To bring our series Fifteen Stories for the 15th Anniversary to an end, we look at some of the challenges, successes and the impact of WINGS’ work over the past 15 years, as well as what the future holds for both WINGS and the Guatemalan people.
“With considerable help from dedicated and skilled leadership and staff, WINGS has exceeded my wildest dreams. We now have a presence throughout nearly half of Guatemala, particularly in the areas surrounding Coban, Antigua, the south coast and increasingly the western highlands. We’ve had to overcome many challenges – machismo, myths, religious beliefs, fundraising (we receive no funding from either the U.S. or Guatemalan government), among others. But with help from faithful donors and local advocates, we continue to grow.”
– Sue Patterson, WINGS’ Founder
Since its founding in 2001, WINGS has grown to be a nationally recognized and respected leader in reproductive health. We are the only organization in Guatemala dedicating the entirety of our time and resources to providing quality, low-cost reproductive health information and services to rural, mostly indigenous communities. The road has been full of challenges, due to the nature of our work, and that many communities see family planning and reproductive health as taboo. However, we have made huge progress and established meaningful partnerships throughout these past fifteen years.
Click here to learn more about the highlights of our work in the last 15 years.
Fifteen years ago, most women would have answered when asked how many children they planned to have, “As many children as God sends me.” Today, more women are aware of the risks of having too many children, especially if they cannot support them financially; also, more women are aware of the reliable birth control options available to them and their right to choose if and how many children to have. Now, it’s more common to hear two or three when asking how many children a woman plans on having. Over the past 15 years, WINGS has educated and counselled more than 200,000 women, men and youth on family planning, as well as prevented over 225,000 unintended pregnancies. The national fertility rate has declined over the years, at 5 children per women two decades ago and now down to 3.1 children per women. However, that still leaves Guatemala with the highest fertility rate in the region. WINGS takes a variety of approaches in our fight to increase information about and access to reproductive health services in Guatemala. We’ve grown throughout the years to cover 13 of the 22 provinces in Guatemala with a network of volunteer family planning promoters, two mobile medical units, 3 stationary clinics, and a network of Youth Leaders.
In Guatemala, it’s very common to see household decisions made by the men in the family. WINGS broke ground in the reproductive health community in Guatemala with our WINGS for Men Program. Launched in 2007, the program aimed to improve access and information to sexual and reproductive health services for men, with the aim that they participate actively and positively in their own sexual and reproductive health and that of their partner. Funded by USAID and ESD (Extending Service Delivery), the program reached men at the community level through small groups where they would talk about reproductive health issues facing both men and women and how to access methods, among other topics. Unfortunately, the WINGS for Men program ended when funding was no longer available, but WINGS has continued to incorporate men and boys in our programs wherever possible.
Our Youth Leader Program trains many young boys, as well as girls, in sexual and reproductive health education. Through a series of workshops, youth learn about gender equality, self-esteem, the importance of setting goals for their future, healthy relationships, and of course the different contraceptive methods available. Our educational activities and services not only consider boys and men to be allies who support the choices of girls and women, but also recognize their specific sexual and reproductive health needs and link them with the information and services they require to make well informed decisions. Through our Youth Leaders, we seek to create a new generation of informed women and men who are shifting gender norms and identities at the community level to achieve greater gender equality.
We also offer affordable vasectomies for men, which is a way for men to take control of their own reproductive lives and become more involved in family planning. Recently we have seen a shift in that men are becoming more positively involved, supporting their partners in their decisions, and also in women feeling more empowered to make their own decisions regarding their life and reproductive health. In the next fifteen years, we will continue to welcome and engage men and boys in our work.
In 2001, WINGS screened 200 women for cervical cancer, a huge accomplishment for the first year. In 2006 we began using a rapid test, visual inspection with acetic acid, and treatment process highly recommended for developing, low resource countries as the testing, results, and treatment were all done in one visit. Since that first year, WINGS has screened over 50,000 women. Still cervical cancer remains the number one cause of cancer-related death in Guatemala. WINGS has conducted thousands of cervical cancer detections and cryotherapy treatments and has helped thousands of women improve their quality of life because we have caught the disease on time. However, the need for this service in Guatemala remains huge – it is estimated that still roughly 60% of Guatemalan women have never had a cervical cancer screening and too many do not realize they are at risk. It is imperative that we continue to educate Guatemalan women about cervical cancer and provide these services so that they can live healthy, long lives without having to worry about a disease that is 100% treatable if caught on time.
