• Jacob Reynolds PT, DPT

Guatemala 2019

As some of you know, I have recently returned home from my second trip to Guatemala through the nonprofit group I help out, MENTOREVOLUTION.

This trip was highlighted by traveling around Guatemala City and Quetzaltenango, teaching various groups of students, physical therapists, and physicians totaling over 300 individuals throughout the week.

These trips always leave me feeling humbled and thankful for the privilege and opportunity I have been given simply by growing up in the United States. 

Guatemala ranks last in nearly every category with regards to health in all of Central America. In the last few decades, Central America has seen an amazing economic boom and has doubled it’s middle class during that time, except for Guatemala. This disparity is painfully obvious nearly everywhere you go, especially in rural Guatemala. Infant mortality rates are high (23/1000), malnutrition is 50% on the low-end (70% in rural areas), 98% of the water is estimated to be contaminated, and chronic disease is the norm. To make matters worse, the ratio of healthcare providers to citizens is ½ of the World Health Organization’s recommendation for basic level care.

I think it’s important to understand this before I opine on observational experiences that I find to be outright impressive about the Guatemalan people and culture as it compares to the United States. So take this think-piece at face value. 

In spite of all of the health disparities and non-privilege that Guatemalans face, their attitude of optimism and resilience is commendable. This is a people group that has every excuse not to thrive, and, in spite of their economic plight and non-luxury, they have found a way to provide for their families and build up their communities.

I have observed individuals with obvious congenital defects work as construction workers, men with notable limps toil in enormous plots of land with only hand tools and actually cultivate massive crops by themselves, and women with clear spinal conditions haul 50 pound baskets on their heads while carrying an infant on the back. These individuals are not letting their physical impairments prevent them from doing what is necessary to live because they do not have that luxury.

I think we, as Americans, can learn something from this. We are a society that has the luxury of tending to our pains no matter how great or small. Which is okay, but I think the aggregate effect of this has landed us where we are today: a society that ranks #2 in the world in “chronic pain” (France is #1) (or unresolved pain as I prefer to call it) and consumes 99% of the world’s hydrocodone (and 80% of opioids worldwide). We have more resources and more access to healthcare providers and options than almost anywhere in the world, and, yet we are amidst a pain crisis that is ever expanding with no clear agreed upon and actionable solutions for individuals with persistent pain conditions.

Which begs the question, why? 

Why does a small country in Central America with major health disparities and minimal resources have less of an issue with pain than the most affluent country in the world? I think this is an important question that requires us to consider where we are focusing our energy and time when it comes to helping individuals cope with and manage their persistent pains. Which, in my opinion, comes down to helping individuals with persistent pain learn how to become more resilient and less reliant on medications and passive procedures. This is something we can learn from Guatemalans. 

Pain is an unfortunate part of life, but it is a part of life. We must accept that. We cannot live, believing that we are so privileged to have to never experience pain. Again, this mindset is a luxury, but it does us no favors when it comes to coping with the pain that life brings. Instead, how much better off would we be if we all took active roles in learning how to manage the pain that life throws our way?

I think it should be noted that pain is multivariate and highly complex, with many different types and origins.

I take this challenge as a provider very seriously and hope that my clients with unresolved pain always walk away feeling more resilient, stronger, and better equipped to manage their conditions. I personally don’t always achieve this, but I will always continue to try my hardest for my clients.

In summary, I think it is our responsibility as a society to appreciate the luxuries we have and to show gratitude for the opportunities our geography has provided. I recognize that we have our own issues with disparity domestically and that stratification is real. I am merely contrasting experiential observation that has challenged me to ask different questions. I am thankful for the opportunity I have been given to bring education to communities around the world and believe it to be a responsibility I have to serve those in need, both domestic and foreign, because of the privilege I have been bestowed. 

I hope you’ve enjoyed this piece and have taken away something positive.

If you are interested in the work I do with MENTOREVOLUTION, you can read about us on our website or follow us on instagram:

Web: https://mentorevolution.org

Instagram: @mentorevolution 

We are a nonprofit that is dependent upon donations and fundraising to do what we do, if you are interested in supporting us here is a link to donate: https://mentorevolution.org/donate

This information comes from:

CIA’s World Factbook https://www.cia.gov/library/publications/the-world-factbook/geos/gt.html

Manchikanti L, Singh A.

Therapeutic opioids: a ten-year perspective on the complexities and complications of the escalating use, abuse, and nonmedical use of opioids. Pain Physician. 2008 Mar;11(2 Suppl):S63-88.



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