In general, water is not potable in almost any part of Guatemala. Travelers with stronger stomachs may be able to drink it without issues, but this is not recommended in any way. Giardia, amoebas, and parasites will ruin your trip, so be safe and buy bottled water like Salvavidas. It only takes a little bit to get sick, so brushing your teeth with purified water is recommended as well. Tip: almost any tienda will sell bolsas de agua pura (bags of water). These are the cheapest source of purified water. Just bite off a corner and squeeze them into a water bottle, or get crazy and drink straight from the bag! Once in a while you may buy bag with a strange plastic taste to it, but this is nothing to worry about.
In rural areas consistent tap water is a rarity, an issue that requires families to store large quantities of water for personal use whenever service is interrupted. The pila, a large cement basin, is a staple in nearly every Guatemalan home. When water ‘falls’ from the faucet, or chorro, families take advantage to fill the pila and other barrels to the brim. They then use this water to bathe, wash clothes, and do dishes until the water ‘comes back’. These stagnant pools are obvious havens for mosquito larva and other parasites, so families must be careful to boil or treat their water with bleach before drinking it.
Visitors will notice that Guatemalans drink a lot of soda, and more are guzzling down energy drinks like Raptor and Volt as well. In addition to lack of nutritional education, the habit can be attributed to the fact that untreated water is related to gastrointestinal disease. Bottled carbonated beverages, on the other hand, won’t get you sick. Excessive soda consumption is related to soaring rates of diabetes and cavities among children. Sadly and almost unbelievably, Guatemalans use the same name for both drinking water and soda: agua. This practice that can’t help but to increase confusion, especially among young children. To order drinking water, you must specify that you want agua pura.
Nothing can ruin your vacation like a case of giardia or traveler’s diarrhea. While eating local street food is a great way to experience a country’s culture, it’s up to you whether or not it’s worth the risk to your health. I spent three years in rural Guatemala with the mentality that sooner or later I should get used to the local intestinal flora. It took me six months before I could eat whatever I wanted without getting sick. If you are set on trying the local cuisine, ask your primary care physician what antibiotics you can take should you start to feel ill. Many visitors rely on Ciprofloxacin, which can be found in any pharmacy.
Modern, top of the line hospitals can be found in Guatemala’s largest cities, but health care in rural areas is provided by small health centers and posts. Medical services can be limited, but in an emergency they are better than nothing. In some areas, Western medicine takes the back seat to traditional healing practices and medicines. Even in more developed regions, certain superstitions may make you question the treatment you receive. For example, the over-prescription of wide-range antibiotics or the belief that flowers suck all the oxygen out of a hospital room. If you get really sick during your trip to Guatemala, it would be wise to try and head to the capital for the best care. Pharmacists, while not professionally trained, tend to be very knowledgeable. Two of the country’s best hospitals are the Hospital Privado Herrera Llerandi in Guatemala City and the Hospital Privado Quetzaltenango in Xela.
For those who have never left the first world, bathroom ‘etiquette’ in Guatemala may be a shock. The first rule of thumb is that toilet paper cannot be flushed. Sewer infrastructure across the country cannot handle more than human waste alone. This may not be true in upscale hotels and restaurants, but it is definitely true 99% of the time. Simply throw your used toilet paper or sanitary napkins in the trashcan conveniently provided next to the toilet. This may seem gross, but an overflowing toilet is far worse.
Another tip is that toilets, by design, cannot flush without running water. If you see a large barrel of water in the bathroom, this is a sign that you must pour water into the toilet after in order to ‘flush.’ There should be a pitcher or bucket floating in the barrel specifically for this purpose. The pressure of pouring water into the toilet will empty the bowl. Keep in mind that very few stores and restaurants have public bathrooms, and even fewer provide toilet paper without charging. As a result, sanitarios are everywhere and typically charge Q1-2. Make sure to specify that you need toilet paper if that is the case. Finally, if you are at a family’s home and need to do your business, do not be surprised if all they have is an open latrine. If you are way out there, you might even be directed towards the cornfield.