As we are approaching the end of 2016 and WINGS’ 15th Anniversary year comes to a close, we are excited and optimistic about what the next 15 years will bring for WINGS and for Guatemala. And we’re most grateful to have you, our supporters, by our side as we move forward. It is thanks to you that we were able to accomplish so much over the last 15 years, and we ask you to stay with us and continue supporting WINGS now that we need your help more than ever. We are thankful for all your support and ask if you haven’t already, please consider making your year-end tax-deductible donation to WINGS before the year ends – you are the driving force of WINGS’ work in 2017 and the years to come, helping thousands of Guatemalans change their lives through access to quality reproductive health education and services.
Why invest in WINGS?
“Every cent that we invest in WINGS and every effort that we give results in better services for our population, more specifically for our women and younger girls. That’s why I invest in WINGS. I think WINGS has a huge advantage over other NGOs and it’s the fact that we provide services at the community level. More people should invest in this type of project.”
– Rodrigo Barillas, WINGS’ Executive Director
Olivia, 35, had never used a family planning method. “My husband didn’t really approve, and people around here say that bad things happen to women who use family planning methods. They say if a woman does not menstruate normally, blood will fill her stomach or go to the lungs and cause cancer. I was afraid, so I never took birth control pills or got injections.”
As a result of the misconceptions and cultural barriers when it comes to accessing family planning services, Olivia has 9 children. “They are all still alive, but some of them are still very small.”
Recently, however, one of Olivia’s neighbors explained the benefits of spacing out pregnancies to her and her husband. This made them both more interested in attending an informational talk on family planning when WINGS’ mobile clinic came to town.
“I’ve learned from WINGS that, with each birth, my health is put at risk. I don’t want to die and leave my children without a mother. And I know I have had too many children already.” Keeping this in mind, Olivia opted to get a Jadelle sub-dermal implant, which will protect her from unintended pregnancies for five years the day of WINGS’ mobile medical clinic.
Olivia is excited that she will be better able to give her children what they need, without worrying about having to provide for another. Her top priority is education, but “sending them to school is expensive. If we can’t afford notebooks, they won’t learn how to write because the teachers do not have extra supplies. We will try to divide our money to help our children the best we can.”
Olivia was fortunate to be able to attend WINGS’ mobile clinic, learn correct information about spacing pregnancies and choose the birth control method she preferred. However, the unmet need for contraception in rural, indigenous communities in Guatemala remains huge, resulting in the country’s fertility rate being the highest in all of Latin America and the Caribbean. WINGS’ mobile units go out to those communities to make a difference and YOU can help! Your donations allow us to reach year after year more underserved, remote communities and to begin to change the shocking statistics. We need you now more than ever – by supporting our year-end campaign with a tax-deductible donation before December 31st, you will help WINGS’ mobile units reach more than 7,000 women, men and youth in 2017. Please do not wait, act now to make your year-end donation count!
How long have you been working for WINGS, and how did you start working here?
I have been at WINGS for six years. A friend who was a driver in this organization referred me to the job. I started off doing one shift a week, then the shifts increased. Time passed and at the end of the year I was going out twice a week. Later on, WINGS gave me a job offer and that’s when it all started.
On a regular day with the mobile clinic, what does your day look like?
Well, they aren’t normal days. It all depends on the time the mobile unit is scheduled to leave in the morning. For example, if we are supposed to leave at 5am, I am already leaving my house at 4am. I make sure everything is okay with the unit before we leave. A trip can be from half an hour to 4 hours long, and this happens before we even have breakfast. Once we get to the mobile clinic location, around 8am, our work day starts. We already know our lunch break is never at an exact time; if we are lucky, we eat at 1pm. If not, maybe at 4pm. On a good day, we’re back at 8 or 9pm, and I get to my house at 10pm. That’s what a work day looks like for me.
What does this job mean to you?
To be a driver at WINGS, it’s not just about showing up and driving. Here, you need extra knowledge and you have to use all your creativity, show support and integrity, and give as much as you can toward the organization. I’ve had so many new experiences here! We support the organization in things that drivers usually don’t. I never thought I’d be in an operating room at a hospital, helping patients through the surgery. If the drivers don’t help, our mobile clinics fall behind. I feel a great deal of satisfaction because I’ve learned a lot and I always want to learn more. It makes me happy to know we’re helping so many women.
