Childhood parasitic infections and gastrointestinal illness in indigenous communities at Lake Atitlán, Guatemala

Lake Atitlán has experienced a decline in water quality resulting from cultural eutrophication. Indigenous Mayans who already face disproportionate health challenges rely directly on the lake water. Our objectives were to: (1) estimate prevalence of shedding of water-borne fecal parasites among children 5 years of age and younger, (2) assess household-reported incidence of gastrointestinal illness in children, and (3) characterize water sources, treatment, and sanitation conditions in households. We hypothesized that household use of untreated lake water results in increased risk of shedding of parasites and gastrointestinal symptoms. A cross-sectional fecal sampling and physical exam of 401 children were conducted along with WASH surveys in partnership with healthcare providers in seven communities. Fecal samples were screened for Giardia lamblia and Cryptosporidium parvum, using a rapid ELISA, with a portion examined by microscope. The prevalence of parasite shedding was 12.2% (9.7% for Giardia; 2.5% for Cryptosporidium). Risk factors for Giardia shedding included age 3 years or older (3.4 odds ratio, z-stat = 2.781 p = 0.0054), low height-for-age z-score (2.3 odds ratio, z-stat = 2.225, p = 0.0216), lack of any household water treatment (2.5 odds ratio, z-stat = 2.492, p < 0.0012), and open access to household latrine (2.04 odds ratio, z-stat = 1.992, p = 0.0464). The majority (77.3%) of households reported water treatment, boiling and gravity fed filters as the most widespread practices. The vast majority of households (92%) reported usage of a latrine, while 40% reported open and shared access beyond their household. An overwhelming majority of households reported diarrhea and fever several times per year or greater, with approximately half reporting vomiting at that frequency. Lake water use was identified as a risk factor for households reporting frequent gastrointestinal symptoms (odds ratio of 2.5, 4.4, and 2.6; z-stat of 3.10, 3.65, and 3.0; p-values of 0.0021, 0.0003, and 0.0028, for diarrhea, vomiting, and fever, respectively) in children 5 years of age and younger. The frequency of gastrointestinal illness with a strong link to lake drinking water cannot be explained by the prevalence of protozoa, and risk from other enteropathogens must be explored. Improving access to water treatment and sanitation practices could substantially reduce the parasite burden faced by developing children in the region.

Tourism Microentrepreneurship and Land Stewardship In a Tz'utujil Mayan Coffee Community

This study examines how livelihood diversification through tourism microentrepreneurship may shape land stewardship among Mayan coffee farmers in Guatemala. Through a primarily qualitative approach assessing ecoliteracy and motivations towards environmental behaviors, data were collected among participants self-identifying as small-scale shade-grown coffee farmers involved in tourism microentrepreneurship in the community of San Juan la Laguna in Lake Atitlán, Guatemala. We found that, when facilitated through cooperatives, tourism microentrepreneurship and coffee farming jointly contributed to land stewardship and provided an opportunity for indigenous farmers to foster traditional relationships with the land.

Complex phyllosphere microbiome aids in the establishment of the invasive macrophyte Hydrilla verticillata (L.) under conditions of nitrogen scarcity

Despite the low availability of nitrogen (N), the highly productive macrophyte Hydrilla verticillata (L.) is a successful invader of the littoral zones at lake Atitlán, Guatemala, with profound implications for lake ecology. To help answer the question of how Hydrilla, accompanied by the filamentous green alga Cladophora Kützing (Ulvophyceae), sustains fast growth under conditions of N scarcity, we studied the composition and potential biogeochemical function of the associated microbiomes. We combined results from next generation sequencing of associated bacterial and fungal assemblages with traditional microscopy-based taxonomical evaluation of algae and cyanobacteria. We focused on the presence of specific N2-fixing genera and their relative importance. Data on community composition are complemented with measurements of diazotrophic activity. The results expand our knowledge of the ecophysiology of these algae-plant-microbe consortia and suggest that several levels of biological complexity should be considered to fully understand aquatic plant ecology and the process of macrophyte invasions.

Lake Atitlan: A Review of the Food, Energy, and Water Sustainability of a Mountain Lake in Guatemala

This paper summarizes the findings of an extensive review of literature that was conducted to understand the historical state of the food, energy, and water nexus in the Lake Atitlan basin and to recommend incentive-based, long-term sustainable policies to become a significant driver to Guatemala’s tourism industry and GDP growth. The SWAT (Soil and Water Assessment Tool) was implemented in the basin to work towards the goal of simulating nutrient loading. A key conclusion of this review study is for the local population to have advocacy for the “zero wastewater discharge to Lake Atitlan” initiative to bring long-term benefits to lake water quality. One of the recommended policy decisions is to seek external financing from international agencies like the World Bank at low-cost interest (IDA Loans) to implement waste management systems and pay this external debt by putting a small but affordable tax on tourists visiting the lake. Once a culture of zero municipal effluent discharge to Lake Atitlan is adopted by the local population, the livelihood of residents will become sustainable and the standard of living will increase because of improved water and air quality, making Lake Atitlan a haven of tourism for Guatemala and lifting its economy.

