TACOMA, Washington — The COVID-19 pandemic uncovered the flaws of various health care systems around the world. While many claimed a virus did not discriminate, reality found that certain populations were more vulnerable than others. One such population was the rural poor of Guatemala, whose limited access to health services before the pandemic became a larger issue as COVID-19 cases began to rise. However, as Guatemala continues to fight this issue, hope finds its way through this crisis as studies show that the virus can improve Guatemala’s healthcare infrastructure.
With a population of 17 million, Guatemala has a mere 195 hospitals and only 0.9 physicians per 1,000 people. In 2015, USAID did a health system assessment in Guatemala and reported that “71% of doctors and biomedical staff are concentrated in metropolitan areas with better access to economic resources and public infrastructure,” leaving rural areas with little coverage. In Alta Verapaz, a department in Guatemala, 23% of the population had to travel more than an hour to reach the nearest care facility.
COVID-19 Response in Guatemala
When the news of the COVID-19 pandemic took a global platform back in March, Guatemala found itself on high alert as many in the healthcare industry knew the country was not prepared. Before the pandemic, there were only 0.6 hospital beds available per 10,000 people, and only 6.2% of the GDP was invested in public health. When the first COVID-19 case was reported in Guatemala, the government took action and immediately closed borders to prevent further spread. A couple of months later, with continuous rising cases and a struggle to respond, the government created a national COVID-19 response team headed by Dr. Edwin Asturias called the Presidential Commission for the Attention to the COVID-19 Emergency, or better known as COPRECOVID.
Upon beginning their work, the commission found itself stuck in the middle of a health care crisis with an already failing public health system. With a legacy of 40 years of little investment in health, Guatemala had to rapidly increase its number of beds and open 5 new temporary hospitals. The biggest hurdle that needed to be faced was the inattention to primary health care. In an interview with The Borgen Project, Dr. Edwin Asturias reported that many countries have shown the best way to respond to a pandemic is through primary health care as tracing, treating and testing are all based on this system. Unfortunately, Dr. Asturias claims that “the current health care access has made it more difficult to deploy testing and contact tracing, especially in the rural area.”
Now, half a year after the first reported COVID-19 case in Guatemala, Dr. Asturias reflects on the major hurdles to increasing health care accessibility. The biggest challenge, he claims, was to increase testing as, without this system, all response methods could be compromised. One of the first measures taken was to use the COVID-19 antigen test to better understand the situation with the limited resources. Guatemala also found itself reorganizing existing hospitals to properly treat different levels of illness, and the government hired more than 1,500 new physicians and nurses and 3,000 contact tracers.
How COVID-19 Can Change Guatemala’s Healthcare Infrastructure
As with most countries, Guatemala found itself alarmingly unprepared for the effects of a pandemic. However, Dr. Asturias finds himself hopeful of the opportunities this pandemic presents. One such opportunity is the increase in infrastructure development, as COVID-19 will leave behind some of the emergency measures that were built. Out of the five emergency hospitals that were opened, three have been confirmed to remain as permanent hospitals for the country’s infrastructure.
The second opportunity COVID-19 might bring to Guatemala is the social mindset of a well-funded healthcare system. “The most important lessons, not only to public health officials but economists and politicians as well, is the importance of health as a driver of the economy and human development. The investment in health care provides a great return on investment for economic growth and social wellbeing,” says Dr. Asturias. “One hopes that after the pandemic, political and business leaders will agree to provide greater support and financing to a healthcare system that needs to double its financing, increase its capacity for providing health care to the population and transform its system to provide care equally to poor and rich, indigenous or ladino populations.”
This pandemic uprooted the lives of people worldwide. Guatemala, with its history of underfunding its healthcare system and ignoring the rural impoverished areas, has found itself in need of a more significant response to the global crisis with its limited resources. However, through the darkness the pandemic has cast, some hope shines a light for new opportunities to improve. The three hospitals that are guaranteed to stay after the COVID-19 virus is only the beginning as this crisis has forced international leaders to acknowledge the impoverished countries and regions in need of more robust healthcare systems, like Guatemala’s healthcare infrastructure.
—Ana Paola Asturias