At WINGS, we believe the key to creating lasting change is empowering people at the local, community level. For this reason, we established our Voluntary Family Planning Promoter network back in 2006. Volunteer promoters are men and women who distribute low-cost short-term contraceptives and provide quality counseling and referrals to WINGS for additional services. As our promoters are locals, they have an intimate linguistic and cultural knowledge of the communities they serve. Currently, 60 women and men serve as WINGS´ volunteer promoters throughout 11 departments.
Lucy, 24 years old, was born in Santa María Cauqué, a small village located in southern Guatemala. She is one of five siblings, and her mother is a midwife. In Lucy´s community, health services are scarce, and as a result she helped with her first delivery when she was only 7. Though Lucy was exposed to reproductive health issues at a very early age, her family and teachers never taught her about her own reproductive and sexual health. When Lucy was sixteen, she had her first baby. She shared with us that at the time she felt like she was still a child herself, not ready to have a child of her own. With little to no money, Lucy worked hard as a farmer so she could make ends meet.
One day a staff member from WINGS came to Lucy’s village to offer counseling and sexual education talks. “It is like she came into my life like a mother, to talk to me about all the things I had never learned”. From there, Lucy became very interested in working with WINGS, and was trained to become a family planning promoter. She said at first only her cousin came to her for a contraceptive method, but slowly, word traveled throughout the community and more women started to arrive. Now, Lucy has been with WINGS for six years and provides counseling and contraceptives to more than 250 women each month.
Lucy explains that her role in her community is crucial to many poor people who cannot afford health care in a private health facility. Many pregnancies in her community are the result of lack of means to pay for contraception. When discussing her role, Lucy mentions that she sees about 60 women per week. She has a form that she fills out for each of the women, to keep track of when they are due for their contraceptive method.
“Without even reading my forms, I always know when each of my patients needs her contraceptive method. I know all the ladies by name!”
Personally, family planning has been challenging for Lucy. When she started working with WINGS, her husband and mother-in-law refused to accept that she only wanted to have two children. Her husband was raised in a family of many siblings, and he told her his mother had many kids, so she should do the same. At some point Lucy’s husband even told her that contraceptives were poisonous and that he would not give her permission to use them. Lucy’s mother-in-law said, “You are a woman; you have to keep as many children as God sends you”. Lucy bravely chose to use a Jadelle subdermal implant without her family knowing. She recalls what she felt making such a big decision; “I did it because I did not want to have the same life that my parents had, and for that I am proud. I can now say that I am in a much different situation than my parents were. There used to be so much ignorance, and now I feel like I’ve reached a very successful point.”
Lucy sees the change and successes in her community. Women never used to talk about family planning. Now, the majority of women ask Lucy when she’s coordinating the next mobile clinic, or when they can stop by for counseling. Now, many want to use long-acting reversible contraception, such as the IUD or the subdermal hormonal implant, which would have been unthinkable in the past.
When asked how working with WINGS has impacted her life, Lucy shared that before, she and her husband would not have been able to afford the most basic things such as water and electricity. That thanks to WINGS, she has an income of her own, which has empowered her in many ways. Together with her husband, she has saved up money to invest in the future of their children. Lucy is humbled by the trust her community places in her, but is most shocked by the change in her husband’s attitude. For a long time, he was reticent about anything that had to do with WINGS. Lucy shared with us that her husband apologized; “I am so sorry, because when you first wanted my support, I didn’t give you that. Now, you have been able to help yourself. You are free; you should do whatever you want to do. Support whomever you want to support. Fight.”
After six years with WINGS, Lucy is extremely happy to be making such a positive impact in her community and hopes to continue for years to come.
by Caroline Webb
Estela was born in 1994, one year my senior, and chose to undergo the surgical process of an elective tubal sterilization provided by WINGS. Already the mother of three children, Estela could not fathom having another pregnancy, birth, or child to feed, clothe, educate, and love.
