Dignity for Forgotten Souls

Author: John Rudolf

It’s my last day in Guatemala City, and I’m running late for a final meeting with Anna Walther ’08M.A., a staff attorney in the human rights office of the Archbishopric of Guatemala. Walther and I are the same age, 33, and I’ve been in town for a few weeks learning about the work she and other rights workers are doing on behalf of the mentally ill and disabled in this choked metropolis. On my trip I’ve seen up-close the decrepit and dangerous mental institution they are trying to reform and have witnessed the misery of the patients there. It’s a low-paid, gritty endeavor made all the more dicey by the grind of living in one of the world’s most crime-ridden cities. Not exactly the typical gig for a recent law school grad. Her contemporaries are mostly climbing the corporate ladder, buying condos and starter homes, leading conventional lives. Instead, she’s here. Who signs up for this?

We are set to meet at the human rights office in the complex of the Metropolitan Cathedral, an imposing neoclassical structure of stone that looms over the Plaza de la Constitution in Guatemala City’s historic center. It might be 25 minutes by car to the cathedral from my hotel when the roads are clear, but from the get-go my taxi hits a snarl of late morning traffic and it’s a steady crawl all the way. It’s a chance to absorb the city one more time, which is not an appealing sight. The air outside the car window is a polluted beige, and the city pulses with frenetic commercial energy. Gaudy billboards and advertisements are omnipresent, promising the good life, touting refrigerators and smart phones, soft drinks and new cars. At a bus stop I spot an ad for an upcoming concert by the Jonas Brothers, the American teen pop idols.

Anna Walter '08MA, photo by John Rudolf

Familiar fast-food restaurants abound: McDonald’s, Subway, Burger King. But there’s an unfamiliar touch: By the door of each restaurant loiters a black-uniformed private guard, his face a sullen or bored mask, his hands cradling a pump-action shotgun. Armed guards stand outside most businesses, mixing with the multitudes of police and assault-weapon toting soldiers on the streets to give the whole town the feel of a low-grade military occupation.

As the cab enters the old city, the broad avenues narrow into tight two-lane streets lined with colonial-era buildings in varying states of disrepair. Here, too, are signs of unrest: graffiti shouting “Viva Chavez” or “Justicicia por Genocidio,” and walls plastered with faded, photocopied pictures of the “disappeared” — men and women abducted and killed during Guatemala’s 36-year civil war, officially ended by the signing of the 1996 peace accords. Ten blocks from the cathedral my cab is detoured by a workers’ protest, where red-shirted demonstrators hoist a banner emblazoned with the familiar beret-wearing image of Che Guevara.

I’m dropped at the curbside of the human rights office, known as ODHAG (pronounced “oh-dog”) for its name in Spanish, the Oficina de Derechos Humanos del Arzobispado de Guatemala. There’s no sign, just a pair of heavy wooden doors, an intercom and a video camera. That’s by design. In 1998, the founder of the office, Bishop Juan Gerardi Conedera, was beaten to death in the garage of the parish house about three blocks away. The murder was retaliation by high-ranking military officers for the bishop’s publication two days earlier of a 1,400 page report documenting the systematic torture and murder of as many as 200,000 civilians by a succession of right-wing dictatorships. Gerardi’s killers were finally brought to justice after a three-year investigation rife with political interference, bribery, judicial corruption, death threats and violence.

I’m buzzed in and meet Walther in the light-filled inner courtyard. She laughs when I tell her about the demonstrators with their Che banner. “There’s a different protest every day,” she says.

And sometimes a bit more. Just yesterday there was full-blown riot just outside on the square, after a platoon of police officers moved in force to clear out dozens of illegal street vendors, some of whom were notorious for harassing young women and selling drugs. The vendors resisted, and soon a large crowd was shouting and throwing paving stones and chunks of concrete. Police surged into the crowd swinging batons. Walther was at her desk when the fighting broke out. “One of my co-workers came in and said the police were beginning to move,” she says, nonplussed. “I could hear sirens and screaming.”

We leave the office and find a table at a cafe a few blocks away, right across the street from the former presidential palace. A vast and elegant edifice of green-hued stone, it acted as headquarters for many dictators over the past century but now serves a mostly ceremonial function and is open to tours by the public. As we sip coffee, camouflaged soldiers stroll by in the hot sun, square caps jammed low on their foreheads, assault rifles strapped to their chests.

