I arrived to interview Sue Patterson in a travelers’ café, which, like many other buildings in Antigua, was open in the center, with the sky overhead. I had flown in the night before, and was still being mesmerized by the way in which the jungle seemed to be on the edge of taking over the city whenever you weren’t looking – a real change from the rust belt city of Milwaukee. Just before coming, I had been reading up on the history, politics, geography and culture of Guatemala, and was here to find out how family planning fits into the mix.
Having served as a Consul General in Guatemala, Sue Patterson possesses a unique familiarity with the nation’s problems, many of which she sees as related to its recent population explosion. During her time years before as a Peace Corps volunteer she realized a passion for the problems of poor women and her current work with two non-profits serving Guatemala’s poor mothers demonstrates that this passion has not waned over the years.
When Sue decided to retire in Guatemala, her aim was to work with micro credit loans, which are loans too small for banks to handle that are made to groups of women with no collateral. These small amounts are generally for use as seed money for their small business projects. This ambition never fell into place, but what happened instead was the creation of WINGS, a non-profit that affords women more control over their finances and their bodies by improving their access to family planning. By creating smaller families, WINGS may create better-fed and better-educated families and communities.
WINGS, Women’s International Network for Guatemalan Solutions, is a small but very rapidly growing non-profit that provides education, cervical cancer screenings and family planning resources to the poorest of Guatemalans. For over thirty years, there was only one organization, APROFAM, legally providing family planning resources in Guatemala. Abortion is illegal there and, up until a few years ago, the government, which was, at the time, dominated by Catholics, was generally very unsupportive of any family planning endeavors. APROFAM survived because of the financial contributions of international foundations, organizations and governments and individual donors. Recently however, the more Evangelical government passed a law stating that every Guatemalan has the right to plan her or his family, making it somewhat easier for organizations like APROFAM and WINGS to do their work and for women and men in Guatemala to learn about and obtain the methods that assist them in planning their families. WINGS began by working very closely with APROFAM.
SP: When WINGS got started, and it was kinda by chance, I was asked by a Guatemalan friend of mind, a nurse who was head of a health unit at an organization called Common Hope that works with poor families – she said she had eight women who wanted to have tubal ligations, but they didn’t have the money to pay what APROFAM charges, which at that time was equivalent to about US$35. So this friend asked me if I would pay for the surgeries (one of these women has at least seven children) so I said ‘yes, I would be happy to pay for one and I would write to a few friends on email.’ So I wrote to a few friends to see if they would sponsor anybody. I thought I might get $150-$200. Before I knew it, I had $4000, $2000 of which was from a woman I didn’t even know – a friend of a friend.
So all of this was just sitting in my own personal bank account and when I added it up, I said, ‘whoa, if I get struck by lighting, this money does not belong to my daughters.’ So I went to APROFAM here in Antigua, and asked them if they ever had poor people come in who are interested in a family planning method, but then leave because they can’t afford it. (Their prices are heavily subsidized, but still, it is out of reach of the poorest of Guatemalans.) They said that they definitely had people like that; so I offered to set up a fund to supplement whatever the family could pay, or the difference between the cost and the service.
Things worked this way for about a year until Sue realized the passivity of this approach and made the first steps towards the establishment of WINGS’ current program.
SP: The people who have some initiative or some wherewithal come in and inquire, but there must be people out there who don’t even know where to go, or that such things are available. So I decided to hire a young Guatemalan woman; she has been working for WINGS now for the last three years. After a year and a half, I hired a young man, and those are our two full-time WINGS employees. They go out and do most of the educational talks working with other non-profit organizations.
WINGS works mainly in rural areas, where need is greatest and poverty most common. By working with community organizations, WINGS educates people in isolated areas on family planning methods and reproductive risks like STIs, HIV and teen pregnancy.
SP: A lot of girls here get pregnant at 15. They have a much higher risk of death; I think it is six to eight times higher than if you are between the ages of 20 and 24. Especially so if you add in the facts: that they are malnourished, they’re small, nobody’s looking after them, they don’t have prenatal care, they don’t have vitamins, they’re anemic, they have all the risk factors.
Maternal mortality is a serious problem in Guatemala, with 36.91 deaths among every 1,000 live births . Another organization, on whose board Sue Patterson sits, Behrhorst Partners for Development, also works on this problem by training traditional birth attendants to better identify crisis situations. WINGS encourages teens to postpone first pregnancies in order to lower their risk of mortality and to better their educational and vocational opportunities.
SP: We are starting to work more and more with teenagers to get them to postpone that first child. Keeping them in school is one of the best ways of doing that. There you get into a whole series of other problems – WINGS does not give school scholarships, but that is a very effective way to get girls up to the age of 16 or so without getting pregnant. We are working now to start a major effort – a train the trainer program for teenagers. With the idea to train these teenage leaders intensively enough that they can be counselors to their peers and reference points, we’ll see how it pays off if we can get kids to postpone that first pregnancy, or at least the second one. I think it’s sometimes easier to catch their attention after the first one, but the traditional pattern here is to start young and have six children. Then, at age 27, to say, ‘wait a second, this isn’t working out so well, I can’t keep having to do this,’ and then to come in for a tubal ligation. We are really hoping to work more on birth spacing.
In addition to education, WINGS sets up mobile clinics providing Pap smears and tubal ligations. Cervical cancer is the top cause of cancer-related deaths among Guatemalan women because many do not have access to regular detection screening and adequate follow-up treatment . By doing Pap smears and educational talks in rural areas, WINGS is able to scout sites for tubal ligation mobile clinic visits. When at least 15 women seeking the procedure are found, WINGS is gets the APROFAM mobile clinic to visit the area, setting up in a home, school, health clinic or other area to perform up to 35 surgeries in a day. “It’s really a fantastic method. We’ve negotiated a rate with APROFAM; they charge us under 100 Quetzals (US$13) per surgery. There is no general anesthetic, only local. The woman is on the table for six minutes, she rests up for 45 minutes or so, the doctor examines her incision and if she is not bleeding, she’s free to go home. These women walk right home. It’s a really efficient method and it doesn’t require a sterile environment,” Sue Patterson describes the efficiency that WINGS’ cooperation with APROFAM has produced in order to help these women. WINGS pays for all of these operations, asking the women to bring what they can as a gesture of commitment to their own reproductive well-being. And they have been quite busy in 2004, “So far, in the first six months of this year, we’ve paid for around 3,000 tubal ligations. $13 is cheap, but still when you multiply it by 3,000, it turns out to be a lot of money, so I spend a lot of time trying to raise money.”
Raising money is not an easy task but Sue hopes that the stories found on the WINGS website, of clients like Alba, speak for themselves.
Alba, 32, already had 5 children when she recently opted for a tubal ligation. From her small village of La Palmas, Alba had to walk approximately 5 miles to Yepocapa, where WINGS had helped coordinate a rural tubal ligation clinic. Although she had wanted to undergo such an operation since about a year ago, she told us, she didn’t have the economic resources to do so. Alba’s husband is a farm worker and gives her Q180 (about $24) per week to provide for the household of 8, which includes a grandparent. “I thank God for the help that WINGS brought me,” she said.
“They lead tragic lives that are ameliorated by our interventions,” Sue explains.
If you would like to help improve the lives of these women, or for more information on WINGS’ work, visit: http://www.wingsguate.org.
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