In all your years working with WINGS, is there a mobile clinic experience that you can’t forget about?
During my sixth year at WINGS, we went to Agua Dulce in Huehuetenango, a community which shares a border with Mexico. It was a long, long trip. I couldn’t stop thinking about how I’d been working at WINGS for six years and now I’d finally covered the whole country; from Livingston to Huehuetenango. It took me six years to travel through all of Guatemala, from one end to the other. I won’t ever forget the experience because we really reached a community nobody could have ever imagined was there.
Have you had the chance to share information related to WINGS work with your family?
Yes. I learned about reproductive health during my school years, so I came into WINGS with some ideas. I just hadn’t seen reproductive health up close in our country’s reality. However, back when I was single, I made a choice to not have many children and that if I were to someday get married, it wouldn’t be because my partner was pregnant; I wanted to plan out everything.
I have had the chance to talk about reproductive health with my family, especially with my eldest daughter. But it’s weird for her if her dad talks about it; she is more open when somebody else talks to her.
Surprisingly, the one who understands the importance of family planning the best is my 12 year old daughter. She always says she wants to get a tubal ligation when she’s older because financial circumstances in Guatemala these days make having a family difficult. I tell her that it’s a big decision to make at 12, but find it interesting that she already thinks about those things.
As a driver, have you seen a great deal of need for mobile clinic services?
Yes, there’s definitely a great need for the mobile clinics. I’ve noticed that sometimes, patients don’t know who is providing the service and they think the government is responsible for it. Government services are available, but language is a barrier, and also the information isn’t always delivered accurately. We need to keep on giving people more information about WINGS and the work we do. The need is there. The challenge is getting our information out there.
In your opinion, how do Guatemalan men view family planning?
Well, even in Antigua, a very progressive city, my male friends don’t understand family planning. It’s like I’m speaking a different language. Nobody likes getting a vasectomy; I tried suggesting it to my brother and it didn’t work. So imagine what happens if I talk to someone who isn’t my family member.
Men make family planning the woman’s responsibility. But then, they also complain if she uses a contraceptive method without him knowing. This is why we need to educate young men starting when they are in school. If not, they blame young girls, teenage girls if they get pregnant, and it shouldn’t be like that. Initiating men into this topic when they are young is important. Trying to change an older person’s mind is difficult. Youth are more open to change.
During your time with WINGS, have you noticed any changes in patients? Are they more interested or more open to the services?
Yes, definitely. In the rural area, I’ve noticed that more people want our services. In the urban area, there are many adolescents who come to our clinics for a contraceptive method, and I think that’s a huge change. Years ago, we’d only see older women getting a method, but that is quickly shifting because younger people are getting more involved. Overall, I think we’re definitely improving and let’s hope it stays that way!
What’s your favorite part of the job?
What motivates me most is when we’re doing a mobile clinic in a new community I haven’t been to. I find myself like a kid with a new toy; I don’t wonder how long it will take to get there, or whether we’re going to eat or not; for me it’s more about the excitement of seeing different communities and people for the first time. I also really like when communities give us a warm welcome; some are very grateful and they even serve us lunch! We don’t forget about those details.
Ana Isabel is a 31-year-old mother of three from the rural community Pueblo Viejo. She spends her days caring for her home and children, while her husband works in the fields. Ana Isabel had her first child, a baby girl, at the age of 20. It was an unplanned pregnancy, as she knew almost nothing about family planning methods at that time.
“Back then, this wasn’t talked about. I don’t know why; but even our parents didn’t talk to us about it. And on the occasions when our parents did talk about these topics, they would ask us to leave the room or they would send us somewhere else where we couldn’t hear anything. We were told that it was adult stuff, so they refused to talk about it.”
After her first pregnancy, Ana Isabel started to hear a bit more about contraceptives from other people in her community. But all the information made her believe contraceptives were dangerous.
“I heard about birth control, but I was afraid to use it because people told me that it caused diseases. I was also told that it would dry up my cervix and that I wouldn’t be able to have kids after, so I got scared.”
