Treating Cancer in Rural, Indigenous Guatemala

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Today, is World Cancer Day! A day to debunk the myths about cancer and discuss how people world wide are grappling with it. I had a conversation with our medical director, Dr. Peter Rohloff, to share how Maya Health Alliance – Wuqu’ Kawoq is providing cancer care in rural Guatemala. Here is what Dr. Rohloff had to share.

Sadly, in rural Guatemala, a cancer diagnosis means death. It often means death and bankruptcy. The infrastructure does not enable early cancer diagnose because primary care services are often not available to provide routine screening services. In the USA, common screenings are available, like the mammogram and colonoscopy, that provide early detection for breast and colon cancers. In rural Guatemala, this infrastructure is not available.

Bankruptcy can occur if rural patients attempt to find treatment. Often, the treatment is so expensive and there is not medical insurance, patients and families must make real life decisions: send their children to school and most likely face death or put all finances towards treatment and not be able to send their children to school.

Our cancer program grew organically out of a commitment to primary and chronic care, as we worked to plug the holes in medical care in Guatemala. In time, we had a large enough base to encounter more and more cancer cases, so we began building our program. Key to our program was providing sustainable services, already found in Guatemala. Now that we have been successful in building a strong network of providers, we have been more aggressive about seeking out patients through referrals from other NGOs and health centers.

Cervical cancer is by far the most common cancer that we see. Nearly 1/3 of all of our cancer cases are cervical cancer. In Guatemala, cervical cancer is the leading cause of death for women in Guatemala. The simple screening for cervical cancer, the Pap smear, is rarely available. This is very different than in the USA where cervical cancer has been drastically reduced due to screenings. After cervical cancer, the cases that we see are really a little bit of everything.

emilianaOne extremely successful case has been that of Emiliana. Emiliana, a 52 year old mother of three, who came to us fighting diffuse non-Hodgkins lymphoma. She lives in a beautiful community not far from Lake Atitlan. Her family went broke trying to save her life due to her medical expenses and they ran out of money before her treatment was complete. They had no other options, until they met us. Now, a year later, Emiliana is disease free! What originally was thought to be only a few rounds of chemo, ended up being a very long road with extremely heavy side effects. However, now, a year later, she is doing extremely well, at home with her husband and children.

We are not reinventing the wheel in cancer cancer care in Guatemala, we are bridging the gap, we are making access to life saving cancer care possible in Guatemala. Primarily, we do the social work and advocacy for our patients. We are connecting our patients with great cancer care that is available in Guatemala City. We are connecting doctors with needy patients and patients who did not even know this treatment was possible. Doing medicine in rural Guatemala is so much more than providing medication…it is providing options, speaking their language, providing the small amount of funds for transportation, and overcoming the fear of the unknown in Guatemala City. Importantly, we provide close care and attention to the needs of our patients, including speaking their language, such as Kaqchikel Maya. Yet, we are not only there to walk them through appointments and treatment, we also do the home care, as there are often many followup needs after chemotherapy. We are also a patient advocate, always demanding quality and the best treatment possible for our patients. if needed, we communicate with the providers in Guatemala City to make recommendations.

Another, large part of our cancer care is palliative care. The reality is that a majority of our patients are not curable. Due to the lack of infrastructure and cancer screening many of our patients come to us in the advanced stages of cancer. It is necessary to have honest and open conversations about prolonging life, providing comfort and being with family as long as possible.

Over the next five years, our program will grow as a model to connect needy patients to available resources. We will grow our referral network and continue filling in the pieces to bring cancer care to the most neediest people. All people deserve access to quality health care, including cancer services.

One of the myths of cancer is that specific people, usually poor, marginalized people, like indigenous Guatemalans do not have the right to cancer care. We at Maya Health Alliance are debunking that myth!

cancer day

From the World Cancer Day Website and the UN Deceleration of Human Rights: Cost-effective interventions must be made available in an equitable manner through access to information and education about cancer at the primary health care level, as well as early detection programmes and affordable, quality medicines, vaccines and technologies, delivered as part of national cancer control plans. 

Social protection measures, including universal health coverage, are essential to ensure that all individuals and families have full access to healthcare and opportunities to prevent and control cancer. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being” – The Universal Declaration of Human Rights