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A Community-based survey of health and safety in postconflict Guatemala
  1. M J Harvey*,
  2. A R DiNardo,
  3. J L Vassy,
  4. C C Branas
  1. Correspondence Department of Biostatistics and Epidemiology, School of Medicine, University of Pennsylvania, Blockley Hall, Room 936 423 Guardian Drive Philadelphia, PA 19104, USA


In 1996, peace accords brought a close to Guatemalas 36-year civil war, which saw 200 000 casualties and over a million displaced persons. Despite the ceasefire Guatemala continues to be an extremely violent country, boasting one of the highest homicide rates in the world. To investigate the association between violence, substance use and mental health, we conducted a community-based survey of 46 Guatemalans in Guatemala City and the rural highland town of Santiago Atitlan. Our survey ascertained respondent demographics, trauma history, mental health, substance use history, exposure to weapons and crime and exposure to political violence. The mean age of our respondents was 36.9 ± 12.9 years, 72% were male, 80% were literate, and 65% spoke an indigenous language in addition to Spanish. The vast majority of respondents (91%) were afraid that they might be hurt by violence, while 41% reported experiencing some form of political violence. Seventy-two percent had seen someone seriously injured or killed. In total, 62% screened positive for post-traumatic stress disorder, eight of which (29%) experienced their first traumatic event after the civil war ended. These data show high levels of violence and post-traumatic stress among the Guatemalans we sampled, even compared with other postconflict countries. In addition, many of our respondents experienced no violence prior to the peace accords, suggesting that levels of violence have not slowed in postconflict Guatemala. These data are useful in beginning to epidemiologically understand the downstream effects of the Guatemalan civil war, although a larger, randomly sampled survey is now needed.

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