Guatemala

Globally, disparities in healthcare delivery can be due to financial, geographical, political, social or cultural factors. All of these are factors that create the maldistribution of medical services in Guatemala.

Despite having a large population, more than half of Guatemalan citizens live in chronic poverty, leaving them vulnerable to a limited healthcare system. The effects of this are deeply felt in the country's rural areas, where most of the indigenous Mayan population, nearly 50% of Guatemala's total population, reside. The public sector includes the Ministry of Public Health and Social Assistance (MSPAS), the Guatemalan Institute of Social Security (IGSS), and the Military Health Services. However, the IGSS and Military Health Services solely serve beneficiaries and affiliates enrolled in their programs — primarily based on their job title or military status. This leaves communities who do not fit the enrollment criteria, like informal workers from rural areas, with no public health coverage.

Traveling surgical teams

There is no perfect solution. While resource allocation, education, transportation and improving the medical system for all residents of Guatemala are all targets of improvement, one short-term solution is the provision of medical services to restore health for individuals through traveling groups/missions. While itinerate programs do not have the time or finances to address complicated diseases, certain focused efforts can restore a child’s ability to work, learn, play and even sometimes survive. Traveling surgical teams have a unique and important role to play given their ability to surgically correct various ailments, and they can do so effectively in a single procedure for a significant number of children in a single week.

The Division of Pediatric General, Thoracic and Fetal Surgery at Children’s Hospital of Philadelphia has found that the outpatient treatment of disabling diseases such as hernia and cleft palate can enhance the livelihood of rural workers and enhance the joy of their children.

Since 2012, volunteer teams have been traveling to Guatemala providing this care. Teams ranging from 18-30 people perform 60-90 operations each trip. Diseases addressed include hernias, undescended testicles, benign soft tissue lesions, head and neck pathologies and breast anomalies. A team made up of nurses, surgical technicians, an anesthesia team, surgeons and pediatric surgical fellows join the CHOP mission. This team comes from many institutions, including Lehigh Valley Hospital, Virtua Health System, Nemours Health, Johns Hopkins Children’s Center, University of Virginia, and Phoenix Children’s Hospital

The facility for these missions is Obras Sociales del Santo Hermano Pedro in Antigua. This institution houses disabled and abandoned residents, many of whom are children. In addition to their resident activities, they host many surgical missions each year.

The NGO in Guatemala is Partner for Surgery. Partner for Surgery is on the front lines of medical and surgical care in rural Guatemala, helping impoverished Guatemalans living in remote locations to access care. Tens of thousands of Guatemalan children and their families have received medical attention and health education, and more than 20,000 people have received access to surgery since Partner for Surgery was founded in 2001.

Facts about healthcare in Guatemala

The Guatemalan government spends relatively little money on healthcare.

The International Monetary Fund (IMF) reports that a historical underinvestment in social sectors in Guatemala has translated into uneven access to essential services and stagnant development outcomes. While healthcare spending per capita has in fact grown nearly 4-fold over the last 20 years in Guatemala, health care spending in Guatemala in 2025 was $1,130 per person. And of this, less than 50% is funded by public funds, meaning that a high cost of healthcare is “out-of-pocket cost” for each person in Guatemala. Per the IMF, “with only modest increases in public spending on healthcare, Guatemala’s health system remains constrained by structural underfunding that limit progress toward universal coverage and effective improvements in population health.”

Guatemala faces profound challenges in providing equitable access to healthcare. The country spends about $97 per person on healthcare compared with $7,825 per person in the United States. This contributes to a healthcare system that is underfunded, understaffed, and often unable to provide the resources needed to treat complex conditions. According to a 2017 Health Policy Plus report, the Guatemalan government lacks the economic ability to fully fund its healthcare system.

Access is especially limited outside the capital. Approximately 80% of Guatemala’s physicians practice in Guatemala City, leaving rural and low-income communities without adequate access to routine medical care. 

Language barriers create an additional obstacle. There are 25 languages spoken in Guatemala – Spanish, 22 Mayan languages, the Xinca language and the Garifuna language. For patients and families who do not speak Spanish, this presents a particularly difficult challenge. Medical care is complex under any circumstances; without effective communication, that complexity can become an insurmountable barrier.

How you can help

With partners across the U.S and in Guatemala, CHOP’s Division of Pediatric General, Thoracic and Fetal Surgery is committed  to improving the lives of children in some of the most underserved regions of Guatemala. We invite you to partner with us in this vital work by donating to the next surgical mission.

Donate here

References

A Fragmented System: A Look Into Guatemala's Healthcare Gap   Emma Obregon Dominguez Boston Political Review Dec 9, 2022

Seyi-Olajide JO,et al; Global Initiative for Children’s Surgery. Inclusion of Children's Surgery in National Surgical Plans and Child Health Programmes: the need and roadmap from Global Initiative for Children's Surgery. Pediatr Surg Int. 2021 May;37(5):529-537. 

Ameh EA, Butler MW. Infrastructure Expansion for Children's Surgery: Models That are Working. World J Surg. 2019 Jun;43(6):1426-1434. 

Goodman LF, et al; GICS Collaborators. The Global Initiative for Children's Surgery: Optimal Resources for Improving Care. Eur J Pediatr Surg. 2018 Feb;28(1):51-59. 

Butler M, et al. Guidelines and checklists for short-term missions in global pediatric surgery: Recommendations from the American Academy of Pediatrics Delivery of Surgical Care Global Health Subcommittee, American Pediatric Surgical Association Global Pediatric Surgery Committee, Society for Pediatric Anesthesia Committee on International Education and Service, and American Pediatric Surgical Nurses Association, Inc. Global Health Special Interest Group. Paediatr Anaesth. 2018 May;28(5):392-410. 

Coughran AJ, et al. Local and Visiting Physician Perspectives on Short Term Surgical Missions in Guatemala: A Qualitative Study. Ann Surg. 2021 Mar 1;273(3):606-612. 

Wang KS,et al; SECTION ON SURGERY, COMMITTEE ON FETUS AND NEWBORN, SECTION ON ANESTHESIOLOGY AND PAIN MEDICINE. Optimizing Resources in Children's Surgical Care: An Update on the American College of Surgeons' Verification Program. Pediatrics. 2020 May;

Hitziger M,et al. Patient-centered boundary mechanisms to foster intercultural partnerships in health care: a case study in Guatemala. J Ethnobiol Ethnomed. 2017 Aug 8;13(1):44.