Walther projects solidity and directness, good qualities for human rights work, I think. She is tall, 5-foot-10, with deeply tanned arms and broad shoulders (she rowed competitively on scholarship at the University of Southern California as an undergrad), and a projecting voice with faint traces of a California surfer’s drawl. In conversation she is earnest and intense, with a dry sense of humor that leans somewhat to the macabre. When working — and at this point I have seen her in the field a few times — she can seem almost like a force of nature, fierce and focused, all business.

She earned a master’s in international peace studies at Notre Dame’s Kroc Institute and graduated from Loyola Law School in 2011. A post-grad fellowship from Loyola funded her work in the archbishop’s office for two years, in her first full-fledged job in human rights. Arriving in mid-2011, she was soon engaged on the office’s biggest case, the investigation of war crimes and genocide during the civil war. She spent months sifting through thousands of recently declassified U.S. State Department documents from the war era, looking for previously undisclosed evidence of massacres, torture and disappearances.

A year ago, she embarked on a new case: an investigation into abuse and neglect at Guatemala’s national mental hospital, called Federico Mora. The work came to her through a series of personal connections. William Bolainez, a friend, had earned his master’s in international human rights law at Notre Dame Law School in 2008. One of his classmates there, Sofía Galvan ’09LL.M., an attorney from Mexico, was working for Disability Rights International (DRI), a pioneering rights group that investigates abuses against the mentally ill and disabled around the world. In summer 2011, acting on a tip, her group began examining Federico Mora. Galvan needed a local partner to help organize a campaign to pressure the government to radically reform the institution. Bolainez suggested Walther, and the next day the two women met for coffee.

Walther was on board almost immediately. She’d felt for some time that the war crimes cases were not her calling. The work was a noble and vital cause, but the investigations and prosecutions were also deeply entangled in Guatemala’s notoriously murky internal politics, raising questions for her about balance and impartiality. And the process — a relentless cataloguing of long-ago crimes — sometimes felt like a quest for retribution, not just accountability. Even while studying at Kroc, she knew she preferred working to alleviate suffering in the here-and-now to sifting through claims of guilt and innocence from past conflicts. Here was her chance to do just that.

“I wanted to do something now. Something forward-looking. Something reconstructive, building up a better society,” she says. “This was the perfect opportunity.”

After the meeting she lobbied her boss at the archbishop’s office for permission to join the investigation, and he quickly agreed. Within a few days she was driving into the hills on the northern outskirts of Guatemala City, headed toward Federico Mora with Galvan, a psychologist and another DRI investigator. Walther had no prior training or experience dealing with the mentally ill. When I ask her to recount that initial visit, she pauses.

“I had nightmares for a week the first time I visited that place,” she says.

The facility was chaotic and filthy, the grounds strewn with human waste. The howls and cries of men and women in crisis filled the air. In a pavilion near the entrance, heavily sedated patients lay on the bare concrete, curled in fetal positions in the hot sun. Others nearby rocked violently back and forth, tied by the waist to plastic lawn chairs. In another corner of the hospital she found a group of severely intellectually disabled women locked in a barren concrete enclosure, sitting in soiled diapers, the floor and walls smeared with excrement. “I saw a woman eating her own feces. That was not cool,” Walther says with a grimace.

She also felt the menace of the outsize security force assigned to watch roughly 70 mentally ill prisoners — some serving prison terms, others awaiting trial — housed alongside the facility’s regular patients. For each prisoner, the hospital is assigned three guards drawn from Guatemala’s famously corrupt prison system. As a result, well over a hundred guards in quasi-military garb, armed with batons and pistols, roam the hospital at all hours for their different shifts, far outnumbering the regular medical staff. Statements obtained by investigators from staff and patients implicated the guards in a range of abuses, including sexually exploiting young female patients and intimidating hospital staff.

Despite the reports, Walther was still shocked when about an hour into her visit she watched a group of young male guards taunt and harass a man with Down’s syndrome, throwing garbage at him and chasing him around a courtyard, laughing all the while. “They made him dance,” she says.

The institution recalled an especially depressing zoo. “You know how you feel bad for animals when they have a really terrible cage, when they’re just lying around listless and sad? It’s like that, but with people instead of animals,” she says.

During the visit, which lasted several hours, she kept her mind focused on recording details for use in a future legal action. When she got home she washed her shoes in bleach, and that night an old nightmare returned that she hadn’t had for years. It took her a few days to process all that she’d seen. What haunted her most was the helplessness of those trapped at Federico Mora, how they had been hidden away and forgotten by the world. “It’s lost in time,” Walther says. “It got spun into its own universe and left to decay.”

