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  • Teta: breast in Cuban Spanish, refers to animal breast in Guatemalan Spanish
  • police stop them on the highway and if they do not have their papers, they take them to the detention center and deport them
  • work with pro bono lawyers from the Legal Aid Society of Palm Beach County, in the Wage Dispute Project (M. Martinez, personal communication, May 30, 2013). They also go to the Health Departments in West Palm Beach and Jupiter and the Caridad center in Boynton Beach to help with the Medicaid eligibility program and ACCESS Florida. "There is also a lady, I think from families first or something like that, who comes here and goes to their homes to do HIV testing and pregnancy tests" (M. Martinez, personal communication, May 30, 2013).
  • 2010 census first time that groups were specified.
  • The studies were examined for the concept of globalization, nursing leadership, and the Guatemalan Mayan immigrant population in the United States. The intention was also to seek explanations and characteristics of the issues relating to the Lake Worth Guatemalan Maya Community that were discovered by the field interview
  • Millender (2012) states that nurses must advocate for the indigenous populations, call attention to existing health care disparities, and provide culturally unique care. According to Millender (2012), nurses can attain stories of acculturation stress directly from their clients and therefore are "uniquely positioned to advance society's knowledge of cultural health care disparities" (p. 62). Stories can be used in bedside nursing to gain a unique understanding of patients' distinct culture and assist in delivering care that is culturally sensitive (Millender, 2011). The method of story telling allows the patient to be at the center and aids in the quest to find what matters most to the patient (Millender, 2011).
  • "Waiting too long to seek care... and not returning to follow up appointments" (Czerwinski et al., 2011, p. 21) are barriers to care that are related to their inclination for traditional care. The information that was given to them by traditional healers and the differences in their beliefs of health and illness can be barriers to care, as well (Czerwinski et al., 2011). The Mayan referred to the importance of breathing the morning air in several occasions in relation to avoiding illness, such as diabetes. They shared beliefs such as diabetes being caused in addition to too much sugar and chicken fat, to "depression, sadness, or big problems such as domestic violence" (Long et al., 2012, p. 137). In general, Mayan indicated that violence could cause illness directly.
  • Partly the political asylum was not granted due to them usually arriving in Mexico first, therefore United States was not their first asylum, which is the United Nation's asylum definition (Burns, 1993). The IRCA did not improve their status, but instead made their working conditions worse, as the employers who were afraid of the sanctions set by the act, no longer hired them, resulting in Mayan finding jobs with less reputable firms who underpaid them (Mayo, 2010; Burns, 1993). Fear of deportationCrimeLack of healthcare coverage
  • The letters addressed their concerns for violations of human rights of the people in Huehuetenango communities, who are being targeted by the military and the police through strategies similar to the Civil War, due to their rejections of building a dam in their area (The Guatemalan-Maya Center, 2012).
  • An immersion experience, with a service learning project based on an identified need, would accomplish both increased cultural knowledge for the student and perhaps trust towards the nursing profession for the Mayan through a service learning product that is viewed as beneficial within the Lake Worth Mayan community.
  • An immersion experience, with a service learning project based on an identified need, would accomplish both increased cultural knowledge for the student and perhaps trust towards the nursing profession for the Mayan through a service learning product that is viewed as beneficial within the Lake Worth Mayan community.
  • An immersion experience, with a service learning project based on an identified need, would accomplish both increased cultural knowledge for the student and perhaps trust towards the nursing profession for the Mayan through a service learning product that is viewed as beneficial within the Lake Worth Mayan community.
  • forming an fill-in-the-blank, ready letter, to be e-mailed to Senator Rubio, is an action oriented leadership strategy suggested by the author of this paper. Additionally, students in local schools of nursing could be invited to participate. Political action in the schools of nursing is an alternative strategy, in addition to service learning, for students to exemplify social responsibility

Guatemalan maya ilse wallace Guatemalan maya ilse wallace Presentation Transcript

  • Guatemalan Maya Lake Worth, Florida
  • Introduction  The Guatemalan-Maya Center  Founded in 1992, as a non-profit agency  By Reverent Frank O'Loughlin  Serves 18,000 persons yearly  North F Street, Lake Worth, FL  21 staff members  Funded by the Children Service's Council, The Literacy Coalition, and Family Central of Palm Beach County (Fooksman, n.d.; Guatemalan-Mayan Center, n.d.)
  • Introduction  The Guatemalan-Maya Center  Family and baby outreach program  Parent and child home program  Escuelita afterschool program  VPK summer program  Translation services  Legal help  ACCESS FLORIDA services (The Guatemalan-Mayan Center, n.d.).
