Surviving Gun Violence with Spinal Cord injury in Guatemala

Abstract

This thesis explores the lived experience of members of a little-studied group, the survivors of gun violence. Although gun violence is a topic of intense interest and discussion around the world, the focus tends to be on mortality, with little consideration given to people who are shot and do not die. The Guatemalan wheelchair NGO Transitions reports that, among adults, the single most common reason for needing a wheelchair is spinal cord injury (SCI) caused by gunshot. This suggests a very serious impact of gun violence in terms of disability and its accompanying challenges in a low-resource context like Guatemala. The study set out to investigate the phenomenon of living with SCI caused by gunshot. No scholarly research, whether quantitative or qualitative, has been published on people who survive being shot in Guatemala. Violence is ranked by the World Health Organization as the third leading cause of spinal cord injury, but it is barely mentioned in global reviews of SCI research. This is because the low- and middle-income countries most affected by violence do not tend to be included in global reviews. However, a search of the Latin American literature reveals gunshot to be the primary cause of SCI in some studies from Honduras, Brazil and Colombia. This may also be true in Guatemala, which is similar to these three countries in terms of crime and violence. Meanwhile, the published qualitative research on the experience of gunshot survivors is mostly limited to studies of current or former gang members in the US, a context very different from Guatemala. In order to gain a deep understanding of the experience of people who are shot and survive with SCI, this study took a qualitative approach, based on semi-structured interviews and thematic content analysis. The participants’ experiences are analysed in terms of six themes: hospital and health, justice, economic impact, family, religious faith, and disability identity and wellbeing. The findings highlight the serious impact of poverty on health and mobility, the common experience of severe and preventable secondary health problems, as well as the key role of family support and religious faith in these survivors’ lives. This research contributes to an understanding of the immediate and long-term impacts of gun violence, and the need for improved policies and services for crime victims and people with spinal cord injury in Guatemala. The recommendations could inform policy (eg crime victims assistance), programs (eg education for SCI patients, their families and health workers), and public awareness in Guatemala. Further research is recommended into the experience of gun violence survivors and their families as well as the economic impact of gun violence. Better data collection is recommended in areas including gun deaths, non-fatal injuries, circumstances of shooting, types of weapons used, police investigations, prosecutions and convictions.