Family Planning for Guatemalans Living in Poverty

by WINGS Vetted since 2008 Top Ranked Effective Nonprofit Site Visit Verified
WINGS mobile unit on its way to the shelters
WINGS mobile unit on its way to the shelters

June and July have been particularly challenging months in Guatemala. Fuego Volcano erupted on June 3 and buried entire communities in the department of Escuintla. According to official data, the death toll has reached 161. However, it is very difficult to determine the real number of deaths, as Guatemala has not had a census since 2002. According to the National Statistics Institute (INE), there were 2,345 people registered in the buried communities (1,535 people in El Rodeo and 810 people in San Miguel Los Lotes). Conversely, the National Civil Registry (RENAP) states there are 4,295 adults registered in El Rodeo and 397 adults in San Miguel Los Lotes, but it is unknown whether they were still living there.

Due to the danger and uncertainly caused by the volcanic eruption, WINGS had to cancel the clinics scheduled in the affected areas, as the hospitals were attending injured people and the health centers and clinics were partially destroyed. Nevertheless, WINGS continued doing what we do best: take supplies directly to those in need. As an immediate response, WINGS started bringing short-term contraception to the shelters, as well as basic hygiene and rescue goods. These visits allowed us to identify suitable strategies to provide long-acting reversible contraception (LARC).

WINGS’ first LARC clinic after the disaster in one of the areas adjacent to the volcano was overwhelmingly successful. Our medical team attended 27 patients in Osuna, Escuintla. We are proud of how quickly and efficiently we were able to detect and respond to needs as they arose. We continue to work hard to assure Guatemalans’ right to access contraceptive information and services regardless of this natural disaster and ongoing crisis.

Nurse Alexia provides contraception in a shelter
Nurse Alexia provides contraception in a shelter
Youth client learns about contraceptive methods
Youth client learns about contraceptive methods

The past few years have been filled with strategic changes for WINGS, all with the aim of streamlining services to further our reach while becoming more cost-effective. Our expertise in both service provision and reproductive rights education is well-known throughout the country. By focusing on patient-centered, rights-based care, WINGS has positioned itself as the provider of choice for many women and men in Guatemala. Stories shared with us during clinics or promotional talks make it clear that people are talking positively about WINGS and referring friends and family to our services.

Internally, we continue to put rights-based practices at the very core of everything we do. Our Board of Directors and staff have ongoing conversations and training sessions about how we can best uphold rights-based care principals and improve our care for all our clients.

WINGS is working toward becoming a leader in rights-based care in Central America. We are guided by best-practice and global experts, including Family Planning 2020 (FP 2020), a global partnership that supports the rights of women and girls to decide, freely, and for themselves, whether, when, and how many children they want to have.

FP 2020 asserts that “rights-based family planning turns the focus to the rights of individuals and couples to decide freely and responsibly the number and spacing of children with quality sexual/reproductive health information and services to do so without facing discrimination or inequality.”

For WINGS, the practical implementation of rights-based care means that we treat every client in a non-judgmental, non-coercive manner that provides ample education for each individual to make well-informed decisions. You can see this in various aspects of our service provision process.

We provide a Youth-Friendly Space within our clinic to attend anyone age 19 or under. This space is staffed by our Youth Program team who are trained and skilled at communicating with youth who then provide a ‘warm hand-off’ to our clinical staff if the youth decides to get a contraceptive method. We offer all services for free to anyone under age 19.

Our clinical team uses techniques to protect privacy and invite clients to ask honest questions before, during, and after any clinical intervention. Each client receives comprehensive information about available contraceptive methods before they choose which one is right for them and can opt out at any moment if they change their minds. This is important in a context where we know that not everyone has been informed that vasectomies and tubal ligations are permanent procedures, for example.

As we continue to learn and improve our service delivery, we hope you will partner with us. Your support allows us work towards a future where all Guatemalans thrive and are able to fully exercise their sexual and reproductive rights.

WINGS Board learns more about rights-based care
WINGS Board learns more about rights-based care

In 2015, we began implementing the LARCs First methodology, meaning that we explain all available birth control methods in terms of efficacy: beginning with the most effective (IUD and subdermal implant) and ending with the least effective method (condom). There are numerous misconceptions about LARCs in Guatemala. It is believed that they are only meant to be used by married women or women who have already had children, some think that they can make women infertile, or that they are permanent methods. To dispel these myths, our educational talks strongly emphasize that contraceptive methods can be used by women regardless of whether they have had children or not, and that they can be removed after 5 years (in case of the implant) or 10 (IUD), or earlier if the person decides to.

Since implementing LARCs First, we have seen the number of contraceptive methods patients shift away from short-acting methods like pills and injections to long-acting methods. What this means for us is that while our projected number of total patients is generally right on the mark, the balance is flowing toward LARCs. What that means for our patients is that they are much more effective in avoiding unintended pregnancy for longer amounts of time!

As you can see from the chart of data, our patients last year showed an overwhelming preference for subdermal hormonal implants over IUDs. We believe this is because myths about the copper T or IUD are so very pervasive. We have women ask us all the time if they will get pregnant and have a baby with the T embedded in the baby’s forehead or if the T becomes embedded in the uterine tissue forever. Using a rights-based approach, we offer education to dispel these myths in all of our programs, whether within our Youth Peer Education Program, our community outreach, or in one-on-one patient counseling. Despite these misconceptions about the IUD, we are delighted that the subdermal hormonal implant is so popular.