I made my own visit to Federico Mora a few weeks earlier, not long after my March arrival in Guatemala. It is a crucial time for the investigators: After nearly a year and half of work, their efforts seemed to be making real headway. The previous October, Disability Rights International had filed a complaint about the institution with the Inter-American Commission on Human Rights, a branch of the Organization of American States — a regional body that serves as a sort of United Nations for South and Latin America. The complaint describes in dense detail the widespread violations of basic human rights at the facility, including allegations of routine sexual abuse of female patients by guards. The commission responded in November by urging Guatemala to adopt a series of “precautionary measures,” broadly endorsing the complaints as valid and requesting the state take immediate and drastic action to protect the patients.

The government in turn dug in its heels, with the ministry of health denying the worst of the allegations while offering to make a few limited changes at the hospital. The government’s position set the stage for a delicate dance of negotiations and public and private pressure by the campaigners over the next few months.

This dance is at a pivotal stage when I show up in March. In a small coup, Archbishop Oscar Vian Morales has agreed to make his first-ever visit to the facility. Guatemala is among the most devoutly Catholic countries in the world, and church leaders retain a degree of popular authority and political sway that has largely waned elsewhere. The archbishop’s visit is guaranteed to attract media attention, and his political influence could sway reluctant officials to act, if he chooses to exercise it. I’m allowed to tag along.

We meet at the human rights office on a sunny morning in mid-March. Walther darts in and out of the inner courtyard, her face stern. It is a big morning. After some last minute coordination, she rides off in a black SUV with the archbishop and his entourage, and Eric Rosenthal, an American attorney and the executive director of Disability Rights International. I’m to follow them in a taxi with Sofía Galvan and another DRI staffer.

Sofia Galvan '09LLM, photo by John Rudolf

As we wait for the taxi, Galvan and I chat about her background for a few minutes. Only 30, she graduated from a top Mexican law school at 23 and is already an experienced rights campaigner, winning a national youth award in human rights from the president of Mexico in 2011. She took a job with DRI in 2010, a few months after earning a master’s in international human rights law at Notre Dame, and now runs the group’s Latin America office. She wrote much of the petition to the Inter-American Commission, and her visit to Guatemala this week is more like a whirlwind tour, with each day packed with official meetings, strategy sessions, press conferences and other obligations from early in the morning until late at night. It can be a grind, she admits. But she’s devoted to her work, which focuses on reforming antiquated and dilapidated mental institutions, where the mentally ill and developmentally disabled are warehoused and forgotten. “Being in these institutions is like being dead in life,” she says.

This morning she looks exhausted. She laughs and apologizes often, and unnecessarily, as we talk, in what seems like a nervous reflex. Over the past 18 months Galvan has been to Federico Mora a number of times but is nevertheless worried that the taxi driver might lose his way.

It’s not an idle concern. Guatemala City is divided into numerous subdivisions, called zonas, and Federico Mora sits at the top of a deep ravine in Zona 18 on the northwestern edge of the city. At the bottom of the ravine runs a toxic black river of untreated sewage. The hospital’s immediate neighbors are a grim, smoky slum clinging to a steep hillside and the Centro Preventivo, a notorious prison that looms over its walls to the north. Unsurprisingly, Zona 18 is known as especially dangerous, even in a city infamous for its rampant street crime. “If we get lost we will get killed,” Galvan says. I think it’s a joke.

Luckily, our driver knows the way, and we arrive at the hospital’s imposing iron gates after an uneventful drive up into the hills. A stern female guard checks our credentials and eventually waves us through. As we enter I’m struck by the layout, which reminds me of a badly down-at-the-heels community college. As I learn later, the hospital was designed and built in the early 1970s as tipo granja, or in the style of a farm, with open space and vegetation. The wards are low-slung, one-story buildings connected by concrete walkways and small, park-like courtyards of trees and desiccated grass. We enter the facility in the wake of the bishop’s entourage and are met by a large group of hospital staff. As we begin our tour, I notice workers with buckets and mops vigorously scrubbing the walkways and exterior walls. Small groups of gray-uniformed guards linger in groups around the courtyards, smoking cigarettes and reading newspapers, eyeing us warily.

The first stop is a short-term ward for female patients in psychiatric crisis. Passing through the barred door, where a padlock and heavy chain hang ominously, I’m hit by the overwhelming smell of ammonia. Pale green paint peels from the cracked walls and uneven shafts of sunlight filter through old plywood nailed over the broken windows. In a mostly barren common room, a small television plays silently from a fixture near the ceiling, and several young women sit in chairs, their nails being painted by nurses. The patients smile nervously as we file in. Other women, clearly disturbed, wander barefoot, talking to themselves, laughing and crying. Some are in their early and mid-twenties; at least one seems young enough to be in college.