  • Field Interview (The Guatemalan-Mayan Center, n.d.).
  • Field Interview  M. Martinez arrived in Florida during early 1980s escaping violence brought upon by the Civil War  The interview took a form of story telling  M. Martinez told a story with each issue, problem, or concern that she discussed  The major problems and challenges of the Guatemalan Maya people in Lake Worth are: lack of language, working too many hours, lack of legal documents, domestic violence, and no healthcare coverage
  • Lack of Language  24 different Mayan languages in Guatemala  10 different Mayan languages in Lake Worth  Spanish is also spoken by some  Problems, especially, in healthcare to understand treatment or their diagnosis  There are differences in words and their meanings even in Spanish  Two stories: Cuban nurse at St. Mary’s and 18 year old boy (M. Martinez, personal communication, May 30, 2013)
  • Working Too Many Hours  Both parents often work  Children are home alone or are taken care by others and picked up late by the parents (Story of little girl)  “There is no time to raise your children like you want to, but this gives me strength to be here and help my people”  Real problem is with teenagers: Are alone at home. They are bored and running the streets, doing drugs, drinking alcohol, selling drugs, prostitution, and gangs. Also girls are leaving with older men and their mothers are worried not knowing where they are (M. Martinez, personal communication, May 30, 2013)
  • Lack of Legal Documents  Many in their community do not have legal papers  Have no job or have very low paying jobs  "It is just not fair, how little our people are paid, they are good and hard workers"  They do not know were to go to get documents  Many men have been deported  Single mothers in the community  "Problem is too that if they have accidents in jobs and do not have papers, then they cannot get any money or healthcare" (M. Martinez, personal communication, May 30, 2013)
  • Domestic Violence  Domestic violence is a problem in the Maya community  Both women and men are victims  Alcohol is often involved  "The Lake Worth police department sends them back home to danger because they do not have anyone who even speaks Spanish, so we try to tell our people to come here and then we call the police to do the report here because we can interpret”  A young woman with her children was being helped as we spoke. (M. Martinez, personal communication, May 30, 2013)
  • No Healthcare Coverage  Due to lack of papers, they cannot qualify for Medicaid and in day jobs do not have health insurance by their employer  Use Caridad Center in Boynton Beach  Sometimes Health Department  Traditional Healers  Story of young man dropped off to the curb by hospital (M. Martinez, personal communication, May 30, 2013)
  • Globalization "Our people, they are so worried about surviving themselves here every day" (M. Martinez, personal communication, May 30, 2013)
  • Global Health Policies ”They have so many problems locally” (M. Martinez, personal communication, May 30, 2013)
  • Community Leadership "This center is the leadership with Father Frank, who founded it. He is your people" (M. Martinez, personal communication, May 30, 2013)
  • Community Leadership  Two afterschool programs and this summer started a new VPK program  To help with children being home alone  New counseling group meets Thursday nights. Hosted by two nurses with a Honduran heritage who volunteer their time  Mothers of the runaway girls or victims of domestic violence  Partnerships with various organizations  Legal help and help to get access to healthcare (M. Martinez, personal communication, May 30, 2013)
  • Community Leadership  Their action is through the use of various media  TV (Channel 5)  Radio (Radio Fiesta)  Newspaper (Palm Beach Post)  The locals will come to them if they hear about anything concerning  "It they hear something, they come to us". (M. Martinez, personal communication, May 30, 2013)
  • Background  Maya account for approximately sixty percent of the population in Guatemala  The largest indigenous groups in the Americas  Ladinos have exploited them for centuries and still continue in Guatemala today  36 year war in Guatemala, started in 1960, resulted in destruction of over 400 Mayan villages and the death of over 200,000 people, majority of whom were Mayans, causing many to flee to Mexico and to the United States (Burns, 1993; Brown and Odem, 2011; Green, 2009; Hiller, Linstroth, & Vela, 2009)
  • Background  Many Guatemalan Mayan immigrants came to the United States in the 1980s due to the immense violence of the war  Or in the late 1990s after the end of the Civil War in 1996, when the Mayan villages were terribly struck by hunger, unemployment, and continued violence  The Maya who came to Florida in the early 1980s came as families, however, later in 1980s this changed to mostly young men arriving alone (Burns, 1993; Brown and Odem, 2011; Green, 2009; Hiller, Linstroth, & Vela, 2009)
  • Background  The Guatemalan Mayan refugees come mostly from rural, poor western highland villages where more than twenty different Mayan languages are spoken  Most of the Guatemalan Maya who arrived in Florida came from the province of Huehuetenango and are referred to as Kanjobal Maya here in the United States  The indigenous heritage and injustice that Guatemalan Maya experienced in their home country, is often carried with them into their new life in the United States (Burns, 1993; Brown and Odem, 2011; Green, 2009; Hiller, Linstroth, & Vela, 2009)
  • Background  1.1 million Guatemalans live in the United States  81,887 Guatemalans in Florida  19,615 in Palm Beach County  4,358 in Lake Worth  Lake Worth has the highest Guatemalan population of all Florida cities  Miami at second place with 4,060; West Palm Beach at third place with 3,775 (Pew Research Center, 2013; U.S. Census Bureau, 201
