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The Republic
of Guatemala, more commonly known as Guatemala, is located in
Central America and it shares land borders with Mexico, Belize,
Honduras and El Salvador. The Pacific Ocean runs along its Western
coastline with the Caribbean Sea to its East. Guatemala has a
population of 13.3 million people within a total land area of
108,890 square kilometers. The official language is Spanish
although Guatemala’s rich Mayan history and culture has ensured
that twenty one Mayan dialects have remained in daily use; these
dialects are more commonly spoken amongst the indigenous
population, particularly in rural areas. Guatemala experiences a
tropical climate. The varying levels of altitude across the
country ensure hot and humid conditions year round in the lowlands
and cool and pleasant weather in the highlands. The wet season
normally runs from May to November and in previous years
hurricanes have caused loss of life and considerable damage to
property.
Guatemala’s healthcare system is three tiers in structure: public,
private non-profit and private for-profit. The Ministry of Public
Health and Social Welfare (MSPAS) in conjunction with the
Guatemalan Social Security Institute (IGSS) and various
non-governmental organizations (NGOs) administer the country’s
public health system through an integrated network of hospitals
and clinics.
The Ministry of Public Health and Social Welfare operates in
excess of 1,300 healthcare facilities nationwide and is the
primary organization responsible for implementing national policy
within the healthcare system. MSPAS facilities are generally
available free of charge to patients, with the exception of
certain hospitals where “donations” are accepted. A Health Policy
and Planning document drafted by government in 2007 outlined
specific targets in relation to financing, delivery of services
and accessibility of Guatemalan healthcare. The latter has proved
to be an enduring issue for the MSPAS as health care coverage is
widely acknowledged to be poor in the country, with an estimated
40 percent of the population having no access to health
facilities.
The private non-profit sector comprises approximately 1,000 NGOs
and a number of indigenous medicinal clinics. The private
for-profit sector operates under the auspices of the MSPAS, and
Private For-Profit facilities, such as hospitals and clinics, are
on the whole more comparable to international standards. Private
sector providers range from high-end tertiary hospitals,
individual practices, pharmacists and traditional providers. The
San Carlos University is the preeminent center for education and
training of health professionals in Guatemala. Most doctors
operating in private medical facilities will have studied in the
United States or Europe.
The Guatemalan Social Security Institute, or IGSS, is effectively
a Guatemala medical insurance fund, with health care services
available to employees of a number of companies who contribute to
the system; spouses of fund participants, and children under 5
years of age, receive limited healthcare services under the IGSS.
Because IGSS facilities cater to employees of the private sector,
they tend to be concentrated around the capital Guatemala City and
other large population centers where employment rates are highest.
There are four main sources of healthcare financing and
approximate figures for each are: household and family
contributions (69 percent), government (18 percent), the private
sector (11 percent) and aid from international donors (2 percent).
Total annual health spending as a percentage of GDP is
approximately 5 percent, of which government spending is
approximately 2 percent. This figure has fluctuated both
positively and negatively in recent years. Significant changes to
the financing structure have occurred within the past decade with
contributions from the household’s sector increasing by 60
percent, while government’s contribution has decreased by 40
percent. The Guatemalan healthcare system has changed from one
being primarily financed by government, the private sector and
international donors to one financed mostly from household and
family contributions.
The standard of medical facilities in the capital Guatemala City
and other large cities contrast sharply with those in rural areas.
A wide range of treatments are available in the capital while
facilities in rural areas are basic and limited. Public sector
hospitals are often unhygienic and suffer from a lack of
personnel, funding, medicines and equipment. Long waiting times,
particularly in accident and emergency departments, are coupled
with unusually strict rules such as visitors being restricted to
family members and friends during official hospital visiting
hours. Expatriates and short term visitors who may require medical
treatment in Guatemala are advised to use private clinics where
possible. Hospitals in Guatemala are reluctant to give medical
treatment unless they can be satisfied that you have medical
insurance and generally require payment in cash prior to providing
treatment. Purchasing comprehensive international medical
insurance before travelling to Guatemala is strongly advised. It
is also essential that you carry confirmation of your insurance
policy at all times.
Guatemala possesses a variety of tourist attractions such as
pristine beaches, a number of active and dormant volcanoes, Mayan
national heritage sites, jungles and rainforests. Tourists and
short term visitors to the country are advised to seek medical
advice at least 6 weeks before traveling. The routine vaccination
and those for Hepatitis A, Hepatitis B, Typhoid and Rabies are
recommended. Malaria is widespread in rural areas at altitudes
under 1,500 meters. Standard precautions such as using
prescription anti-malarial drugs, using efficient insect repellant
and wearing trousers and long sleeve shirts can help prevent bites
by mosquitoes. Incidents of Dengue Fever have also been reported
recently. Traveler’s diarrhea is quite common and short term
visitors are urged to carry anti-diarrheal medicine during their
time in Guatemala.
Guatemala suffers from one of the highest crime rates in Central
America, with, on average, 98 murders occurring per week. Law
enforcement officials are poorly trained and lack sufficient
resources to adequately tackle the crime problem and the majority
of criminal gangs operate in the knowledge that they can easily
avoid arrest and prosecution. While foreign nationals are rarely
involved in serious incidents of crime, tourists are frequently
victims of assault, theft, armed robbery, carjacking and
kidnapping. Opportunist criminals such as pick pockets and purse
snatchers are common in all areas of Guatemala, particularly in
areas frequented by tourists such as the central market,
restaurants and hotels.
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