Health
 Guatemala
Project #2501

Prevent and Detect Cervical Cancer in Guatemala

by WINGS
Vetted
Nurse Rosy during a talk about contraceptives
Nurse Rosy during a talk about contraceptives

In Guatemala, cervical cancer is the number one cause of cancer-related deaths among Guatemalan women. While the disease is preventable and highly treatable if detected early, in countries like Guatemala where healthcare is largely inaccessible, it’s a grim story. Inadequate health centers, lack of knowledge, and geographic barriers make it difficult for women to get screened for cervical cancer in Guatemala.

Ten years ago, WINGS developed its Cervical Cancer Prevention Program to overcome these challenges by providing visual inspection with acetic acid and immediate cryotherapy treatment for pre-cancerous cells. We continue to offer these life-saving services in stationary clinics in Sololá, Cobán and Antigua, and through our mobile clinics, which travel to the most remote areas of the country to reach underserved women. We have provided lifesaving services to improve the lives of thousands of women in Guatemala, even within our own team! 

41 year old WINGS’ Nurse Rosy was born in a rural community in San Cristobal, located in northern Guatemala. Rosy travels every month with our mobile team to provide family planning information and contraceptives to the most remote areas of the country. Like many of the girls and women we serve, Rosy has faced many challenges in her life. When she was only 15 years old, her family forced her to marry a man who turned out to be abusive. Sadly, in Guatemala it is very common for young girls to be married off without their consent. Rosy suffered through her marriage because, similar to many women in her situation, she didn’t have a say in any decisions. Although Rosy was finally able to separate from her husband, the difficulties persisted. As a single mother, Rosy had to figure out how to make ends meet so she could feed her four children and send them to school. Luckily, her former father-in-law was very supportive and encouraged her to go back to school.

Rosy and her family had never received any information about reproductive health and prior to resuming her studies, she knew very little about her own health in general. As a child, she lost her mom and aunt to cervical cancer. Neither had ever been screened and Rosy was terrified that the she would face the same health burden. However, as an assistant nurse providing these important services throughout Northern Guatemala, Rosy decided to undergo a screening with our team. Unfortunately, our staff discovered abnormal cell growth which could lead to cancer, but our team treated Rosy immediately.

As Rosy shared with our team that day, “I am truly grateful to WINGS for supporting me and allowing me to keep being a mother to my children. I now have my nursing diploma and I am so proud to be able to help people who need it. I am thankful for the opportunity to work with WINGS; I love every part of my job. I give educational talks to different communities in my native Mayan language; I provide different birth control methods; and I screen women to help prevent cervical cancer. This work is so important and I hope that I can keep doing it forever.”

Like Rosy’s aunt and mother, there are thousands of women in Guatemala who do not know about the causes of cervical cancer and how to prevent it. WINGS has worked endlessly to change this and provide information and reproductive health services to Guatemalan women in need. In 2015, we surpassed our cervical cancer screening projection by 141%, ensuring that 3,062 women were able to undergo preventive screenings.  And in the first three months of 2016 alone, we have already provided 496 cervical cancer screenings.

It is because of supporters like yourself that we are able to provide these imperative services, saving thousands of women from cervical cancer in Guatemala. Thank you for believing in the work WINGS does!

Rosy giving a talk about cervical cancer
Rosy giving a talk about cervical cancer
Rosy explaining cervical cancer at a mobile clinic
Rosy explaining cervical cancer at a mobile clinic
Educational talk before cervical cancer screening
Educational talk before cervical cancer screening

If caught early, cervical cancer is highly treatable. However, it is the number one cause of cancer-related death among Guatemalan women.

There are many reasons why fighting cervical cancer is so difficult in Guatemala. For one, there is an obvious lack of access to health centers, especially in rural areas, where people are predominantly poorer than in the rest of Guatemala. In fact, more than half of Guatemala’s population lives in rural areas, and the rural poor account for more than 70% of the country’s poor population. Additionally, transportation to a place where women could potentially get a cervical cancer screening is also very unlikely. Not only do rural areas lack proper roads, but there are many villages where public transportation simply does not exist.

