“The body is tired of so many pills”. Use and abuse of medications and drinks in agricultural communities in Escuintla, Guatemala

INTRODUCTION

Medication and energy drinks are commonly used for improving work performance among agricultural workers, who face precarious conditions in Guatemala. Médecins Sans Frontières intervened in Escuintla to develop a comprehensive model to address chronic kidney disease of non-traditional causes (CKDnT), highly prevalent in this context. During the intervention, widespread use of medications, carbonated beverages and energy drinks was documented.

METHODS

A qualitative study was conducted to explore social and cultural aspects of this practice. 38 semi-structured interviews and 7 focus group discussions (FGD), using pile sorting strategy, were conducted. Participants included community members and leaders, workers and health staff. Interviews were audio-recorded, transcribed and systematized using NVIVO for thematic analysis.

RESULTS

Findings reveal widespread daily use of substances, such as carbonated beverages, energy drinks, and medications, used to manage pain, gain energy and rest. Initially common among young male agricultural workers, this practice has extended to other community members and daily life activities, like chores, recreation and school.

Participants mentioned health risks, including overdoses and CKDnT, as well as risks based on popular beliefs, like empacho (indigestion). To mitigate perceived harms participants mentioned purges or intense physical activity to “burn off” substances.

CONCLUSION

This practice is deeply embedded within community life, influenced by the dependance on agricultural work. The widespread use of substances has a perceived impact on the overall health of the population. Educational strategies are needed to raise awareness of the risks of medications and beverages, however structural factors that underline this practice must also be addressed.