Paying Respects

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Group of nurses tending to patients in Guatemala

Honoring Guatemala’s disappeared with medical care for the survivors

By Rachel Berger

National Nurse Magazine - Jan | Feb | March 2020 Issue

As a registered nurse working in the emergency room of an Arizona hospital, Andrea Valdez, is trained to expect the unexpected.

But she was caught off guard when she, her fellow nurses, and other medical professionals were greeted with applause on the first day of their medical mission in the Coban region of Guatemala.

“We got out of the van and people started clapping,” said Valdez, who estimates there were some 600 people lined up to get care when the medical team arrived at 7 a.m. on Dec. 4, 2019. “We’re not used to getting that kind of recognition.”

Over the next three days, Valdez, along with 16 other nurses and nurse practitioners from across the United States, provided much-needed medical care to more than 2,000 people as part of a Registered Nurse Response Network (RNRN) deployment. RNRN is a disaster relief program sponsored by National Nurses United, California Nurses Foundation, and California Nurses Association.

“This was probably the only primary care they would have all year, until the next medical mission,” said Mary Jane Perry, a registered nurse from California, who served as the team lead in Guatemala and has deployed with RNRN several times.

The mountains of the Coban region are covered in lush subtropical forests often enshrouded in a heavy mist. These cloud forests are home to a variety of animals, including exotic birds like the macaw, the toucan, and the quetzal, a bird the Mayans view as the god of air and a symbol of freedom and wealth.

But in recent history, freedom and wealth have been more elusive than the quetzal for the indigenous Mayan people who have made their home in Coban for millennia.

“It was really heavy learning what they have to go through,” said Valdez, whose family left Guatemala when she was 6 years old. “There is a lot of poverty and violence. It is a very difficult life.”

When the Spanish set foot in Guatemala in the 16th century, they stole the Mayans’ land and forced them to work on cocoa and tobacco plantations. A series of military dictators backed by the United States ruled the country until the Guatemalan Revolution in 1944.

Over the next 10 years, Guatemala enjoyed a period of progressive and social reforms. An ambitious land reform program instituted in 1952 by President Jacobo Arbenz aimed to return land to the indigenous people and other poverty-stricken Guatemalans. But this policy ran counter to the interests of powerful multinational corporations, including the United Fruit Company, which held vast amounts of land in Guatemala.

In 1954, the United States Central Intelligence Agency helped carry out a coup, installing the first in a long line of military dictators who pushed the region into chaos, brutality, and a 36-year civil war. According to a United Nations-commissioned report, at least 200,000 people, the vast majority of them Mayan, were killed during the war.

The 1999 report found that entire Mayan villages were attacked, burned, and the villagers killed because the government assumed they would sympathize with those seeking to overthrow the government. Many of those who died were forcibly disappeared, kidnapped, and tortured. As part of the RNRN medical mission, the nurses learned much of this history.

Monica Ramos, a labor and delivery nurse from Hollister, Calif., said she appreciated that RNRN took the time to educate the nurses on the history of the Guatemala.

“The organization did a good job of helping you understand who you were serving and why the conditions were the were they were, so we didn’t just go there totally blind and try to serve somebody we had no connection with,” said Ramos. “It really felt like we really understood where they were coming from.”

In Guatemala, the RNRN volunteers worked with Fundación Amancio Samuel Villatoro (FASV), a foundation founded by the Villatoro family to honor the union leader, who was forcibly disappeared in 1984. Villatoro’s son, Samuel, is the executive director of the foundation.

“These medical missions shed light on the atrocities that have happened,” said Perry. “Samuel was just 8 years old when his father disappeared.”

Nineteen years after he disappeared, the remains of the elder Villatoro were found in a mass grave on a former military base, where the remains of more than 200 people were discovered. It wasn’t until 2011 that DNA testing confirmed the remains were those of Amancio Samuel Villatoro.

The family decided Villatoro’s remains should not be buried, but instead become the focal point of a small museum to honor all those who were disappeared and killed during the war and to educate future generations about the atrocities that were carried out in Guatemala.

“If you asked any of the patients, everyone had a family member or friend who disappeared,” recounted Perry. “Even a local Guatemalan nurse from Coban who was working with us said her 22-year-old daughter had disappeared. It literally touched the lives of all Guatemalan people.”

