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Prevent and Detect Cervical Cancer in Guatemala

by WINGS
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Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Prevent and Detect Cervical Cancer in Guatemala
Field Supervisor Celeste explaining WINGS services
Field Supervisor Celeste explaining WINGS services

At the end of November, WINGS held a jornada or clinic day in the community of Santo Domingo Xenacoj in the department of Chimaltenango, about an hour away from our Antigua headquarters. In most jornadas where we provide Long-Acting Reversible Contraception (LARCs), we also offer cervical cancer screening using visual inspection with acetic acid for immediate detection of cervical cell abnormalities and same-day treatment using cryotherapy for pre-cancerous cells that may lead to cervical cancer. For these jornadas, we travel hours each day to get to hard-to-reach rural villages with an entire mobile unit team, consisting of a driver, two nurses, and equipment to serve up to 150 women per week.

In small communities, where our staff anticipates fewer patients, we usually schedule what we call a mini-jornada – a clinic with two WINGS nurses who pack all the necessary equipment in backpacks and travel to the (easier-to-reach) village, usually by bus, expecting to serve no more than 10 women, and without the extra weight of the cryotherapy equipment. In Santo Domingo Xenacoj though, our two nurses Carolina and Nely met with 23 women!

In addition to the subdermal implants and IUDs that were provided that day, we screened 10 women for cervical cancer, 3 of whom we needed to refer for cryotherapy in our clinic a few days later. Nurse Carolina remarked how much it meant to her to be able to provide this life-saving procedure to the three women, none of whom had ever had a cervical cancer screening before.

It is with your support that WINGS continues to be able to offer cervical cancer screening to women who might otherwise have limited or no access to such an important test. We are so very grateful to you!

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Field Supervisor Luis giving educational talk
Field Supervisor Luis giving educational talk

In May of this year, we visited El Mora, a community of the department of Escuintla in Guatemala where we had first made contact in March of this year and where a previous educational talk was given for future clinic days. This is an area where the women leaders of the Catholic Church play a significant role in community leadership. In that first contact, they let it be known quite clearly that they were only interested in WINGS providing rapid screenings for cervical cancer and expressed their distinct rejection for contraceptive methods. 

During the May visit, despite the common logistical challenges involved in nearly every clinical set-up, WINGS successfully held a cervical cancer clinic in the Catholic church in El Mora. The leader in charge of the church, besides showing her interest for the conservation of privacy, the importance of the follow-up and the attention of the nurses, showed a surprisingly supportive attitude for our work. WINGS, in our approach to underserved communities, has managed to create a relationship of trust with community leaders who are our greatest allies so that we can take our services to the individuals who need us most. 

Having a clinic in a Catholic church, with the support of community leaders, is a HUGE step for WINGS. After the success of the cervical cancer-screening clinic, WINGS staff was delighted to get the call to schedule a future contraceptive method clinic. We are so excited to see where this relationship might lead in El Mora and beyond.

We have learned over time that creating this relationship of trust requires continuous, unflagging efforts; especially in those communities where culturally there is more rejection for the contraceptive methods that we provide. 

Your support means that we have the resources and highly trained staff necessary to do this life-saving work. We appreciate your commitment to help us make a difference for so many women and their families.

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Regional Field Supervisor Josefina gives a talk
Regional Field Supervisor Josefina gives a talk

WINGS has provided 1,455 cervical cancer screenings from the beginning of this year through May. Our goal for 2019 is to provide a total of 2,000 screenings using visual inspection with acetic acid (VIA) for immediate detection of cervical cell abnormalities and same-day treatment using cryotherapy for pre-cancerous cells that may lead to cervical cancer. We’re already at 73% of our annual goal just 5 months in!

We’ve had success this year with a new strategy we are implementing. Instead of promoting our VIA service as part of every contraceptive clinic we host, we are now also offering large-scale VIA-only clinics on a regular basis. We’re seeing that women in some communities need cervical cancer screenings more often than contraceptives so by promoting days where we are only offering VIA screenings we can reach those women who need screenings but have their contraceptive needs met. Our nurses also see that many women who are not yet interested in a contraceptive method are interested in VIA and the screening gives us a way to gain their trust and begin a broader reproductive health conversation.