Eventually, after her third child Ana Isabel began using the 3-month injection to plan her family and continued using that method until recently, when she decided she wanted to have another child.
A woman in Ana Isabel’s community told her that WINGS’ mobile medical team would be offering a family planning and cervical cancer prevention mobile clinic in their community. Ana Isabel decided to attend and undergo a cervical cancer screening. She shared, “…the reason I wanted to get a cervical cancer screening was that I can’t manage to get pregnant, and I would love to have another baby.” Ana Isabel admitted that before the mobile clinic, she didn’t actually know what cervical cancer was, but thought she might have some illness and maybe WINGS could help. “Sometimes, because of ignorance, we don’t know what goes on inside us, and we can’t afford getting a checkup. So, when a mobile clinic comes here, we have to take advantage of it because it helps us. We can’t go to hospitals because it would be too expensive, and here, we don’t have the means to afford those services.”
Thankfully, the results of Ana Isabel’s cervical cancer screening were negative. WINGS’ nurses did detect a common sexually transmitted infection during the exam, and gave Ana Isabel counseling and treatment for herself and her husband. WINGS’ mobile team are happy to have provided reproductive health services for Ana Isabel, which she could not afford elsewhere. Ana Isabel left well-informed about her personal health and with the reassurance that she did not have cervical cancer.
WINGS’ Mobile Units travel to many remote, rural communities each month to provide long-acting reversible contraception and cervical cancer prevention services. We put every effort into reaching Guatemalans who normally don’t have access to these services. We dispel myths about contraceptives and raise awareness of cervical cancer and the importance of regular screenings. Each clinic brings women the power to control their reproductive health and lives. It is thanks to your support that we can continue reaching even further. Support our year-end campaign Reaching the Unreachable this December to help.
Happy Mother’s Day! Today, in celebration of all mothers who impacted our lives, we’re sharing another story from our series: 15 stories for the 15th Anniversary!
WINGS’ mobile clinics travel to remote areas of Guatemala, where access to health services is extremely limited. During the clinics, we provide contraceptive methods, cervical cancer screenings and cryotherapy treatment. In many Guatemalan communities, family planning or anything related to reproductive health is still much stigmatized, so it takes courage for women from these villages to go to our clinics. We have met strong women who have overcome many struggles, as is the case with Ana Maria.
25-year-old Ana Maria was born in Nicaragua. Both her parents died when she was a child, and without family or opportunities, she came to Guatemala, told by a prospective employer he would provide her steady work and a place to live. At just 14, Ana Maria was sold into the sex slave industry, and obligated to pay off her travel and housing debts. After 3 months living a nightmare, Ana Maria managed to escape with the help of a friend, now her husband.
A few years later, Ana Maria went to a WINGS talk about family planning and cervical cancer. The risk factors for cervical cancer really concerned her, considering her past. Ana Maria wanted to undergo a screening, but worried about the cost; her husband works on a banana plantation and some months they barely have enough money to feed their 3 children. WINGS nurse Alejandra heard Ana Maria’s concerns, and offered to waive the fee for the screening. Unfortunately, Ana Maria’s screening results came out positive for pre-cancerous cells. WINGS’ staff provided Ana Maria with immediate cryotherapy treatment that day, to prevent precancerous lesions progressing to cervical cancer. With tears running down her face, Ana Maria said: “I could never afford this treatment. Sometimes we don’t even have enough to eat. I thank God that there are organizations providing services to the poorest people.”
Ana Maria’s three children and her husband were also very grateful to WINGS. The children are still very young, and with their father busy working at the plantation during the day, Ana Maria is their main caretaker. Thanks to the cervical cancer screening and treatment, Ana Maria got the opportunity to be with her three children and see them grow up.
Ana Maria was very lucky. WINGS provided her with cervical cancer screening and cryotherapy treatment in time and she avoided developing cervical cancer. But what happens to all the women living in remote, rural area of Guatemala where access to health services is almost nonexistent? In many cases, these women have never attended a talk about cervical cancer and they don’t even realize they may be at risk. As a result, they do not get screened and there is a higher chance for cervical cancer to develop. If caught early, cervical cancer is highly preventable and treatable. It should not be the number one cause of cancer-related deaths in Guatemalan women.
