Lifting the Burden on Guatemala's Isolated Communities

In the midst of a week of torrential rains, floods, and mudslides so severe that a state of emergency was declared, Dr. Zanotty and three clinical staff inch their vehicle through the countryside of Guatemala. The drive takes longer than normal as they traverse washed out bridges and carefully make their way past tipped over tractor-trailers. Despite the hazards, the team knows that a group of women will be waiting for them, waiting for sexual and reproductive health information and services.

Dr. Zanotty and his staff run a reproductive health care program in the southeastern most region of Guatemala that is operated by APROFAM, our partner in the country. Although most of Dr. Zanotty’s time is spent at the area’s main clinic, Dr. Zanotty and his team of community outreach coordinators bring much-need health care and education to groups that are impoverished and underserved in Guatemala. For many in these remote communities, APROFAM's mobile health unit is their only contact with the health system.

The team's first stop is Acatempa, a small community in southeastern Guatemala facing extreme violence, water shortages, and poverty. Today, they lead an informational session on family planning and reproductive health with nearly twenty women who traveled on foot with their children to learn more about birth control, cervical cancer prevention, and basic family planning. Although the cinder block and cement structure offers refuge from the rain, most of the women are still damp from the long walk.

Despite being cold, the women are thoroughly engaged. In a culture where sexual and reproductive health issues are rarely discussed, this is one of the only places where they can learn about contraception, breast exams, and the warning signs of sexually transmitted infections. "These are not issues that we discussed when I was younger,” says one dark-haired woman in her thirties, “but I think they are important to discuss now as adults, and with our children.”

The team’s second stop is another small, impoverished community. They bring a community health worker, Rosa Lidia Santos, a new supply of contraceptives. In remote communities like these—sometimes more than two hours away from the nearest clinic—Rosa is critical in providing high-quality health services to local women and youth who would otherwise receive none.

“When I started having children, I didn’t think about how many," says Esna Marina Aroche. "But I started birth control so I wouldn’t have too many children. Life can be hard and sometimes you can’t pay for what the children you already have need. Imagine having so many that one day you just can’t do it any more. It's better to avoid that.”

Esna talks to her kids about sexual and reproductive health. She buys birth control pills for herself and her daughter. “If I didn’t get the pills from Rosa, where would I get them?”

Community health workers also refer women who need additional sexual and reproductive health care to APROFAM’s clinics and facilitate public discussions about adolescent pregnancy, cancer, and HIV. The country’s alarming sexual and reproductive health indicators, such as high rates of unintended pregnancy and death during childbirth, demonstrate the tremendous need for these services.

Dr. Zanotty, his team, and APROFAM’s network of trained community health promoters are crucial to reaching overlooked populations and providing them with quality health care. By delivering targeted and appropriate services to this population, IPPF/WHR and APROFAM lift the burden of the country's troublesome health indicators and contribute to reversing these worrisome trends.


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