Walther hangs to the rear and pulls me aside. She scoffs at the impromptu salon. “It’s not really like this,” she whispers. “They’re prepared for us.”

The archbishop is a short, stout man in crisp clerical robes. In a soft voice he asks a few benign questions but otherwise says little. We walk through the ward, past small rooms jammed with ancient metal cots. In a corner, a toothless woman in a wheelchair howls inconsolably. As we leave the ward I fall in beside a staff psychologist and subdirector of the facility, Dr. Irma de Alvarado, a middle-age woman with her hair pulled back in a severe bun. I ask her about allegations that female patients are being sexually abused and exploited by the guards.

“It’s not the truth,” she says. “It’s not possible. The female patients are in a special place. They never walk or stay alone.”

With Alvarado and other officials hovering about, it seems an inopportune moment to interview patients or rank-and-file staff members about the goings-on at the hospital. So when the tour group begins moving toward the next ward, Walther and I loiter near the back, and in a few minutes it’s out of sight. Almost immediately we’re beset by two men in their mid-thirties, who are desperately unhappy with the conditions.

One of them, a tall man with shaggy black hair, holds his arms out. The skin of the hands and forearms is inflamed with rash and covered with scabs and open sores. “There’s a lot of sickness in here, and we need to get out,” he tells me. “I had to go steal medicine from the nurse’s office to put on my skin.”

His name is Ricardo, and Walther knows his story. Diagnosed as a schizophrenic, he was committed to the hospital several years ago. While a psychiatrist has cleared him to leave, the judicial system requires a family member to sign for his release and vouch for his care. With no family member able to be found who is willing to do so — and with no community-based care system available for the poor anywhere in Guatemala — he is essentially trapped at Federico Mora. “They put us here for protection, but there’s no protection,” he says.

Ricardo’s plight is a common one at Federico Mora. Guatemalan law lacks clearly defined rights for those deemed seriously mentally ill, giving rise to Kafkaesque situations where patients are deemed sane enough to return to society but remain forcibly hospitalized because they cannot find a family member to sign for their release. Judges and doctors also wield broad discretion over the long-term fate of patients found incompetent, a ruling that can be made during a single brief hearing. Unraveling the country’s tangled mental health statutes has been one of Walther’s key tasks since she got involved in the case, and revising the legal code is among the urgent reforms requested in the complaint to the Inter-American Commission.

“There’s a hole in the law. There’s an empty space where most countries have a legal system for forced commitment,” she says. “Completely apart from the conditions, the fact that the law has this hole is a serious violation of people’s rights.”

As for the conditions, they are perhaps not as dire as before — the human feces have been largely cleaned up — but the facility is still a terrible mess. Most unsettling is the pervasive sense of disorder, with patients wandering aimlessly, barefoot and in ragged clothes, sleeping on benches and on the bare concrete. There are broken toilets and no heat or hot water. There is no budget for shoes or soap. One orderly tells me, “Nos falta todos.” We lack everything.

Eventually we make our way back to the entrance. The archbishop departs with his entourage; the next day he releases a measured statement suggesting that many of the patients could be better cared for in a community setting. Just before my group leaves I interview one more patient, a pudgy young man sitting alone on a low concrete wall. I’m told he is a paranoid schizophrenic awaiting trial for murdering his parents; he lived in the United States for a few years and speaks some English.

Among other things, he tells me it is common for some female patients to prostitute themselves, sometimes for as little as five quetzales, or less than a dollar. “I see when they have sex for money. To buy food. All they have is beans. Sometimes the police go to see and take the picture and the video,” he says.

A few days later Walther and I grab lunch near the cathedral. She says it has been challenging to fully document the worst of the abuses the human rights workers suspect are happening inside the hospital. Some of the guards are said to be affiliated with gangs, and one female staffer recently told them that after she reported the abuse of a patient, the tires on her car were slashed. In a city known for criminal impunity, intimidation often equals silence.

“Bad things can happen to you cheap here,” she says.

When Walther was in her teens, she began questioning her devout Catholic upbringing and eventually drifted away from the church entirely. Now a confirmed agnostic, she finds it ironic that in adulthood she continues to circle so closely in the Catholic Church’s orbit — first at grad school at Notre Dame, then Loyola Law School and now in her job with the archbishop’s office. “It’s the grand universe laughing,” she says.

