2015 is an exciting year for WINGS as we are guided by our major goal - to provide accessible, affordable, and appropriate contraception to the youth, women, and men who want to space or limit pregnancies. What the means is we began this year working with local Guatemalan physicians to provide voluntary tubal ligations and vasectomies, 30 so far, mainly women, but also one very enthusiastic man, along the Pacific Coast and in the Guatemalan highlands.
For years, we worked in partnership with a reproductive health NGO to refer women and men interested in permanent procedures to their offices and subsidize the cost of the procedures. While this partnership enabled the NGO and WINGS to ensure thousands of women and men received their method of choice, we were unable to guarantee the availability or the quality of services. So what 2015 means is that we can promise effective, quality permanent voluntary surgical contraception provided by WINGS.
In addition to our permanent procedures, we've been scaling up the number and geographic reach of our family planning clinics. Every week, our nurses and family planning educators travel throughout Guatemala to reach rural, impoverished communities and offer long-acting reversible contraception for less than $3.25. This mean for the IUD, women pay $0.32 a year for up to ten years of protection from unwanted pregnancies and for the sub-dermal implant, $0.65 for five years of protection.
Mildre chose the sub-dermal hormonal implant in our most recent clinic in the indigenous town Santa Maria Cauque. The 20 year old mother gave birth less than a year ago and decided, “We’re not ready to have another child yet. We need to make your our son has everything he needs now to be healthy and happy.” With the full support of her family, Mildre visited our day clinic with her mother-in-law who shared how proud she was of her son and daughter-in-law for thinking about their future together.
While Mildre had the support of her husband and family, we realize that for many women and even men, family planning remains highly stigmatized within their families and communities and that is why we work with young boys and men to be allies in family planning and take into account their own needs. One these young men is 19 year old Hector who began attending WINGS’ workshops over three years ago in Villa Hermosa, a community close to the Mexican border.
Hector began volunteering with WINGS in 2014 as a peer educator when he was finishing his last year of “basic” high school, comparable to 10th grade in the United States. He was happy to have the opportunity to continue learning, albeit informally, and share his knowledge about family planning with his peers. “I wanted to become a nurse but I stopped studying after básico. My father is a farmer. He had five children, but I don’t think I’ll have more than three. You just don’t have enough resources to give them food, send each one to school, make sure they grow up healthy. I had to leave school because my father just couldn’t help me.”
We were so thrilled this January to offer Hector a part-time job with WINGS working as a community educator in northern Petén and since, he’s spent the past three months travelling throughout the communities to organize talks, plan our upcoming clinics, and provide clinics. “I’m happy, you know. I have this opportunity to work and I want to use it to learn as much as possible. My favorite topics that we teach are self-esteem…and contraceptive methods of course!”
Not only is Hector doing a fantastic job helping his neighbors access the information and services they need, but he’s also now looking to his own future. “I think within a year, I will have saved enough to go back to school.” He still plans on studying nursing one day because “we have a health center that doesn’t actually provide services…no one works there. That’s why we need to be here, so that people know about family planning and can use it to their advantage.”
Working with young men like Hector alongside their female peers helps us break down the barriers to family planning and enables us to provide more services to women and men who want them but have not been able to use them due to geographic, economic, and cultural limitations.
So what’s next? This month, we are hosting two permanent contraceptive clinics as well as a series of family planning clinics for long-acting methods. We are also in the process of training 170 youth throughout the country to be leaders within their communities and help other young women and men receive information and use reproductive health services as they see fit.
This past December, Guatemala became the first country in the region to adjust its guidelines for the screening and treatment of cervical cancer in alignment with new recommendations from the World Health Organization. This is a huge step in the right direction. While in much of the developed world death as a result of cervical cancer is uncommon, it is still a real issue in Guatemala and other developing countries. Cervical cancer is the leading cause of cancer-related deaths among Guatemalan women of reproductive age.
WINGS will follow the Ministry of Health’s lead and implement the new guidelines into our own work with cervical cancer. The new guidelines take into consideration the limited resources many developing countries face, and recommend VIA-visual inspection with acidic acid- as a highly effective tool in detecting the presence of cancerous lesions. While WINGS has been using VIA to detect cervical cancer since 2006, we are excited to see this form of screening adopted by national health institutions and other NGOs. Results with VIA are immediate, which eliminates the need for women to wait or return the next day for their results and/or treatment.
The primary cause of cervical cancer is the human papilloma virus, or HPV. There is a serious gap in HPV related data for women in Guatemala, particularly indigenous women. WINGS Board member and retired OB/GYN Roger Duvivier recently participated in a study to obtain current data on the prevalence and strains of HPV in the underserved indigenous population of highlands Guatemala. And based on this study, roughly 50% of indigenous women harbor some form of the virus. While no nationwide plan is in place to distribute the HPV vaccination, further studies such as this one, will set the stage for such a campaign.
With vaccination, regular screening, and treatment, no women should die of cervical cancer. In 2014, WINGS held 82 medical clinics, in which over 2,000 women were screened using VIA for cervical cancer. 51 cases required treatment for lesions using cryotherapy. WINGS is determined to continue spreading awareness of cervical cancer among the underserved, indigenous population in so that no more women die unnecessarily from this treatable disease.
What happens when we improve “access”?
When people are given access to reproductive health education and services they are able to take control of their own lives and make responsible decisions concerning their futures.
For one person, this might mean they decide against the cultural norm of marrying young and dropping out of school to start a family and instead choose to continue their education.
For one family, they might decide that 3 children is the perfect number based on their economic situation and resources, and now that they have information about different family planning methods, choose to adopt a method.
In 2014, access meant Guatemalan women avoided 6,387 unintended pregnancies and 1,387 unsafe abortions.
Access saved $155,419. Money that is now available for education, jobs, housing, nutrition, and improving overall well-being for Guatemalans.
For Marta, a 19 year old student:
I have been given the opportunity to keep studying. I already trained in baking and am now finishing my third year of secondary school. I am motivated by what I’ve learned and in the future I want to be a professional and only have two children. I don’t want to repeat my family’s history of struggling to provide for nine children.
For Marco, a 35 year old father of four and teacher:
When I see a family that decides to plan their births, I see a better quality of life. Their children have the opportunity to continuing studying, they are healthier, have more space in the home, and are more likely to pursue careers. At the community level, there is less poverty, fewer maternal deaths, and fewer malnourished children. When I got married, my wife and I didn’t know about family planning and that’s why we have four children. Recently, we started planning with the Depo-Provera injection. My wife’s well-being is important to me and I am grateful for the information we received.
For Elvira, a 26 year old teacher:
During the first WINGS workshop I participated in, I began to see my life and the world in a new light. At the time my partner was pressuring me to engage in sexual relations. I could have many children right now if I hadn’t known about family planning and the reproductive risks women face by having many children at a young age. I have a vision for my life. I want to continue studying and be a successful teacher. WINGS opened so many doors for me.
For Jose, a 38 year old father of two:
This was a great learning opportunity for us men, and for our families on family planning. If we all put family planning into practice and correctly use a method that’s right for us, we will have a better future and a better quality of life. Most importantly, family planning helps us avoid the unfortunate reality of not being able to provide for so many children. I understand now that family planning involves men as well as women.
For Linda Azucena and Linda Sucely, 16 year old twins and the youngest of 10 children:
This is really important for our lives, for reaching our goals and obtaining the quality of life we want for our future families. In our family, all our siblings are professionals and we don´t want to fall behind. It has been more than difficult for our parents to meet the basic needs of their children. We see the same pattern repeated in hardships our older siblings currently face. But we can say that our lives with be different, our lives will be better.