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Information presented here is based on 5-week volunteering experience at Primeros Pasos clinic in the rural Palajunoj Valley outside the city of Quetzaltenango, Guatemala. Almost all of the patient population is rural, indigenous Quiche Maya. Guatemala has a relatively high GDP and patient-doctor ratio (1000:1) compared to its neighboring Latin American countries, but these resources are extremely localized to its capital, Guatemala City, where 70% of the country’s physicians work.

Only the wealthy are able to utilize private clinics and hospitals that are known to provide the highest quality care. At these clinics, patients pay out-of-pocket. Indigenous, rural communities typically rely on under-funded, understaffed, overcrowded government Puestos and Centros de Salud that are often far from their homes and difficult to access.

Theoretically, these public clinics allow for Guatemala’s healthcare system to claim “universal coverage,” but a lack of funding for public hospitals and clinics have left many of them in dire condition.

By 2015, 4 out of the 44 public hospitals were forced to shut down all but emergency services because they could not afford to pay their employees. [3] Guatemala’s Deputy Prosecutor, Hilda Morales, blames the lack of funding and resources on “structural failures,” such as corruption within the system, debt, delays in payment to suppliers, and the poor maintenance of medical equipment. Many of these issues are rooted in the violence, corruption and prejudice against indigenous cultures during the Civil War.

Publication Date



Barriers to Care Amongst Rural Indigenous Mayans in Guatemala’s Western Highlands, CWIC-PH, College within a college, Thomas Jefferson University, Sidney Kimmel Medical College, Jefferson College of Population Health


International Public Health | Medicine and Health Sciences

Barriers to Care Amongst Rural Indigenous Mayans in Guatemala’s Western Highlands