  • Background  Median age of Guatemalan in the United States is 27  Median income is $17,000  26 percent of them live in poverty  Only 8 percent have at least a Bachelor's degree (Pew Research Center, 2013)
  • Background 18 31 48 0 10 20 30 40 50 U.S. Hispanics Guatemalans % of population without health insurance (Pew Research Center, 2013)
  • Review of Literature  Language and race  Families and communities left behind  Stress  Health and illness  Undocumented immigration
  • Review of Literature Language and race  The Maya are considered Native American and not Latino or Hispanic  Healthcare providers are often unaware of the difference between Hispanic and Mayan  Creates many problems in their care because their traditions and language are vastly distinct.  Mayans do not consider themselves Hispanic, nor identify with the Latino community (Czerwinski, LeBaron, & McGrew, 2011; Hiller et al., 2009)
  • Review of Literature Language and race  21 official Mayan languages in Guatemala and over 50 Mayan dialects  4 most common Mayan languages are Mam, K'iche, Chuj, and Q'anjob'al  The majority of the Lake Worth Mayan speaks Q'anjob'al today  Some Mayan speak or understand Spanish or a non-standard Spanish, called "la castilla"  Critical need for interpreters of the various Mayan languages because not speaking good enough Spanish or English is an immense barrier to health care (Czerwinski, LeBaron, & McGrew, 2011; Hiller et al., 2009)
  • Review of Literature Families and communities left behind  Today increasing amount of women are migrating leaving their children to be cared for by other caretakers, typically women, such as aunts and grandmothers  Remittance  Discipline from abroad  Separation (Brown & Odem, 2011; Moran-Taylor, 2008)
  • Review of Literature Stress  Worrying about family’s safety back home  Waiting in job pools on street corners in hope of having a job for the day  Feeling of not being acknowledged as skilled agricultural workers  Accept drinking over the weekend as a way to deal with the multiple stressors  Have a higher risk for stress and mental health disparities because of their distinct culture, language, history of trauma, and immigration status. (Millender, 2010; Millender, 2012)
  • Review of Literature Health and illness  Illness is caused by an imbalance between hot and cold elements in the body  Use traditional healers and medicines, such as herbs, and they often wait to seek help from Western medicine only if these traditional methods are unachievable or their illness has become serious  The Mayan prefer to receive health information through word-of-mouth communication  Frightened by the healthcare system and mistrust the care because their culture is disrespected (Czerwinski et al., 2011; Long et al., 2012)
  • Review of Literature Undocumented immigration  Many Guatemalan Mayan work low paying jobs as day laborers, as majority of them do not have documentation due to the immigration laws that do not qualify them for political asylum  The United States immigration officials saw Guatemalan Mayan as economic refugees and not political refugees  1986 Immigration Reform and Control Act  Obama administration’s immigration reform S.744 (Burns, 1993; Mayo, 2010; Ruiz, 2013)
  • Globalization  At the grassroots, the Maya community in the Lake Worth, does not have a sense of globalization  Letter, on behalf of the Guatemalan-Maya Center, Corn Maya, and IkBalam, to the Guatemalan President, the high commissioner for human rights in the United Nations and the office of high commission of human rights in Guatemala (M. Martinez, personal communication, May 30, 2013; The Guatemalan-Maya Center, 2012 )
  • Globalization Interconnectedness and interdependence between United States and the Guatemalan Maya  During the Civil War, the United States government sited with the Guatemalan military and the U.S involvement has been seen as the key aspect contributing to the human rights violations during the war  Causing Maya to flee to Mexico and to the United States  The lack of U.S. authorities to recognize the Maya as refugees  Lack of legal papers is still a critical issue, which also affects their access to healthcare and the quality of their care (Bradbury-Jones, 2009; Miller, 2011) “What happens in one country matters for the rest of the world"
  • Globalization  Nurses are expected to be global citizens and be aware of various issues that cross borders and impact all of us  Influence of the United States globally, effects health care and its determinants locally  In 2009, President Obama started the Global Health Initiative (GHI), and one of its focus areas is combating malnutrition of the Maya women and children in the highlands of Guatemala  USAID also supports the indigenous women of Guatemala and receives funds from the U. S. Global Health Budget (Kriel, 2011; Mill, Astle, Ogilvie, &Gastaldo, 2010)
  • Leadership Strategies 1. Internationalizing the Curriculum  According to the review of literature and the field interview, the Mayan feel apprehensive about our health care system and share that their culture is not understood or respected  Nursing education has the responsibility to prepare students to give care in a global context  Service-learning experience in a local, culturally diverse community  Study abroad experience in a Guatemalan Mayan village
  • Leadership Strategies Multidisciplinary Service-Learning  The Maya Heritage Community Project (MHCP) is an example of an interdisciplinary service-learning project  Students and faculty from various disciplines, such as history, education, and nursing, work together to serve the local Mayan community  Various service-learning projects, such as the toolkit for health care providers, the handbook on teaching students of Maya heritage, and helping with the Mayan annual national conferences (Kennesaw State University, 2011; National Service-Learning Clearinghouse, 2013).