This is where we are asking you to step in. We are aiming to screen almost 4,000 women for cervical cancer this year and you can help us make this happen. Join our Mother’s Day campaign today and make a donation to WINGS in the name of the mother you wish to honor. We will send you a beautiful personalized card for her, explaining the impact her Mother’s Day gift is making. Help us save lives!
“Cervical cancer is a problem that not only affects women, but the entire family. There is a lot of emphasis on reducing maternal deaths, that is to say, pregnancy related deaths. But what happens to those women who die from cervical cancer? They also leave behind family, children left without a mother now even more vulnerable to violence, poverty, and malnutrition, among other things.” –Michelle Dubon, WINGS´ Medical Director
In many countries, the incidence of cervical cancer is kept low by regular screening. In Guatemala, where an effective countrywide screening program is lacking, cervical cancer is responsible for 60% of female cancer cases attended by the INCAP Cancer Institute in Guatemala City.
In fact, cervical cancer is the number one cause of cancer-related death among Guatemalan women. Risk factors such as multiple births with little spacing between pregnancies and becoming sexually active at a young age put women in greater danger of developing cervical abnormalities.
“The sad fact is that this cancer does not appear overnight; the natural course of this disease takes up to 20 years. That is why no woman should die of cervical cancer; there are so many methods to detect and treat it in time, which is why our efforts and resources should be focused on helping these women.” –Michelle Dubon, WINGS´ Medical Director
Where screening programs exist, cervical cancer mortality has been reduced by 90%.
WINGS has been providing cervical cancer detection and treatment services since 2001. Beginning with 840 Pap smears in 2001, the program has grown fivefold and now provides up to 4,000 screening tests annually, as well as needed follow-up treatment. Over the course of 15 years, WINGS has screened over 50,000 women for cervical cancer.
Through our Cervical Cancer Program, WINGS ensures that Guatemalan women living in hard-to- reach and often forgotten rural areas receive vital information, cervical cancer screenings, and follow-up treatment when problems are detected.
In 2006, WINGS started to use an alternative method of detection and treatment called VIA/Cryo or “see and treat”. This method involves using acetic acid to visually inspect the cervix and the provision of cryotherapy treatment all in one visit (VIA/Cryo). It is a very effective, low-cost technique, which allows for immediate detection of cell abnormalities and treatment if necessary, eliminating the need for women to return for results or a follow up treatment. It also presents fewer logistical and technical constraints than the Pap smear.
In 2015, Veronica, 21 years old and a mother of two, came to a WINGS clinic to get a long-term method. After listening to the information talk given by WINGS nurses, she also decided to be screened for cervical cancer. She was nervous to get screened and afterwards shared, “Before today, I didn’t know this kind of cancer existed. I had my first child at 18, so I was nervous to get tested because I learned that being sexually active at a young age is a risk factor for cervical cancer. Thankfully, my result came back negative.”
And most recently, this year 87-year-old Maria had her first screening ever. A mother of 12, she encouraged her daughters and daughter-in-laws to attend as well. In her own words, Maria “wanted to be a good example.”
As reproductive health is considered a taboo topic in Guatemala, many women are uncomfortable learning and talking about cervical cancer. During an informational talk given by our nurses in Quiché, a province in northern Guatemala, women immediately lowered their heads and stared at the ground when the nurses showed photos of a cervix with cancer and a cervix without cancer; this made them very uncomfortable. One brave woman explained that most women were not interested in getting a screening because they had heard it involved their cervix being taken out, and they were very afraid of the pain. Our nurses thoroughly explained the actual process of a cervical cancer screening and why it is so important and in the end many of the women agreed to get screened.
On the other hand, women shared with WINGS nurses during a clinic last week in Santo Tomás Milpas Altas, that they understood the importance of being screened and had in fact gone to their local health center to get screened, but three months later they are still waiting for results. Every time the women call, the health center staff say that “the results aren’t ready yet”. Sadly they are used to this; the health center is continuously behind in their work, and in the end never provide the women with the help they need. During the same clinic, a few women mentioned that when they went to get a screening in the health center near their village, they were given a toothbrush and some form of liquid, and were told to insert the toothbrush themselves. That was the extent of information and instructions they were given. Thankfully WINGS was able to provide these women with accurate information about the screening process and immediate results after using VIA/Cryo.
How can you help? Support WINGS, and your donation will allow us to reach even more women in these remote communities with cervical cancer information, screenings, and immediate cryotherapy treatment.