At WINGS, we know that the education we provide is just as important as the actual physical contraceptive methods we provide. We could not provide wither of these dimensions of our services without the generosity of donors like you. Thank you so much for standing with WINGS as we provide life-changing reproductive health services to Guatemalan youth, women, and men. We <3 LARCS and YOU!

We love LARCs
We love LARCs
Examples of Contraceptive Methods
Examples of Contraceptive Methods
Nurse Martha explains contraceptive methods
Nurse Martha explains contraceptive methods

WINGS began providing Voluntary Surgical Contraception (tubal ligations and vasectomies) in 2015. We currently partner with 14 hospital and numerous health posts throughout Guatemala to provide these highly sought-after services. In the first 9 months of 2017, we have provided 1,050 tubal ligations and 129 vasectomies. In a country where machismo challenges our work daily, we are especially excited about the slowly increasing demand for vasectomies. We ask our patients for a donation of Q. 50 (less than $7) for these procedures.

While vasectomies are far easier to perform, both for the patient and the doctor, we still see many more women than men wanting to permanently prevent pregnancies. Each month, our mobile unit teams travel to rural areas of Guatemala to offer VSC as well as Long-Acting Reversible Contraceptive methods (LARCs). In an average month, our team of 2 doctors, 8 nurses, 2 health educators, and 2 drivers host 32 jornadas or pop-up clinics.

During a recent tubal ligation clinic, a 30-year-old woman who was not on our patient list arrived wondering if she might get a tubal ligation that day. In performing her patient intake, the WINGS nurses asked how many children she had. She surprised the nurses when she answered 7! While she was waiting for the procedure, she held her baby in her arms and mentioned that he was 42 days old. Our nurses became worried when they realized that he was having trouble breast-feeding and noticed breathing problems as well. When mom was asked about baby’s health, she said that he had “a bit of a cough." Because of the baby's age, our nurses recognized this as a danger sign and recommended he be sent to the emergency room of the same hospital and he ended up receiving a nebulizer treatment. The mom was operated on successfully and was incredibly grateful for the attention that she was given.

Martha, one of the nurses that attended this patient and her son that day remarked that, “Comprehensive care is one of the main pillars in health. As an institution we cannot limit ourselves to paying attention only to what is happening directly to our patient, we must be aware of their surroundings and environment as well. That’s why we provide counseling not only on contraceptive methods, not only in sexual health or reproductive rights, but we also focus on issues that affect our patients’ families and children.

Thank you so much for standing with WINGS as we provide life-changing reproductive health services to Guatemalan youth, women, and men. We simply couldn’t do this work without you!

Enma Rodas - WINGS Volunteer Health Promoter
Enma Rodas - WINGS Volunteer Health Promoter

One of WINGS’ longest-standing programs is our network of roughly 35 Volunteer Health Promoters: community leaders identified within underserved rural areas to be a local point of service. Through their intimate linguistic and cultural knowledge of the communities they serve, they are able to provide quality contraceptive counselling, low-cost short-acting methods, and referrals to WINGS medical clinics for additional services.

Our Volunteer Health Promoter, 40 year old Enma Rodas, started with WINGS 5 years ago after being referred by a friend that was in the program at that time. She has become one of our strongest supporters, advocating for reproductive health in Guatemala: “Family Planning means everything to me. It helps us in every single aspect of life and thanks to it, I have a better life. My siblings have a better life. My community has a better life. Everyone is better.”

Enma serves the community of San Pedro Yepocapa in Chimaltenango. She used to sell cosmetic lotions in her community and started promoting contraceptive methods to her clients. Now she has around 40 patients. “I bring everything I learn from WINGS to my village. Now, after all this time, I see meaningful changes in the women that are using a contraceptive method. They are happier because they can enjoy their lives without being afraid of getting pregnant.”

San Pedro Yepocapa is a poor community and most of Enma’s patients are unemployed or work as farmers. She explains that promoting reproductive health to village elders is extremely difficult, since they believe many myths and are closed minded regarding contraceptives. “They say, for example, that anyone who uses the birth control injection will accumulate filth in her stomach and it will make her fat. It is hard to stop the rumors,” she explains.

Enma’s mother had 10 children but 3 of them died as children. Enma wanted to have 2 children, but she ended up having 3. “When my last daughter was 6 months old, I got a tubal ligation and it was the best decision of my life. I feel that I still have a lot of energy and I can fully enjoy my children, who are already teenagers!” She has two sons, 20 and 17 and a daughter who is 16 - she is proud that she talks about reproductive health with all of them. They, as well as her husband, are totally supportive of her.

She recognizes that working with WINGS means facing some hard moments. “Every patient reacts differently to each contraceptive method and sometimes they are scared, but I always try to calm them.” She loves to be part of this journey and she sees the rewards. “One of my patients is a 30 year-old woman with 8 children. I tried to convince her for long to use a contraceptive method. Now she is truly thankful to me and WINGS for helping her. Before she had no time for herself and her body was going through many changes. Now she is gets a monthly injection and she is happy because she feels self-confident and young again.”

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Organization Information

WINGS

Location: Antigua, Sacatepequez - Guatemala
Website: http:/​/​www.wingsguate.org
Facebook: Facebook Page
Twitter: @WINGSGUATEMALA
Project Leader:
Kirsten Taylor
Development Director
Antigua, Guatemala
$42,599 raised of $50,000 goal
 
810 donations
$7,401 to go
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