  • Leadership Strategies Study Abroad  Larson, Ott and Miles (2010) discuss the impact of their school of nursing's first elective course offering a two-week immersion experience in Guatemala  Gained a deeper understanding of US politics in developing countries, and recognized the intersection of health and economics  Allowed them to respect the traditions and beliefs of the Mayan people, instead of seeing them as barriers to health or as odd
  • Leadership Strategies Study Abroad  Wright (2009) explains that during the past six years their school of nursing in the United States has offered a study abroad clinical course in Botswana  No matter where humans live, they have basic similarities  Partnered with a local school of nursing and after several years, the faculty from the U.S. school of nursing was asked to help the local school to start a bachelor level program
  • Leadership Strategies Internationalizing the Curriculum  Interdependence in education involves moving away from isolated institutions to collaborating with other institutions and organizations both locally and globally, with a goal of "harnessing global flows of educational content, teaching resources, and innovations" (Frenk et al., 2010, p. 1924).
  • Leadership Strategies 2. Political Activism  Nursing must be committed to social justice and social responsibility should be its core value  Health remains a goal to achieve and a commitment for humanity  One of the biggest issues that the field experience revealed centered on the lack of legal documents  Legal status would improve not only their wages and chances for stable employment, but their access to and quality of health care  Political activism is a way to take action against racial prejudice and social injustice, therefore promoting human diversity and health care for all (Kelley, Kun, Connor, & Salmon, 2008; Racine, 2009)
  • Leadership Strategies 2. Political Activism  Healthcare is political because it is expensive and there are limited resources to be matched with the needs  It is nurses' responsibility to get involved  At this time of immigration reform, writing to Florida Senator Rubio urging him to vote in favor of the immigration reform bill, is a concrete and effective leadership strategy that would help both provide the W visas for the hard working Guatemalan Mayan immigrants and allow for the unification of their families (Roux & Halstead, 2009)
  • Summary  The field interview revealed that the challenges of the Guatemalan Mayan people in Lake Worth are lack of language, working too many hours, lack of legal documents, domestic violence, and no healthcare coverage  The review of literature confirmed that especially immigration and healthcare are of concern to the Guatemalan Maya people in the United States.  The review of literature further exposed that Guatemalan Maya did not trust the healthcare in the United States, due to their culture not being understood or even disrespected  Through the stories told by M. Martinez, this same theme for lack of cultural competence and distrust emerged
  • Summary  The suggested leadership strategies were centered on the two key needs of the community locally and globally: 1. Need for enhanced cultural competence for the nursing profession 2. Migration as it relates to healthcare  Including an interdisciplinary service-learning experience in a local community and/or including a study abroad experience in the nursing curriculum, were suggested as leadership strategies for enhancing the cultural competence  Political activism in a form of writing a letter to Florida Senator was suggested as a leadership strategy related to migration  Legalizing the Guatemalan Maya immigrants would not only improve their social status from "second class citizens", but would also assure them access to healthcare (LeBaron, as cited in Hutto, 2013)
