There is currently widespread use of health care by undemocratic governments in an effort to control elements of their populations. A number of recently published articles have dealt with this problem. What has not been widely reported is the peoples' response to this situation. This article relates the response of the people of Guatemala and addresses those conditions in Guatemala that reflect the health needs of the people and the government's measures to meet and use these needs for political and military ends. The peoples' response, namely the creation of a clandestine health care system based on the secret training and practice of village health workers is presented. The data were obtained by personal observations, interviews and accounts from recently published periodicals.