Education is also lacking; especially in rural areas. Indigenous girls attend school, on average, for only three years of their lives. Even for those who do attend school; it is most likely that they will not receive education about reproductive health in general, let alone information about cervical cancer. With Guatemala being such a conservative country, reproductive health education and family planning have never been a priority. This results in many women not knowing about the risk factors for cervical cancer, or the importance of getting screened. To make matters worse, those who do need treatment for cervical cancer can rarely afford it. The poorest people in Guatemala live on approximately $2 per day, which simply does not permit paying for treatment, when there is a family to feed and other basic needs to meet.

Take Gabina Sajbin. She is 25 years old and she has three children. She’s from Ximaxox, a very remote village in Quiché. Gabina wanted to get a contraceptive method and a cervical cancer screening, but she thought she did not have enough money to afford both, so she chose to get a contraceptive method first. Gabina had been in constant pain and discomfort for the past few years. She got a pap smear two years ago, but never received the results. Her mother, the local midwife in their town wanted to help Gabina, but there was no medical facility within reach. Thankfully, WINGS held a mobile clinic in Gabina’s town, and once we found out about her financial concerns, we covered the costs of her services.

Gabina’s cervical cancer screening came out positive, but WINGS’ mobile clinics are prepared to provide immediate treatment of pre-cancerous cells using cryotherapy, so Gabina received treatment on the spot. We noticed that it was challenging for Gabina to understand certain words because Spanish is not her first language, but thankfully one of our staff members speaks Gabina’s native tongue, Quiche. This gave Gabina the opportunity to fully understand the importance of screening, the disease progression, and the treatment. To this day, we are still in contact with Gabina, making sure that she gets the attention and treatment she needs.

There are so many women in need of screening and treatment in Guatemala, but lack of resources and other challenging life circumstances create significant barriers to access. WINGS breaks down these barriers in many ways. We provide talks and training that explain the risk factors of cervical cancer, the disease progression, treatment, and the importance of screening. We also reduce our patients’ financial burden by providing low-cost, high quality services made possible through generous donations to WINGS. Last but not least, our mobile clinics are key; if a patient cannot come to us, we will go to them. Through our mobile clinics, we are able to reach people in the most remote, rural areas of the country, in the hope that more Guatemalans can get the medical attention and services they need. In 2015, WINGS surpassed its cervical cancer screening projection by 141%, screening 3,062 women. And just in the first three months of 2016, we have already done 496 cervical cancer screenings.

 Thank you for standing with WINGS and bringing vital cervical cancer education and screening to vulnerable women in Guatemala.

WINGS doing outreach in rural Guatemala
WINGS doing outreach in rural Guatemala
WINGS nurse and a patient during our mobile clinic
WINGS nurse and a patient during our mobile clinic
Raising awareness for women
Raising awareness for women's group

2016 marks the 10 year anniversay of WINGS' development and implementation of a cervical cancer program using the screen and treat visual inspection with acetic acid and cryotherapy method (VIA-cryo). Prior to 2006, WINGS provided nearly 5,000 referrals a year to a national partner organization for pap smears. As high as the need was and remains for these services, what we realized early on is that in a low-resource setting like Guatemala, the traditional pap smear was not the best or most practical option for women from rural, indigenous, and low-income villages. Why not? Because first and foremost, there were and still are so few adequate facilities and competently trained lab technicians to read pap results. Second, unlike in the United States, there is quite a bit of lag time in preparing the results to share with each woman. And finally, because the results are ready up to a month after the initial pap, it was often difficult to communicate with each woman in question to provide her with a positive or negative result: many did not have cell phones, clear addresses, or even live near the facility in which they underwent the pap smear. 

VIA-cryo is a wonderful alternative because it can be performed outside of a clinical facility, including in many of the remote jungle and mountain settings we work in, and provides immediate results. Same-day treatment is provided for pre-cancerous lesions while more advanced cases, including women suspected to have cancer, are referred to a partner gynecologist for further examination (biopsies, colposcopies) and treatment. Moreover, international guidelines recommend that women who have a normal result do not need to return for an examination for 3 years. 

We provide VIA-cryo through two service components: daily mobile clinics in communities and stationary clinics in peri-urban areas. The ease and availability of this service means nearly 4,000 women visit our clinics on an annual basis for cervical cancer screenings. As pleased as we are to see women arriving daily at our clinics for screening, we know one major issue remains in our path to making preventative cervical cancer screenings a norm in Guatemala: a fatalistic view of cancer, and cervical cancer specifically, among many Guatemalan women. Fatalism tends to be more damaging after a woman has undergone screening and does in fact have a positive result or suspected case of cancer. In many communities, people believe that they do not have control over their future - that cancer is part of their destiny. Take 28 year old Carmena who we met in our mobile clinic in Zacualpa, Quiché. The mother of one had been struggling to conceive as she and her partner are ready for their second child, so she thought it best to undergo a screening and see if our team could detect anything. Unfortunately, we did.  