  • References Bradbury-Jones, C. (2009). Globalisation and its implications for health care and nursing. Nursing Standard, 23(25), 43-47. Retrieved frohttp://ezproxy.barry.edu/login?url= http://search.proquest.com/docview/219889301?accountid=27715 Brown, W. & Odem, M. (2011). Living across borders: Guatemalan Mayan immigrants in the U.S. South. Southern Spaces. An Interdisciplinary Journal About Regions, Places, Cultures of the U.S. South and Their Global Connections. Retrieved from http://www.southernspaces.org/2011/living-across-borders-guatemala-maya-immigrants- us-south Burns, A. F. (1993). Maya in exile. Guatemalans in Florida. Philadelphia, PA: Temple University Press. Czerwinski, K., LeBaron, A. &McGrw, M. (2011). Maya Health Toolkit for Medical Providers. Retrieved from http://www.brycs.org/maya-toolkit/upload/Maya-Toolkit.pdf Frenk, J., Chen, L., Bhutta, Z. A., Cohen, J., Crisp, N., Evans, T., . . . Zurayk, H. (2010). Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world. The Lancet, 376(9756), 1923-1958. doi:10.1016/S01406736(10)61854-5 Fooksman, L. (n.d.). Day in the life of Guatemalan-Mayan Center. Retrieved from
  • References Green, L. (2009). The fear of no future: Guatemalan migrants, dispossession and dislocation. Anthropologica, 51(2),327-341. The Gutemalan-Maya Center. (2012). Important letters. Retrieved from http://www.guatemalanmaya.org/letters Hutto, T. (2013). The Maya: Elevate your graduate journey. Kennesaw State University Graduate College Magazine, Spring 2013, 22-26. Retrieved from http://www.kennesaw.edu/graduate/admissions/magazine.shtml Kelley, M. A., Kun, K. E., Connor, A., & Salmon, M. E. (2008). Social responsibility: Conceptualization and Embodiment in a school of nursing. International Journal of Nursing Education Scholarship, 5(1), 1- 16. doi:10.2202/1548-923X.1607 Kennesaw State University. (2011). The Mayan Heritage Community Project. Retrieved from https://commons.kennesaw.edu/maya-project/ Kriel, L. (2011). Healing the World. Retrieved from http://www.globalpost.com/dispatch/news/health/110714/ghi-targets-chronic-malnutrition-guatemala Larson, K. L., Ott, M., & Miles, J. M. (2010). International cultural immersion: En vivo reflections in cultural competence. Journal of Cultural Competency, 17(2), 44-50. Retrieved from http://search.proquest.com.ezproxy.barry.edu/docview/365997203/fulltextPDF?accountid=27715
  • References Long, J. M., Sowell, R., Bairan, A., Holtz, C., Curtis, A. B. & Fogarty, K. J. (2012). Exploration of commonalities and variations in health related beliefs across four Latino subgroups using focus group methodology: Implications in care for Latinos with type 2 diabetes. Journal of Cultural Diversity, 19(4), 133-142 Mayo, E. J. (2010). Maya USA: The Immigration Reform and Control Act of 1986 and its impact on Guatemalan Mayan in the United States. International Journal of Critical Indigenous Studies, 3(2), 29-44. Millender, E. I. (2010). Stress experienced by Guatemalan-Mayan immigrants. Archives in Psychiatric Nursing, 24(3), 212-214. doi:10.1016/j.apnu.2009.04.001 Millender, E. I. (2012). Acculturation stress among Maya in the United States. Journal of Cultural Diversity, 19(2), 58-64. Moran-Taylor, M. J. (2008). When mothers and fathers migrate north. Caretakers, children, and child rearing in Guatemala. Latin American Perspectives, 161(35), 79-95. doi:10.1177/0094582X08328980 National Service-Learning Clearinghouse. (2013). Interdisciplinary models of service-learning in higher education. Retrieved from http://www.servicelearning.org/instant_info/fact_sheets/he_facts/interdisciplinary
  • References Olmedo, S. (2008). Mayan immigrants face prejudice. Daily Sundial. Retrieved from http://sundial.csun.edu/2008/04/mayanimmigrantsfaceprejudice/ Pew Research Center. (2013). Hispanics of Guatemalan Origin in the United States, 2010. Retrieved from http://www.pewhispanic.org/2012/06/27/hispanics-of-guatemalan-origin-in- the-united-states-2010/ Ruiz, D. R. (2013). Maya migration north: Transnational indigenous identities. Cultural Survival. Retrieved from http://www.culturalsurvival.org/publications/voices/debra-rodman-ruiz/maya- migration-north-transnational-indigenous-identities Roux, G. & Halstead, J. A. (2009). Issues and trends in nursing. Essential knowledge for today and tomorrow. Sudbury, MA: Jones and Bartlett Publishers. United States Census Bureau. (2013). American Fact Finder. Census Group 2010. Popgroup Guatemalan. Retrieved from http://factfinder2.census.gov/faces/tableservices /jsf/pages/productview.xhtml?pid=DEC_10_SF2_PCT43&prodType=table Wright, D. J. (2009). Planning a study abroad clinical experience. Journal of Nursing Education, 49(5), 280-286. doi:10.3928/01484834-201000115-05