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.
During September WINGS held our biannual family planning and cervical cancer prevention clinics in El Tejar, Chimaltenango and Antigua. Each clinic lasted two days and offered both long term family planning methods, specifically the Jadelle sub dermal implant and the copper IUD, and screenings for cervical cancer at extremely subsidized costs.
Generally, WINGS offers such clinics in Alta Verapaz where the population is mainly rural indigenous, as the more urban departments in Guatemala typically have more options available when it comes to reproductive health. However, as seen by the large turnout of women that attend our clinics in Chimaltenango and Antigua, there is still great need for WINGS services in semi-urban areas.
At our Antigua clinic, we received a group of 50 women from Escuintla, who first walked over an hour to reach the nearest bus stop, many with a baby strapped to their back or a toddler in tow, and then traveled an additional 2 hours by bus to attend. Another group of 25 women came from a local nonprofit, Camino Seguro, in Guatemala City, and were so pleased with WINGS care that future collaboration is being discussed.
To begin each clinic, WINGS nurses give a short talk about the methods being offered and the importance of getting screened for cervical cancer. Women are given the opportunity to voice any concerns or questions they may have about any of the services before deciding which they would like to use. It is very common that a woman comes to the clinic looking only to use a family planning method, and decides to do the cervical cancer exam as well, or vice versa.
In total, WINGS attended to 233 women throughout the 4 clinic days.
We performed 173 rapid cancer screenings, and implanted 76 Jadelles and 10 copper IUDs.
Thankfully treatment for precancerous lesions was only necessary in 2 cases.
We are encouraged that 20% of women in attendance were under 25 years of age, demonstrating interest from younger women in taking action concerning their reproductive health.
*For more photographs from our recent clinics, visit WINGS´ Facebook page.