Valdez says she came away with a deeper understanding of why her family had to flee her native country. “My uncle was part of a workers’ union and he was being threatened,” she said. “My father was part of the university students who were being threatened.”

Paul Banach, a registered nurse from Connecticut, said he knew before his RNRN deployment that the United States had a hand in the destabilization of Guatemala, but he didn’t realize the extent of the involvement. “You couldn’t help but wonder what would have happened if the working-class people fighting for fair treatment by their government and from their employers had had the support of the U.S. government and U.S. allies instead of giving support to an already powerful government and military,” said Banach.

This experience changed my life,” said Alexis Webster, an emergency room nurse from Arizona. “On the days of the clinic, I was so heartbroken,” said Webster. “There was one mother who came from about an hour away. She was asking me for food and how her baby could breathe better and how her skin could be not so dry. I felt really sad because she was very eager to take care of her baby, but [she] wasn’t sure how.”

Many of the patients, who spoke Q’uechi, a Mayan language, sought treatment for respiratory and gastrointestinal complaints. The team was able to provide vitamins, anti-parasitic drugs, and medication for diabetes and high blood pressure.

A dentist who was part of the mission spent her days pulling teeth and seeing some 170 patients. Banach, who spent some time working in the dental clinic, said he was impressed by how well the community, including the children, handled the long waits for treatment.

“There were three little boys lined up in chairs,” he recalled. The boys had gotten their Novocain and the dentist was treating others as the boys waited for the anesthetic to take effect. “The dentist was so good, playing her music and making them laugh. The boys were so patient, and when they got their teeth pulled, I think only one cried. I kind of winced and looked away, but they didn’t flinch at all.”

“You are doing what you can in place where this is no health care system,” said Debra Buccellato, who works as an emergency room nurse in San Rafael, Calif. “It feels like putting a Band-Aid on a gushing wound.”

But she says she’s encouraged that medical professionals came from all over the world to provide care. The medical mission in Coban included a Cuban and an Argentinian doctor, as well as the nurses. “You feel like yes, it’s a start, you get more and more people participating and trying to set up care, and hopefully it grows and there is more available for the people in time.”

Banach says he wants to be one of those who helps create a vibrant health care system in disadvantaged Latin or Central American communities. “This trip honestly felt like a breakthrough for me to reconnect with my values and what type of work I want to do with my life,” he said.

Perry says RNRN nurses play an important role sharing stories of those in Guatemala with those in the United States. “We serve as a global bridge,” said Perry. She says talking about the history of and conditions in Central America are often a shock to her friends and colleagues. “You understand more why people are fleeing their country.”

“It opened my eyes,” said Webster, who often treats immigrants at her hospital in Tucson. She said she understands better why people are leaving their homes. “You see mothers are just trying to take care of their children.”

Ramos said the current administration’s policies towards immigrants – separating children from their families, holding people in deplorable conditions in detention centers, as well as forcing asylum seekers to remain in unsafe conditions in Mexico – is a “stain on American history.”

Despite their challenges, she was struck by the strength of the Mayan people she met in Guatemala. “You see they have faith in good and they have a strong community,” said Ramos. “They depend on one another for survival and so they will share with neighbors, friends, and family.”

Webster said she found the people very friendly, but also resilient and fierce, motivated by the belief that they come from the earth and must protect the land. “They were always explaining to us they had the warrior Mayan spirit in them,” said Webster.

Valdez said on this return trip to the country she left at age 6, she was overcome by a deep connection to that spirit when the nurses visited a cave where the ancient Mayans would commune with their gods.
“We entered the cave almost crawling, and then they make you turn off the lights,” Valdez explained. “You can actually hear the cave. I got chills throughout my body. It was a very spiritual experience. I felt like I was connected with the ancient people.”

The connections the nurses made on this trip, both with one another and with the people of Guatemala, has many saying they intend to return. “Health care is a human right, despite class, color, religion. I keep coming back to Guatemala because I have nursing skills and I can give something back,” said team leader Perry. “Mother Teresa said, ‘Do ordinary things with extraordinary love,’ and that is one thing I know every nurse can do with every patient they serve.”


Rachel Berger is a communications specialist at National Nurses United.