The young mother has what our team refers to as a "suspected case of cancer" and was given emotional counselling by our team and immediately referred to a more advanced medical facility in her area so that the appropriate course of treatment could be determined. Carmena has been hesistant to actually visit the medical facility because she thinks it's her fate. This is an indication for our team that so much more needs to be done in addition to making services accessible: Guatemalan women need to know and understand that they can have a say in their health, their lives, and their futures, and in this case, following through with a screening or treatment is the first hurdle. 

Both our medical team and our Reproductive Health Educators are working with Carmena to help her move beyond the idea that cancer is her fate so that she can go forward with a treatment plan and be there with her daughter. Learning from Carmena and other similar cases, our team is all the more dedicated to ensuring that women in Guatemala understand they have a right to health which does not stop at a positive diagnosis. 

Thank you for standing with WINGS and bringing vital cervical cancer education and screening to vulnerable women in Guatemala. 

Healthy mothers, healthy children
Healthy mothers, healthy children
Educational talk about cervical cancer
Educational talk about cervical cancer

WINGS permanent clinic is in full swing here in Antigua! This past month we held back to back clinics offering cervical cancer screening and treatment of precancerous lesions to women from both nearby and remote communities. Despite the rain, over 60 women attended the clinics, many bringing their 1 or 2 children along!

Cervical cancer when detected early is treatable. There is absolutely no reason why any woman  should die of cervical cancer today. However, because basic information about cervical cancer is non-existent in so many rural villages and services are equally limited in developing countries, cervical cancer remains a preventable tragedy. In Guatemala, cervical cancer is the leading cause of cancer-related death among women. And regionally, a woman in Latin America is 3x more likely to die from cervical cancer than her North American counterpart (PATH, 2014). This dark reality is what we are trying to change through outreach, mobile services, and now, an easy to reach stationary clinic.

Maria, 45 years old, and a mother of eight, came to WINGS looking for answers. During an informational talk about cervical cancer, the screening procedure, visual inspection with acetic acid (VIA),  and cryotherapy treatment for precancerous lesions, Maria raised her hand to ask what the risk factors for cervical cancer are. She also wanted to know if heavy, continued bleeding is normal or indicates something is wrong. Based on Maria´s concerns, we knew she needed an immediate examination.

During the consultation prior to screening, Maria explain that 9 years ago she was diagnosed with a vaginal infection, but at the time could not afford the prescribed treatment. Since then, she never returned to see a doctor or receive treatment. WINGS examined Maria, referred her to a partner clinic to undergo a colposcopy, and when it resulted that she would require surgery, we accompanied her through the pre and post surgery process.

As is often the case, women in Guatemala seek medical care only when something is clearly wrong, as in Maria´s case. Preventative care, such as routine cervical cancer screenings, are deemed unnecessary, in part due to the costs and difficulties in accessing these services. Thankfully for Maria, treatment was still an option and with our team, affordable. We know Maria is lucky and unfortunately this is not the case for far too many women in Guatemala. Thus, we will continue to urge women to take a proactive role in their health and make it easier for them to do so.  

Our dedicated team is out visiting different communities every week, talking with women about the real risk of cervical cancer and the importance of regular screenings, and following up with them so they feel comfortable attending our clinics. Thankfully, cervical cancer awareness is growing, as evidenced by high attendance at our clinics this year. Between January and June, WINGS staff performed 1,131 screenings, reaching 52% of our annual projection. And we couldn’t have done this without you.

Thank you for your support and for making reproductive rights a reality in Guatemala.

