governmental Health-Related Agencies and Health Regulatory Organizations
The main body, which manages healthcare in Guatemala, is the Ministry of Public Health and Social Welfare (Pan American Health, 2007). The General Office of Regulation, Accreditation, and Control of Health Facilities are responsible for all the stages of accreditation of healthcare institutions and universities (Pan American Health, 2007).
Healthcare Personnel and Hospitals
The total number of physicians is 93 per 100,000 people in Guatemala. The density of nurses constitutes only 40 per 100,000 people. Moreover, the number of hospital beds is 60 per 100,000 citizens (Central Intelligence Agency, 2016).
Nursing Education System and Accrediting Organizations
The system of health education is at the stage of development in Guatemala. “Five of the country’s 11 universities train physicians and surgeons.” (Pan American, 2007, p. 39). The University of San Carlos and the National University of Guatemala are among the universities that provide such training. All the universities work in accordance with the accredited programs. Only 6 accredited schools train nurses (Pan American, 2007).
The majority of nursing schools in Guatemala have associations. Many Guatemalan nurses are the members of the association of community health services, which is the biggest and the most influential association in Guatemala (Pan American, 2007).
In fact, numerous health problems make it possible to distinguish certain health priorities in Guatemala. The first priority is to increase the general medical level of education of the public in order for them to understand the importance of applying to hospitals. Secondly, it is important to balance the economic system of the state in order to make medical services more accessible and affordable for the citizens. Thirdly, the focus should be placed on solving the problem of malnutrition, which will decrease the number of children’s deaths.
Conclusion: Nursing Implications
Actually, Guatemala should solve its economic and fiscal problems in order to improve the living conditions of its citizens. The nurses should act independently of economic problems. Moreover, the nurses should educate the citizens about the general questions of healthcare and they should also show the public that family members and the healers cannot treat their diseases in the same way the healthcare professionals can. In addition, the nurses can collect some data and information and support them by the global statistical values regarding the number of nurses and physicians that is recommended for the effective operations of the state. This information should be formalized in the form of a petition that should be sent to the government for consideration. The last nursing implication relates to the following action: asking healthcare professionals to compose a list of products needed for the development of children around the age of 3-5 years. The list can be sent to charity organizations. In fact, it will be very useful for Guatemalan nurses to establish international cooperation with the nurses worldwide. Actually, the governmental financial support will greatly facilitate nursing activities.