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Lessons from Guatemala: A Student Reflection on the Social Determinants of Health Following an International Practice Experience, by Daniel Leslie

Last April, 10 University of Victoria nursing students studying at Selkirk College departed the Kootenays for Guatemala on the 8th International Practice Experience.   This opportunity, which is available to students in their third year of the Nursing program, provides students with a hands-on opportunity to explore social justice issues, population and community health, primary health care, and the social determinants of health in developing countries.

It was a trip I will never forget and an experience that has given me incredible insight and inspiration for my future practice as I begin my nursing career here in British Columbia or take on opportunities around the world. Those of us who participate in this practice placement throughout the years are committed to sharing the stories and perspectives of the people and organizations we met and worked with in Guatemala. This dialog increases understanding of the current situation in Guatemala and our connection to common environmental issues such as mining and resource extraction.

Guatemala is a country sandwiched between Mexico to the North, Belize to the East, and El Salvador and Honduras to the South. It is a country with great biodiversity and an incredibly vibrant and diverse culture, and it has retained strong resilience and pride despite impacts of colonialism. The people of Guatemala have been ravaged by genocide, civil war, rampant poverty, and a political system that has been compromised by decades of corruption, greed, and injustice.

We were accompanied by Mary Ann Morris, an instructor of nursing at Selkirk College, and Michael Chapman, community volunteer who is active in social justice issues. As the eighth group of students to embark on this practice experience, we were welcomed with genuine affection, curiosity and respect - expanding the relationship between our program and the communities in which we share this experience.  Our practice partners included individuals and organizations whose ultimate purpose is to address the health and wellness of the citizens of the country and advocate for change to a system that continues to marginalize much of the population.

One of the greatest influences on the social determinants of health for many of the Guatemalan people is the activity of Canadian mining companies in developing countries. Canadian mining companies have continued to ignore and allow the devastating effects on the people and environment of Guatemala (Zarsky & Stanley, 2011).

We witnessed firsthand many of the negative impacts on social determinants of health that often accompany mining activities in developing countries.  For example, income from employment is promised, but many jobs are lost once the initial infrastructure of the mine is complete, leaving environmental devastation with minimal positive spinoff to the community. Long-standing occupations such as subsistence agriculture and herding, are greatly compromised by the accompanying pollution. Physical environments become arid wastelands with polluted soil, air, and water at levels that would be illegal and considered unsafe in Canada. Water consumption by the mining activities leaves only the minimal supply necessary to maintain the life of the people and their animals.

One mine we visited pays nothing to use hundreds of thousands of liters of water every day for the mineral extraction process, whereas community members pay a fixed amount for water they can’t access - water they need to drink, to cook with, to water animals and to bathe. Social support networks are greatly challenged as community members opposed to mining become outcasts and experience threats and violence from mining supporters. Impacts to the social environment of a community include murders, violence, and disappearances, which in many cases have been linked to their opposition of mining (Amnesty International, 2012). Health effects from pollution include respiratory and skin infections, cancer, and increased livestock miscarriages.

This experience has increased my understanding and perspective of international nursing, shed light on many concerns of international trade agreements, and inspired different ways of approaching health and wellness as learned from our practice partners in Guatemala who must rely on health promotion and Primary Health Care to improve health and wellness and avoid costly and often unavailable tertiary care.  

The incredible resilience and resourcefulness of the people of Guatemala inspires me to challenge hegemony and to look for ways to improve our own healthcare system. As I return to life in Canada, I continue to see the impacts of mining in Guatemala as news stories describe the violence and discontent. I also see the impacts that mining and the oil and gas industry is making in our own country, contaminating water and air and creating health concerns for people of all ages. I feel that our focus on improved primary healthcare in Canada includes addressing the environmental and individual health impacts of mining and mineral resource extraction.

Nurses in BC have a powerful voice in health policy. We can bring the health and wellness of Canadians to the table as the resource we are responsible for, working with stakeholders to ensure that Canada is among the countries with the healthiest people in the world.


Amnesty International. (2012). Guatemala: Lives and livelihoods at stake in mining conflict.

Zarsky, L., & Stanley, L. (2011). Searching for gold in the highlands of Guatemala: Economic benefits and environmental risks of the Marlin Mine. Global Institute and Environment Institute, Tufts University. 


Daniel is currently in his 4th year of the UVic BScN program studying at Selkirk College. He returned to school after many years as a ski patroller, avalanche technician, and crew-leader on forest fire suppression crews for the Province of BC. He is currently a director and member of Nelson Search and Rescue, combining his love for the outdoors, teamwork, and serving his community. Daniel has completed an associate certificate in mental health and addictions through Selkirk College and is currently pursuing his BCIT Emergency Nursing.  He hopes to work in these fields in the future as well as continue to work, volunteer, and travel.   Daniel is involved with ARNBC through the Network Leads Program. 

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Lisa Davison


Thank you so much for writing this - what an amazing experience!

Do you think that your observations would be informative in the discussion around the northern pipeline? I would think that the experiences in aboriginal villages could be very much the same if the pipeline goes ahead. Have you considered additional ways of warning or flagging about how social determinants of health could be impacted by environmentally hazardous 'progress'? I think you are right in that there are parallels to be considered.

Ron (Poppa) Leslie

Well Daniel, I am pleased to be Your Dad! You have very wisely, eloquently and certainly with inspired experiential conviction, appreciated a transformational trip.

Your observations and reflections are well presented; evoking careful reflection and resolve within we who become involved readers. Well Done. May You be well and progressively inspired, encouraged, and equipped to pursue Your call into nursing and more! Thanks.

Liz B

I'm not sure what I love more - your blog or the fact that your dad commented, and so nicely too!

Seriously though, this is a blog that needs to be noticed. I think as Canadians and nurses, we often get so mired in our own worlds we forget to look at the world around us and consider how things like economics, the environment, poverty, socialization and culture can impact health and well-being.

Nicely done - sounds like a great trip. Like Lisa who already commented, I'd love to know whether you think your experiences could somehow inform the current discussion around pipelines in BC.


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