As I sat by Estela’s side outside a pop-up surgical operations clinic in Chimaltenango, she breathed heavily through the nausea, a side effect of the voluntary surgical contraception (VSC), and I was humbled by her strength in the face of her decision to make a free, informed choice about her fertility and family.
Though the two of us have been circling the sun for roughly the same amount of time, our lives and responsibilities are miles apart; I have never known the weight of such a permanent, life altering choice, and due to the privileged world into which I was fortunate to be born, probably never will. Allow me to draw a comparison: as I face decisions of undergraduate majors at my fancy private school, consider potential careers, revise my resumé, or rationalize decisions because they build character and do things “for the experience,” Estela – and many of the women with whom WINGS works in Guatemala – faces decisions that ultimately determine her family’s future and reproductive path.
During my time interning with WINGS, I have been exposed to shocking truths and realities of many strong women like Estela. These will forever inspire and humble me.
As a Development Intern with WINGS, I worked primarily in the Antigua office, but was also able to assist in the field: I accompanied the incredible unidad movil to assist in a pop-up mobile cervical cancer screening/STI testing/method distribution clinic in a rural highland community, the VSC operations clinic where I met Estela, and a women’s health conference at a community hospital in Mazatenango. I assisted WINGS’ youth educator in a taller at a local school presenting to male adolescents the reality of pregnancy (complete with realistic pregnancy simulators!) and the misconceptions of gender roles. Another field experience took me to Escuintla, a region in Guatemala with high rates of AIDS and HIV, to assist in a unique charla with female sex workers, teaching about cervical cancer, HPV, different methods of contraception, and the accessibility of these options through WINGS’ services.
During these trips – replete with rutted rural roads, sunrise departures, surprise traffic obstacles (a camioneta accident ahead is not a valid excuse to arrive late to meet women waiting to take control of their reproductive health), and mara extortion – I met incredible women working toward a better future for themselves, their families and Guatemala, and witnessed firsthand the incredibly valiant yet tiring work the empathetic nurses, promotoras, and educators do to manifest WINGS’ mission.
WINGS’ vision of creating a future where all Guatemalans are capable of exercising their sexual and reproductive rights is already becoming a reality. One by one, with each IUD or subdermal implant distributed, cervical cancer screening or tubal ligation performed, and each woman, man, and youth learning and talking about sexual health and their reproductive rights, WINGS enables individuals to be their own agents of change.
Estela, like so many women I have had the privilege of knowing through WINGS, inspires me through exercising her agency to choose her fate, plan her family, and be the dueña of her body. By taking advantage of WINGS’ tubal ligation service, Estela will never again need to consider contraceptives nor worry about an expanding family to support. Thanks to WINGS’ services, Estela’s three young children may now have a better chance of transcending the vicious cycle of poverty by having access to more education, nourishing meals, better resources and special attention from their mother.
For World Humanitarian Day 2015, WINGS is celebrating one of our dedicated team members. A true humanitarian who provides reproductive health education to thousands of youth, women, and men in some of the most underserved communities in Guatemala, and never loses her enthusiasm and motivation! We don’t know what we’d do without her and we know that countless families throughout Guatemala feel the same.
Meet Ana Lucia…
How did you start working with WINGS?
I started volunteering with WINGS in 2007 after having participated in a reproductive health workshop. I was so inspired by what I learned that I joined WINGS to teach other young people about sexual and reproductive health. I accepted a formal position as a Youth Educator in 2011 and since 2013, I have supervised our promoter network as a Family Planning Educator.
Tell us about the work of WINGS in Guatemala.
WINGS works to improve the lives of Guatemalan families through sexual and reproductive health education and services. We strive to reach the most remote and underserved areas, helping women decide on the number of children they want and giving them the tools to space pregnancies, with the goals of alleviating poverty and reducing maternal and infant mortality.
What are the biggest challenges facing Guatemala with regards to reproductive health?
Sexual health is still a taboo here: religion is barrier to accessing services and the education system does not help – reproductive health and family planning are not given enough attention within the education system.
