"The country had just lived through 30 years of civil war. With 300,000 people dead, and hundreds of thousands more missing, it was obvious that we'd have our work cut out for us. Of specific concern was the fact that many survivors suffered from post traumatic stress disorder and large numbers of children were also affected' showing signs of agitation, and having trouble focusing and sleeping".
- Gaston P. Harnois

In 1994, the World Health Organization asked our Collaborating Centre to provide assistance to Guatemala in the area of mental health. Explains Dr. Harnois, "Our challenge was to respect their culture, while helping them use their strengths to deal with the consequences of war, which had exacerbated problems such as chronic violence, alcoholism, and drug abuse. Especially affected were the indigenous Mayan people, who make up 60% of the population, and tend to live in poverty."

A "Cosmic" View of Healing
To pinpoint what was already working in the way of mental health treatment, Dr. Harnois spent time with local Mayan healers, who treat most people's mental and physical health complaints. Healers divide all medical ailments into six categories. Each of these categories calls for a specific, culturally-defined treatment and has a unique color associated with it. Once a sickness is diagnosed, healers use a variety of treatments—a multimodel approach, if you will. First, they counsel the patient and their loved ones. They may use medications, based primarily on local herbs, which can be procured at local pharmacies for $1.50. In some cases, they ask Mayan priests to lead ancient ceremonies to promote health and well-being.

Recalls Dr. Harnois, “Senior consultant Karen Hetherington and I were honored with an invitation to one of these Mayan ceremonies, which began at 4:00 in the morning and lasted for hours. With prayer and incense, the priests evoked the gods, nature, and their ancestors, asking them to bless us. We found the experience both calming and refreshing, and were impressed with their ‘cosmic' view of healing.”

Support for Coloured Skirts
During his visits over the years, Dr. Harnois and his staff have also been working to improve the only psychiatric hospital in all of Guatemala.
They proposed small, but important, changes.

One of them involved the hospital's dress code for female Mayan patients. Mayan women in Guatemala come from a variety of regional groups. The women show their place of origin through the color and design of their skirts. This tradition has become a rich part of their cultural identity.

When Dr. Harnois saw that female Mayan patients spent their days in institutional pyjamas, he convinced hospital administration that they should be allowed to wear their traditional clothing—both as a mark of respect for their heritage and to encourage them to think of themselves as people first and patients second.

Currently, Dr. Harnois is working to encourage the hospital to set up satellite clinics in neighboring cities, so people may be treated closer to home and in a more inviting setting.

Mayan Representatives Visit Montreal
In response to the respect and sensitively shown by the Centre staff to the Mayan community for their traditional ways, and for the help they have provided to date, they were able to bring three Mayan healers to Montreal in 2003. At the CLSC des Faubourgs, the healers showed a video of their community to a fascinated audience of 125 persons, and afterwards met with healthcare professionals and made personal contacts.

The Power of Small Steps
Today, improvements are happening at all levels.

• Guatemala's new Deputy Minister of Health, himself a Mayan physician, is more open than his predecessors to the importance of traditional Mayan culture and medicine.
• The country's psychiatric hospital now takes 81 percent of the country's mental health budget—compared with the jaw-dropping 91 percent it consumed ten years ago.
• The healers and other local health providers are becoming more receptive to the Centre's suggestions for educating their community on mental health issues.

In short, thanks to a team effort with the community and with colleagues at the World Health Organization, the Canadian embassy and local NGOs (Médicos Descalzos), significant progress is afoot in Guatemala's mental health system.

Says Dr. Harnois, "I wish to thank current and past Centre colleagues, for making this project an ongoing success. Like me, they believe in the power of small steps. I'm impressed with their determination and talent."
 

Information

Florence Meney
Media Relation
Communications and public affairs
Phone: 514-761-6131, ext. 2769
Cell.: 514-835-3236
florence_dot_meney_At_douglas_dot_mcgill_dot_ca