Of course, it’s hardly coincidental that Walther’s interest in human rights led to this awkward pas de deux with the church. A number of Catholic universities have become powerhouses in the study of human rights law and conflict resolution, with cutting-edge programs to educate and train a new generation of legal activists, civic leaders and scholars to fight injustice and foster peace and democracy around the world. Notre Dame’s world-class programs in this area owe their existence in large degree to Father Theodore Hesburgh, CSC, the university’s legendary former president, who founded the Law School’s Center for Civil and Human Rights in 1973, the Kellogg Institute for International Studies in 1982, and the Kroc Institute for International Peace Studies in 1986.

The efforts of graduates from these programs make a huge difference but can be perilous, says Sean O’Brien ’95, ’01J.D., ’02LL.M., assistant director of the Center for Civil and Human Rights. The center grants around 15 fellowships each year to lawyers from around the world to train them in international human rights law. Its nearly 300 alumni are at work in such countries as Egypt, Indonesia, Zimbabwe and Iran. Tangling with oppressive regimes over human rights is akin to “kicking the hornet’s nest,” O’Brien says.

“A lot of our lawyers come to us having faced physical danger and psychological stress because of the work they’ve done. They’ve been living in an adrenaline-filled situation where they move from one crisis to the next,” he says. “That’s not a normal lawyer’s life.”

Beyond just an education, the program tends to forge connections that last long after graduation. “It’s a very intimate community of like-minded souls,” O’Brien says. “The relationships that they form while they’re here help give them the courage and strength to continue the fight when they get back home.”

On my last day in Guatemala, near the end of our conversation in the cafe by the cathedral, Walther mentions that a long time ago she experienced violence in her own life. Exactly what she went through, or how it shaped her path in life, is not something she wants to delve into. What she will say is that in some strange way, these events in her past make her feel almost more normal in Guatemala than at home. It’s not strange to be paranoid here, to watch for strange cars out of the corners of your eyes, to never let down your guard, she says.

Even vigilance is not always enough to stay safe, however. She and Mario, her Guatemalan boyfriend, were recently burglarized and have been held up in the street on multiple occasions. When I connect with her on the phone after I return to New York, she says that gunfire erupted on her block just that morning. Her upstairs neighbor, whose son-in-law was shot to death last year, is moving out. She’s also thinking of finding a safer neighborhood.

Despite all the craziness, the danger, the disease — what she calls her “adventures with Guatemalan water" — Walther is not heading home. The effort to reform Federico Mora is yielding results, most notably a decision by the health ministry to build a separate facility for the criminally insane, announced after the ruling from the Inter-American Commission. It looks like there will either be a negotiated settlement with the government or a lawsuit in international court. Either way she intends to stay involved, although the work will probably be too slow-moving to keep her fully occupied.

She has other projects in mind. One would aid rural peasants impacted by strip mining, investigating the maze of shell companies that shield multinational corporations from liability for the pollution they cause. It may not be as risky as chronicling massacres and prosecuting death squad leaders, but local activists in the region have been killed for less.

At some point while we talk, I’m reminded of a well-known essay, “Famine, Affluence, and Morality,” that the ethicist Peter Singer published in the early 1970s. He reasons that the same moral imperative that compels us to rescue a child we find drowning in a lake similarly requires those of us who live in wealthy nations to help people suffering and dying in far-off lands whom we never see. Singer asks much, arguing that while we live in comfort, we intrinsically owe a sizable debt to assist those in desperate need, wherever they may be. This debt is an obligation, not something optional, he says; we don’t deserve applause for fulfilling it. It’s a bracing moral test most of us would probably fail, but Walther passes it with flying colors, though she’s not the type to shout it from the rooftops.

That seems like a good thing. She is intense but not overzealous; she likes barbecues, beer and hanging at the beach; she can be a bit goofy. When I ask her about the tattoo on her wrist of a heart merged with a peace sign, she calls it her “hippie heart.” She emails me some pictures from her graduation from Kroc, when her hair was dyed bubblegum pink. Other times it’s been fire-engine red or electric blue. In Guatemala, Walther keeps it her natural chestnut brown, but only out of duty. “I don’t think they’d trust a lawyer with blue hair,” she says.

Where she’s headed in the long run is not fully clear. But it’s becoming hard for her to imagine another way of life. Her experiences down here have marked her.

“No one wants to look. But if you look, it stays with you,” Walther says. “This is what it’s all about. It’s people alive now in situations that can be improved.”

John Rudolf is a freelance writer based in Brooklyn, New York.