Aldea

Thirty years ago the New England Journal of Medicine (NEJM) published an editorial about Dr. Carroll Behrhorst, a Kansas GP who had moved to Guatemala to work with the rural Mayan communities. The story was compelling and since 1987 I have contributed to the foundation supporting his work, now called Aldea, and followed their progress.  To commemorate the 50th anniversary of its foundation Aldea this month offered tours of  remote villages and a celebration dinner in Antigua, Guatemala, a beautiful old Spanish colonial city near some of the villages. Deb and I have just returned from this celebration.

Guatemala has wealth but it is concentrated in a small percentage of the people. Although the country is a democracy, policy is controlled by the wealthy elite and corrupt politicians; the wealth does not reach the Mayans and other native americans who comprise about 40% of the population. They receive little health care or education. Childhood malnutrition and death rates are very high due to poor food choices, respiratory and gastrointestinal diseases.

Women collect water 5 to 7 times a day

"Doc" Behrhorst quickly recognized that American style medical care was not the answer to the Mayan's needs and developed educational, infrastructure and public health activities to address the problems. Over the decades his successors have refined approaches to provide education, clean water and good quality food to inhabitants of several hundred small villages. Their methods have been cited by the World Health Organization (WHO) as one of the best in the world for developing nations and is used as a model for other countries.

Typical open fire for cooking

The success of this model is emphasized by the fact that all new participating villages have asked Aldea to come work with them; Aldea does not recruit new partners. When a village requests help, Aldea experts evaluate the best way to create a clean water supply for every household and then works with government engineers to design the project. Villagers are then helped to build gray water and sanitary latrine systems at each home. Efficient, ventilated stoves have been specially designed to allow each householder to build their own unit with plans, equipment, and help from experts. Firewood use is decreased 50-80% and the homes are now free of indoor smoke, carbon monoxide and other pollutants.

Efficient smoke free stove

Aldea-trained local teachers have group classes for women, educating them about their rights, nutrition and child care. These women are excited! The new water and cooking facilities cut their work day in half or less; their children, their husbands and they themselves are much healthier (respiratory and enteric diseases almost vanish); they have time to weave cloth for sale; their health, new income and knowledge of women's rights and respectful family relationships create a new world.

Women learning leadership skills

Part of the Aldea team is a Mayan agronomist who shows each family how to cultivate a vegetable garden around their hut.

Woman describing how she cultivates her garden

The best seeds are made available at low cost. For each child  between ages 2 and 5 the family gets a baby goat who will provide milk for that child after maternal breastfeeding ends. Goats are bred and the family passes the kid (goat, not child) on to another village family with a small child. In a few years all the children have a safe, reliable milk supply.

Milking a goat

We met villagers whose lives have been changed and those who are waiting for Aldea; they live in different worlds, all for a cost of $1400 per family.

Deb and Jack with Mayan family

This is lifestyle medicine at its best. Check out the Aldea website to read more details. www.ALDEAGuatemala.org