Time and again we hear of cases like a recent one from the nearby community of El Hato. A woman had been seen by another clinic and was told she needed a referral but didn´t understand and never received a follow-up call from her provider. A family member of hers reached out to WINGS via Facebook and we invited her to come in to our Antigua clinic to get screened again. She came in and we screened her and she did require a referral for further care. Because our staff is trained in rights-based, patient-centered care,we know that we need to spend extra time and provide adequate follow-up to patients, especially when their lives are at risk.

Your support means that we have the resources and highly-trained staff necessary to do this life-saving work. We appreciate your commitment to help us make a difference for so many women and their families. 

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WINGS' 2018 CERVICAL CANCER SCREENING RESULTS
WINGS' 2018 CERVICAL CANCER SCREENING RESULTS

WINGS has provided 60,239 cervical cancer screenings since 2001. In 2018, we saw a 28% decrease in our cervical cancer screening service from 2017. This result was by design since we aimed for a decrease in the provision of both cervical cancer screenings and short-acting methods in response to both community needs and available funding. In the past, WINGS staff emphasized cervical cancer screenings in promotional talks and patient education. We saw large numbers of patients seeking us out exclusively for this screening to the point that it impeded our ability to attend those patients who needed contraceptives. Starting in 2017, we asked our staff to become more passive in their promotion of screening. Staff began educating patients who came for contraceptive methods about the benefits of cervical cancer screenings, but we did not publicly advertise this service. This shift in promotion of services combined with no longer organizing massive cervical cancer screening clinics with agricultural employers resulted in a decline in screenings provided.

Nearly a quarter of WINGS patients had their first cervical cancer screening with us last year and almost half saw us for a contraceptive method as well. WINGS offers cervical cancer screenings in all our clinics, either within our stationary clinic or our mobile unit clinics. We use visual inspection with acetic acid (VIA) for immediate detection of cervical cell abnormalities and same-day treatment using cryotherapy for pre-cancerous cells that may lead to cervical cancer.

A trend that our nurses have begun to see is that the health posts and other health facilities managed by the Guatemalan Ministry of Health are increasingly more likely to have both trained staff and sufficient inventory to meet the needs of communities. WINGS always tries to fill in any gaps left and work closely with local health officials to plan coverage of rural areas.

In 2019, we aim to provide 2,000 VIA screenings, knowing that many communities are being covered by governmental resources. WINGS will be available and prepared to fill in gaps as our field staff notices any unmet needs. This work would simply not be possible without your help. You are truly helping us to save lives. ¡Gracias!

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Nurse Alexia talks to patients in Alotenango
Nurse Alexia talks to patients in Alotenango

Here at WINGS, we hear incredible stories of how our services affect the lives of individual women and even their extended families. One of our favorite situations is when women come to us because a sister or aunt has referred them because they trust us to provide the highest quality of reproductive health care.

A few weeks ago, Fátima visited WINGS’ clinic at the hospital in Cobán (department of Alta Verapaz in northern Guatemala), where we offer reproductive health services every Wednesday. She made a 5-hour trip from El Estor (department of Izabal in eastern Guatemala) to get a cervical cancer screening.

Fátima told our nurse Carmencita that her aunt had been screened with WINGS and that the results showed cervical intraepithelial neoplasia (CIN) at stage III, the latest stage before developing into cancer. WINGS helped her get the necessary information to have surgery in Guatemala City.

Despite having access to health facilities nearby, Fátima preferred to visit WINGS because her aunt had a pap test at the local health center and the results were negative. However, it turned out to be an advanced precancerous condition when she got her results with WINGS. Unfortunately, a pap smear is more likely to show false negative results, which may have been the case of Fátima’s aunt.

After the aunt was cured, one of Fátima’s cousins decided to attend to a WINGS clinic and we discovered pre-cancerous cells. WINGS provided cryotherapy that same day and she is now fully recovered too.

These experiences encouraged Fátima to get screened. She was so satisfied with WINGS’ services, she brought her mother the following week. Both of them had a negative result. Fátima told WINGS how thankful she was for our work, as we had saved the lives of two of her relatives. She also mentioned that getting screened had given Fátima and her mother peace of mind regarding their sexual health.

Thank you for supporting our cervical cancer program. Early detection can save lives like Fátima’s family’s.

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Organization Information

WINGS

Location: Antigua, Sacatepequez - Guatemala
Website:
Facebook: Facebook Page
Twitter: @WINGSGUATEMALA
Project Leader:
Kirsten Taylor
Development Director
Antigua, Sacatapequez Guatemala

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