Cancer Knowledge and Practices Among Indigenous Women in Guatemala

PURPOSE Guatemala, a low- and middle-income country, has some of the poorest worldwide health indicators, including a high cancer incidence. We explored general cancer knowledge and breast and cervical cancer screening practices among Indigenous women in Lake Atitlán, Guatemala. METHODS We conducted 14 in-person, semistructured interviews and one focus group with 5 traditional midwives (comadronas). All participants were Mayan women from a rural community in Lake Atitlán (median age, 43.5 years; range, 18-72 years). The interviews and focus group were conducted in the participant’s preferred language, Spanish or Kaqchikel. Three coders analyzed the data using a process of inductive thematic analysis. RESULTS Participants had little knowledge and awareness about cancer in general, including screening and prevention. They associated the term cancer with death. Most had more knowledge about cervical cancer risk factors and screening compared with breast cancer. Participants voiced misinformation that breast cancer is caused by bad breast milk and that screenings for cervical cancer involve a hysterectomy. The terms uterine, ovarian, and cervical cancer were used interchangeably. None of the participants had ever been screened for breast cancer and all participants reported not knowing anyone who had been screened in the community. Some participants reported having received pap smears in the past. Major barriers reported include the cost and travel to health institutions and fear that the procedures may hurt. There was a strong preference for female doctors to conduct screenings given stigma. Participants reported experiencing discrimination and language barriers when attending hospitals. Participants mostly relied on family members and natural traditional medicine when they felt sick. Community and family support seemed to be key for health-seeking behaviors. CONCLUSION Findings highlight the lack of knowledge, limited screening practices, and numerous barriers among Mayan women in Guatemala. Efforts should focus on health promotion through educational workshops and increased accessibility to health services.

La crianza de animales domésticos de traspatio en las comunidades del lago de Atitlán, Guatemala The raising of backyard animals in communities of Lake Atitlan, Guatemala

El presente reporte de caso expone las prácticas de un grupo de mujeres de orígenes tz’utujil, kaqchikel y k’iche’, respecto a la crianza de animales de traspatio en la cuenca del Lago de Atitlán, Sololá, Guatemala. Lo anterior, es el resultado de observaciones de campo, realizadas por estudiantes de medicina veterinaria y zootecnia. Además, se presenta brevemente la experiencia de organizar, capacitar y asistir de manera técnica a un grupo 35 mujeres. Se reconoce que la crianza de animales de traspatio en los alrededores del Lago de Atitlán involucra pequeñas cantidades de gallinas (Gallus gallus) y cerdos (Sus scrofa), a los que se alimenta principalmente de maíz y de excedentes de comida del hogar. Los animales son albergados en refugios que se construyen con materiales locales de bajo costo y el tratamiento de las enfermedades se basa en la utilización de plantas. La medicina farmacológica y las vacunas son la segunda opción para atender las enfermedades. Se discuten las oportunidades que presenta la crianza de traspatio para mujeres de pueblos originarios en esta región y se propone a las epizootias como la principal amenaza de este medio de vida.

De la tradición y la modernidad: San Pedro, un pueblo maya del lago Atitlán de Guatemala

Los pueblos del lago Atitlán y, especialmente San Pedro, en estos últimos años han creado estrategias de sobrevivencia frente al avance de la modernidad. Sin embargo, no lo han hecho en forma homogénea ni conjunta. Las posibilidades de elección que ofrece la modernidad implican aperturas hacia otras formas de existencia pero también riesgo de fragmentación tanto a nivel individual como social. Los papeles sociales se han multiplicado dando lugar a una sociedad cada vez más diferenciada a nivel religioso (evangelistas, carismáticos, católicos “de antes”...) como laboral (agricultores, hoteleros, maestros, comerciantes, guías turísticos, universitarios, tejedoras, curanderos, peones, médicos…). Todos ellos mantienen lazos sociales pero escasos contactos culturales. Por ese motivo la fiesta del santo patrono cobra gran importancia. Durante la fiesta los pobladores logran establecer lazos entre el presente y el pasado y actualizan una pertenencia territorial y por ende identitaria.Abstract: In recent years, the villages of Lake Atitlan, and especially San Pedro, have created strategies for survival with the advance of modernity. Nonetheless, they have not done this in a homogenous manner, nor together. The possibilities of choice that modernity offers imply openings to other forms of existence but also the risk of fragmentation, not only at an individual level, but also in society. Social roles have multiplied, giving way to a much more differentiated society on the religious level (evangelists, charismatics, “traditional” catholics...) as well as on the professional (farmers, hotel personnel, teachers, doctors, businessmen, tourist guides, university students, weavers, folk healers...). All of the villagers maintain social relations, but few cultural contacts. Consequently, the celebration of the patron saint takes on great importance. During the “fiesta” the locals are able to establish a relationship between the present and the past and to regain a sense of territorial belonging and identity.Résumé : Ces dernières années, les villages du lac Atitlan, et en particulier San Pedro ont développé des stratégies de survie devant l’avance de la modernité. Or ils l’ont fait de manière ni homogène ni coordonnée. La modernité offre des possibilités de choix qui entraînent des ouvertures à d’autres formes d’existence, mais aussi un risque de fragmentation au niveau individuel et collectif. Les rôles sociaux se sont multipliés, donnant lieu à une société de plus en plus différenciée tant sur le plan religieux (évangélistes, charismatiques, catholiques traditionnels) que sur le plan professionnel (agriculteurs, hôteliers, instituteurs, commerçants, guides touristiques, universitaires, tisserands, guérisseurs, médecins…). Tous maintiennent des liens sociaux, mais peu de contacts culturels. Cette situation fait que la fête du saint patron prend une grande importance. Pendant la fête, les villageois réussissent à établir des liens entre le présent et le passé, entretiennent leur appartenance à un territoire et finalement leur identité.