Pursuing Health Equity in Guatemala

In 2014, 59% of the population in Guatemala lived below the poverty line (vs. 13.2% in the United States).   While private insurance is available, it is not common in Guatemala, especially outside of the capital city.  Thus, most individuals rely on government subsided public hospitals.  According to the Constitution of Guatemala, every citizen has the universal right to health care, but limited resources prevent this right to be implemented effectively.[1] Guatemala is considered a low-income country according to the World Bank.

El Petén is the largest department in Guatemala. This department has a growing population, which increased from 464,763 in 2004 to 687,192 in the most recent census in 2013. The Hospital Nacional in San Benito (HNSB) is one of four public hospitals in the region and is the largest referral hospital. It is located just outside of the capital city of Flores in San Benito, which is 294 miles by road from Guatemala City. 

HNSB has three operating rooms staffed by eight general surgeons. Approximately 250 general surgery operations are performed monthly. Despite being a major hospital in the region, it does not have computed tomography imaging capabilities, and it only obtained limited laparoscopic capabilities in 2013. The most common elective operations are open inguinal hernia repairs and open cholecystectomies, with approximately 90 hernia repairs performed per year.[2-5]

There is no question that a laparoscopic cholecystectomy is the gold-standard for the management of benign gallbladder disease.[6,7] HNSB has shown proficiency in performing laparoscopic cholecystectomies.[2,8]  I began my trips to HNSB in 2014 to assist with medical mission under a non-profit organization that has now stopped going to this site.  

As a general surgeon, I have been able to observe the tremendous skill of surgeons at this site only to be limited by resources.  Over this tenure, our relationship has solidified, and four medical students and two residents have been able to receive education from delivering health in a low-income country in a county hospital at HSNB.  Today, I have served as the senior author for six publications in collaboration with surgeons from Guatemala.[2,8-12]

The goal of Aid Via Action (AVA) corporation will be to provide immediate and long-lasting care to the people in Guatemala in need of surgical care with the overall goal of minimizing disparities that currently exist in low-income countries compared to high-income countries.  The main mission with be to strengthen the infrastructure of the local health care system to allow physician to provide care the Guatemalan people with care and compassion. A second goal will be to foster education in health care such that more Guatemalan physician graduate with a good education to provide care to its citizens.   

- Sergio Huerta, MD, FACS, HEC-C