Health Outreach

GUATEMALA

Guatemala is situated between Mexico to the north and El Salvador and Honduras to the south. There is coastline on the Pacific Ocean and the Caribbean Sea. It is truly a beautiful country. The landscape is spectacular. Tranquil lakes, rivers and majestic volcanoes cover the countryside.

The diet is basic and not very nutritious. The staple food is corn. The daily diet includes tortillas (flat corn pancakes), black beans, rice, herbs, and hot chili peppers. Meat, milk and eggs are rarely eaten. Families make a living working in the cornfield, planting two crops a year. If no irrigation system exists, only one harvest per year is possible.

The sewage system is usually inadequate for most rural Guatemalan communities. In many areas, wastewater runs down small canals on the sides of the houses. The majority of homes have latrines. The lack of a drainage system causes rivers in the streets during rainy season.

The absence of infrastructure leads to a high incidence of gastrointestinal and respiratory illnesses in children. There is often only one ill-equipped health post in each community. A nurse usually attends to the entire population. For serious illnesses, people must travel several miles to a hospital in Guatemala City.

Despite all of this, people are friendly and sincere. They are happy people in their humble surroundings.

The common dental problems seen by us were chronically infected teeth in both adults and children. The story always seemed to unfold in the same manner. Small cavities started undetected. These progressed unnoticed until they caused a severe toothache. Still unable to afford basic dental care, most people simply put up with the pain until the tooth died. The pain often subsided to a low-level ache. Many just accepted this discomfort without realizing that infection persisted in their jaws.

FOOD AND WATER PRECAUTIONS
Contaminated food and drink are the major sources of stomach or intestinal illness while traveling.

Water
In areas with poor sanitation, only the following beverages may be safe to drink: boiled water, hot beverages (such as coffee or tea) made with boiled water, canned or bottled carbonated beverages, beer, and wine. Ice may be made from unsafe water and should be avoided. It is safer to drink from a can or bottle of beverage than to drink from a container that was not known to be clean and dry. However, water on the surface of a beverage can or bottle may also be contaminated. Therefore, the area of a can or bottle that will touch the mouth should be wiped clean and dry. In areas where water is contaminated, travelers should not brush their teeth with tap water.
Treatment of Water
Boiling is the most reliable method to make water safe to drink. Bring water to a vigorous boil, and then allow it to cool; do not add ice. At high altitudes, allow water to boil vigorously for a few minutes or use chemical disinfectants. Adding a pinch of salt or pouring water from one container to another will improve the taste.

Chemical disinfection can be achieved with either iodine or chlorine, with iodine providing greater disinfection in a wider set of circumstances. For disinfection with iodine, use either tincture of iodine or tetraglycine hydroperiodide tablets, such as Globaline®* and Potable-Aqua®*. These disinfectants can be found in sporting goods stores and pharmacies. Read and follow the manufacturer's instructions. If the water is cloudy, then strain it through a clean cloth and double the number of disinfectant tablets added. If the water is very cold, either warm it or allow increased time for disinfectant to work.

CDC makes no recommendation as to the use of any of the portable filters on the market due to lack of independently verified results of their efficacy.

As a last resort, water that is uncomfortably hot to touch may be safe for drinking and brushing teeth after it is allowed to cool. However, many disease-causing organisms can survive the usual temperature reached by the hot water in overseas hotels.
Food
Food should be selected with care. Any raw food could be contaminated, particularly in areas of poor sanitation. Foods of particular concern include salads, uncooked vegetables and fruit, unpasteurized milk and milk products, raw meat, and shellfish. If you peel fruit yourself, it is generally safe. Food that has been cooked and is still hot is generally safe.

HEALTH SAFETY AND IMMUNIZATION

Diseases do exist in Guatemala. Certain precautions must be taken to guard one's health. The following information is taken from reliable sources including Center For Disease Control and the World Health Organization. However, it is essential to consult a physician for individual circumstances. Please note that recommendations will change.

Diseases carried by insects:
• Dengue
• Malaria

Diseases carried in food or water:
• Escherichia coli diarrhea
• Hepatitis A
• Typhoid fever

Diseases from person-to-person contact (i.e. Blood-borne):
• Hepatitis B
• HIV/AIDS

Vaccination/prophylaxis

The following vaccines/prophylaxis are often essential for travel in Guatemala, especially for health-care workers.

• Hepatitis A or immune globulin (IG)
• Hepatitis B
• Typhoid
• Booster doses for tetanus-diphtheria and Measles, as needed
• Anti-malarial medication in risk areas*. Recommended: chloroquine.

See your doctor at least 4-6 weeks before your trip to allow time for immunizations to take effect. 


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