Links:

Nurse Claudia with patients, San Pablo
Nurse Claudia with patients, San Pablo

Scaling up our service provision throughout Guatemala this year has already made an important impact on our team’s ability to prevent tragic cases of cervical cancer in the lives of women, mothers, sisters, and friends. In June alone, our two mobile units hosted 8 clinics in the Northern and South-western regions of the country, offering preventative services to over 100 women. For 39 year old Olivia from Chivencorral, a farming village in Alta Verapaz, the availability of these services could not have been timelier. Olivia was one of many women survivors of domestic violence in Alta Verapaz who sought integral support from our local partner Ak Yu’Am and attended our cervical cancer clinic at the center. The single mother of three had left an abusive relationship to ensure the safety of her 11, 16, and 19 year old children and herself at Ak Yu’Am’s center.

Using visual inspection with acetic acid (VIA), a technique ideal for low resource settings in that results are instant, to perform the screening, WINGS Nurse Rosa detected precancerous cells. Olivia was terrified, telling Nurse Rosa, “I’m going to die…what will happen to my children?”

Olivia was confused as she visits her local health center each year to undergo a pap smear and never received any negative results in the past. Unfortunately in low resource settings like Guatemala where laboratory facilities are often underequipped, we find that pap smears do not necessarily detect cell abnormalities as effectively as VIA. Nurse Rosa quickly calmed Olivia, explaining that the cells had not yet led to cancer and we would provide cryotherapy immediately to treat the abnormal cells and thus prevent cervical cancer from developing.

Although relieved to know that treatment was available, Olivia was worried about paying for treatment. As a domestic worker, she earns $65 per month which just provides for her family. WINGS was more than happy to forgive the cost of screening and treatment so that Olivia could lead a healthy future and be there for her children.

On the other side of Guatemala, 47 Maria-Filomena returned to WINGS’ mobile clinic in San Pablo La Laguna to undergo VIA. She visited WINGS three years ago for screening and as her results were normal, Maria-Filomena was able to wait three years until her next VIA. However, at our June clinic hosted in collaboration with the Organization for the Development of the Indigenous Maya (ODIM) at one of their two wonderful fixed clinics on Lake Atitlan, Nurse Flori, who conducted the screening three years ago, detected abnormal cells on her cervix and provided Maria-Filomena with immediate cryotherapy treatment. Both Maria-Filomena and Olivia have said that they are recovering (emotionally) from their brief scares and were fortunate to have undergone timely cervical cancer screenings.

Not only do we emphasize the importance of timely detection and prevention, but we also believe in the importance of collaborating with other local NGOs to bring reproductive health services to the most vulnerable individuals. By working together, organizations can share the load, rather than try to take on every issue that arises. Our relationships with Ak Yu’Am and ODIM allow women we meet to receive high quality care for a range of sexual and reproductive health issues, including gender-based violence. We are grateful to these local organizations for their support and look forward to strengthening our collaboration in the future to make sure that women like Olivia and Maria-Filomena get the treatment they need to prevent cervical cancer.

Stay tune for more updates from our cervical cancer program – this month we’re off to Totonicapán in the Western Highlands to offer clinics to women’s weaving cooperatives and local development organizations.

Thank you for your continued interest and support, and for making WINGS' work to spread awareness of and prevent cervical cancer possible.

Educator Evelyn talking about cervical cancer
Educator Evelyn talking about cervical cancer
Waiting for mama outside the clinic
Waiting for mama outside the clinic
Olivia post treatment and cancer free!
Olivia post treatment and cancer free!
 

About Project Reports

Project Reports on GlobalGiving are posted directly to globalgiving.org by Project Leaders as they are completed, generally every 3-4 months. To protect the integrity of these documents, GlobalGiving does not alter them; therefore you may find some language or formatting issues.

If you donate to this project or have donated to this project, you will get an e-mail when this project posts a report. You can also subscribe for reports via e-mail without donating.

Get Reports via Email

We'll only email you new reports and updates about this project.

Organization Information

WINGS

Location: Antigua, N/A - Guatemala
Website: http:/​/​www.wingsguate.org
Project Leader:
Sally Parmelee
Development Coordinator
Antigua, Sacatapequez Guatemala

Learn more about GlobalGiving

Teenage Science Students
Vetting +
Due Diligence

Snorkeler
Our
Impact

Woman Holding a Gift Card
Give
Gift Cards

Young Girl with a Bicycle
GlobalGiving
Guarantee

Sign up for the GlobalGiving Newsletter
WARNING: Javascript is currently disabled or is not available in your browser. GlobalGiving makes extensive use of Javascript and will not function properly with Javascript disabled. Please enable Javascript and refresh this page.