At the end of the war, half of Guatemala lacked medical care, and the government did not have the means or the inclination to provide it. A patchwork of NGOs and third-party contractors emerged instead, heavily concentrated in the rural areas where La Violencia had left the most lasting damage. It was inevitable that Lucrecia would work in some of the same places that Myrna had. In Myrna’s time, the highlands were hollowed out by mass migration to Mexico or forced relocations to “model villages.” In the 2000s, the residents who had departed for the United States left behind signs of faraway
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