Your donation of $100 provides 12 women in Guatemala with a cervical cancer screening, saving lives! YOU can help us reach over 3,500 women just this year with vital cervical cancer screenings.
Elma grew up in Chiqueleu, a rural village in the highlands of Guatemala. Having grown up in a remote location with scarce access to education or health services, Elma never learned about contraceptive methods or reproductive health.
She became pregnant at a young age. It came to Elma as a big surprise, mainly because she didn’t understand how one becomes pregnant. She shared that in her community no one ever talks about sex or family planning. Even though 69% of the population in Guatemala is less than 30 years old, sexual education still hasn’t reached most public schools, and HIV prevention programs have been focused on sexual abstinence and delaying first sexual intercourse.
When Elma told her boyfriend that she was pregnant, he said that the baby wasn’t his, and disappeared from her life, never to be seen or heard from again. Elma was devastated. Sadly, this is a common occurrence in patriarchal countries where gender roles are still very traditional. Guatemala is one of the most gender unequal countries in the world. Men are not typically held accountable and many people believe that solely women are responsible for their pregnancies. In Elma’s case, most of her community and family shunned her, launching her deeper into depression.
“Once I saw the results, I couldn’t stop crying, plus my boyfriend had just left me completely alone. I honestly came close to committing suicide because I could not find a solution. Luckily, I made the right decision and I’m still here.”
Elma says that 4 years ago, nobody in Chiqueleu had access to or knowledge about contraceptive methods. Now, WINGS has impacted her community tremendously by making contraceptive methods available and providing reproductive health education. Thanks to this, Elma has had the opportunity to further her education; she only has 2 more semesters left to finish nursing school! “I am going to continue seeking advice from the WINGS volunteer promoter so that I can continue to plan my life, finish my studies and move forward”.
Did you know that 1 in 3 indigenous women in Guatemala have no access to health and family planning services? Along with that, only 14% of indigenous girls in rural areas complete primary school. Guatemala has the highest fertility rate in Latin America and the Caribbean, it has among the highest rates of adolescent pregnancies, and one of the highest rates of unmet contraceptive need. Twenty-two percent of women give birth before the age of 18. One big issue is that once adolescent girls become mothers, they are far less likely to re- enter the education system. In fact, 40% of adolescent mothers in Central America never finish their education.
Education is positively associated with contraceptive use by increasing awareness, acceptability, and utilization of family planning services. It is critical that people learn about contraceptives so they can choose if, when, and how many children to have. It is equally as important to raise awareness and increase acceptability to sexual health so that these topics stop being a taboo in Guatemala. This will result in people not being afraid or embarrassed to seek counseling and information regarding their reproductive health. Reproductive health services are important so that all Guatemalans have the opportunity to complete their education, pursue their goals, and break the cycle of poverty in this country.
To support women’s empowerment and to break the cycle of poverty, WINGS has various different programs that have a direct, cost effective impact on education, poverty, health, and gender inequality.
Though we have stationary clinics in Antigua, Cobán and Sololá, we are aware that there are many women in need who are living in very remote areas of the country. For this reason, we also have mobile clinics that go out to those areas, to provide both short-term and long-acting reversible contraception, cervical cancer screenings, and treatment for the most commonly occurring STIs. We do cervical cancer screenings and same-day cryotherapy treatment for pre-cancerous cells that may lead to cervical cancer. We also offer affordable tubal ligations and vasectomies; the donation cost is typically Q50, roughly $6, but we cover the costs for those who cannot afford it.
We offer community-based counselling and distribution of low-cost short-term methods through our network of volunteer family planning promoters, who have an intimate linguistic and cultural knowledge of the communities they serve. They provide quality counselling, low-cost contraceptive methods and referrals to WINGS for additional services.
We also train young women and men (ages 14 to 19) as Youth Leaders who provide accurate reproductive health information and service referrals to their peers through community-based activities. We improve the quality of information and services by training staff members of women’s rights and youth organizations, public health service providers, and partner organizations.
In Elma’s words, “Here in my community, we had no contraceptive methods in the past. Women here have wanted access to these methods for a long time now. It was very hard for me to tell you my story, but I thank you so much for visiting me, for the advice you have given me, and for strengthening our families through reproductive health.”