Guatemala diabetes project expands and inspires

The remote region of Santiago Atitlán, Guatemala is known for its placid lake and twin volcanic peaks. Now, the region has a new source of pride: an innovative diabetes education effort targeting indigenous peoples.

The first WDF-funded project in Guatemala, WDF 11-669, has established 12 diabetes clinics in Santiago Atitlán and surrounding remote areas, and trained 219 local health care workers in diabetes prevention, diagnosis and treatment. It is among the first comprehensive diabetes education efforts in Guatemala, and it had something extra: a focus on indigenous peoples, who have had limited access to culturally appropriate health and diabetes information and services.

The main project partner is Asociacion Pro-Salud, Educación y Dessarrollo K’aslimaal (AK), a local organization based in Santiago Atitlán focused on promoting health, education and development amongst the indigenous population.

“Experiences show that the indigenous peoples here are reluctant to seek medical attention, even when facing health problems, because of cultural gaps between them and the established health care system,” explains Jakob Sloth Yigen Madsen, the WDF programme coordinator for the projects. “So it’s very important that you seek them out, for example by translating materials and offering blood glucose screening in the marketplace, as this project did.” 

More languages, more awareness

The project was such a success – for example, opening 12 clinics, though the target was six – that it inspired a second phase. The second phase, WDF14-909, builds on the first project and increases its scale: from a focus on one Maya ethnicity (Tz’utujil / population of 47,000) to all three Maya ethnicities (Tz’utujil, Kaqchikil, and K’iche) - a population of about 500,000 people.

“Hospitalito Atitlán’s new diabetes program will reach many more Maya with diabetes as well as those who are at risk, through education in schools, with organised groups, healthcare workers and families,” said Victor Ramirez Ramirez, Project Coordinator Diabetes,  Hospitalito Atitlan, Solola, at the launch of the second phase earlier this month.

“Using illustrated booklets in three Maya languages, the programme will educate about the disease. We hope that knowledge will lower the prevalence of diabetes and complications. We hope with diabetes statistics the national health ministry will take notice and individuals in the entire country will benefit from increased detection and awareness.”

‘A model for the country’

Santiago Atitlán is mainly populated by indigenous peoples who do not speak Spanish, the language of most healthcare professionals. Rising mortality rates from non-communicable diseases – and research showing that regions with predominantly indigenous, rural and poor populations are especially vulnerable – have led the Pan American Health Organization to prioritise NCDs in Guatemala. 

“We are really concerned about the continuous increase in the diabetes prevalence in Guatemala. NCDs, including diabetes, contributed to 47% of the deaths in the country. Our indigenous people had abandoned their autochthonous diet; breakfast includes a salty snack and a cola-like beverage, and 30% of our high school students have overweight or obesity,” says Olivia J. Brathwaite Dick, Adviser on NCDs and health promotion for PAHO in Guatemala.

This concern led Olivia and several colleagues to visit the Santiago Atitlán project in January.

“It’s quite well thought-out how they’re integrating activities with the local health services in the area, and the local-language element is very strong,” she said. “This should be a model for the country.”

She and her colleagues are working with the Guatemalan Ministry of Health and the World Diabetes Foundation to apply the learnings in other populations with high diabetes rates, she said.

“Diabetes is an increasing problem here,” she added. “We have to do something.”