What do you enjoy most about working for WINGS?
I love seeing a woman leave our clinics with the contraceptive method of her choice. It might seem like a small thing, but behind her ability to choose is a lot of effort. Our team provides information and education across the country, enabling women to make informed decisions about their own bodies; we raise funds so that we can buy and provide subsidized contraception; we work with municipal leaders and decision makers to organize numerous clinics in the communities and our team of nurses, educators, drivers, and volunteers provide their services to make these clinics a reality.
When I see women happily leaving our clinics , knowing that they can now take control of their lives and give their families a better future, this makes me really happy and proud of the work we’re doing.
And the most important part of your job…
Helping Guatemalan women. I love visiting communities, understanding the needs of women living there and then being able to help them to improve their lives through family planning. I think the most important part of my work is understanding that women have the right to freely decide if/how many children they want to have and then ensuring that they are able to make their own decisions about their reproductive health.
Why are the reproductive health services that WINGS provides so important in Guatemala?
They are important because women are dying. They are dying because they are having many children, they are not spacing their pregnancies, and have very limited access to health services. It is crucial that we continue to provide education and services and work towards a better Guatemala and a better life for future generations.
Do YOU have a question for Ana Lucía? Just ask in a comment, she will be very happy to respond!
To help Ana Lucía and WINGS reach more underserved women, men and youth and provide reproductive health education and services, please make sure you spread the word about our work with your friends and family.
To donate, follow this link: www.wingsguate.org/donate
The invisible girl lives in rural areas, seldom attends secondary school, marries early and has little control over how often she becomes pregnant and how many children she has. She escapes national data because she is hard to reach and expensive to serve. Yet, she is expected to raise her children free of malnutrition, stay healthy, and contribute to the overall well-being of her community. She appears in brochures to fundraise or promote tourism, provided she’s smiling.
This girl exists to the State up to the age of two, when she’s taken for vaccination. She reappears at the age of six or seven, or whenever she gets a chance to attend elementary school. Once she completes sixth grade, she would only be counted if there is a census, or as a member of a household in one of the national surveys. She will again be eligible for a State-run program when she becomes pregnant. Sometimes the gap between leaving school and marriage is a year; sometimes it is a bit more. In the meantime, she will work at home, collaborate in agricultural production or help her family sell these products. She will be courted and will marry and move to her husband’s family home.
This persistent pattern is often labeled “inevitable” or “part of the culture” and thus relegated in the list of official priorities. Yet, we cannot claim that girls “choose” to marry and bear children early if they are not aware of other alternatives. Racism and ethnocentrism play an important role in keeping these girls invisible, and therefore irrelevant. Ignoring their needs is equivalent to planning poverty.
THE COST OF INVISIBILITY
Programs that target these girls have demonstrated that well contextualized, girl-centered planning works. Girls respond well to programs that focus on building self-esteem and skills, are rights-based and focus on their health and family planning decisions as part of a process that remains girl-centered. Girls recognize the challenges of marrying early and the hardship of having little control over their fertility. Attending school and skills-based programs constitute a protective factor that allows them to postpone their transition to adulthood.
Guatemala will not change overnight but working to make girls visible is a step in the right direction of reaching them. However, there is an ongoing bias in favor of in-school, urban youth. In Guatemala, it is easy to make a case for almost every segment of the population and rural girls have historically “lost” when programs make choices based on cost and accessibility. Today, ⅓ of rural adolescents aged eighteen and younger are pregnant or already mothers. There are services that, if minimal, are available to them. The other two thirds are home, working for little or no pay, most likely in the informal sector. Fewer than 15% will be enrolled in high school. Their chances of participating in programs, governmental or not, will decrease once they are married and have children. There is not much choice in this.
Alejandra Colom is a Senior Program Director with the Population Council, managing program activities in Guatemala, and a WINGS’ board member. You can learn more about her and her work at the Population Council.