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.
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.”