Prevent and Detect Cervical Cancer in Guatemala

At the beginning of October, the Guatemalan Government officially ended the state of calamity, removing nation-wide restrictions, and transferring the continued management of COVID mitigation to the Ministry of Health and municipal authorities. We expect to see increasing movement across many sectors soon. This decision, as needed as it may be, will increase the risk of more infections and disruptions to an already decimated health system. 

In terms of the current state of our clinical service provision, we have reopened our Antigua clinic and are hosting regional clinics with stringent safety precautions in place. We are constantly making modifications to our services and protocols in order to protect our staff and patients. 

Unfortunately, we have not yet been able to offer tubal ligations, but we are actively talking to partners in order to begin as soon as it is safe to do so. All WINGS team members are working full-time, but compared to pre-pandemic times our services are down, although higher than we had anticipated. Tubal ligations account for the vast majority of this decline, but this is also affected by the lack of public transportation (patients are finding it difficult to come to us), and the fact that the hotels our staff stayed in are still closed or not fully operational makes it impossible to go out to the communities for a whole week as we used to. In sum, we are back; we are strong; we will keep on going!

I recently read an article which described the current economic recovery in a “K-shape”. From the midpoint of a bold vertical line begins two rightward traversing lines, one slanting 45 degrees upward from the horizontal, and the other 45 degrees downward. WINGS, thanks to the steadfast leadership of its Board, the unwavering support of individuals like you, and its staff’s quick decision-making and strong internal processes, is fortunate to be situated in the line heading upward, and as such our responsibility and commitment to the almost 25,000 individuals we reach every year with sexual and reproductive health services and education is stronger than ever. We know that WINGS, with your support, will continue to be in a position from which it can provide these critical essential services to our communities. WINGS must continue to be agile, determined and steadfast in our emphasis on quality care as our country and our world begin standing back up from the blow that COVID has dealt us. Every day we make progress. Our plans remain unchanged: to have national presence through mobile units by 2025.

Guatemala and the United States are both living in a traumatized state, with a public health disaster, an economic crisis, environmental threats, demands for social and racial justice, and a very long etcetera. If I may dare paraphrase Dr. King’s “I have a Dream” speech, twenty-twenty is not an end, but a beginning, and this pandemic must be a new beginning towards a better and brighter future for all, but especially for the most vulnerable populations. 

As always, thank you for your continued support. 

The last few months have been intense! I am happy to report that our Antigua clinic reopened its doors in mid-June, almost three months after we took the unprecedented decision to suspend most field operations.  It took us a bit longer than expected, and we had some challenges getting all the PPE and other supplies (for example, non-contact thermometers) that were sold out or unavailable in the country. 

Anticipating high demand for services in Antigua, we set up two clinic spaces, where patients are seen by appointment only.  We will gradually reopen the rest of our services.  Next up is the clinic near the Guatemala City dump.  The Ministry of Health has officially approved our clinic license application, giving us the green light to begin services as soon as possible. We are excited that this clinic space will allow us to serve a population living under the harshest of conditions of urban poverty.  We anticipate this clinic will eventually offer services 4 days a week.  

Shortly after will be time for what we are calling “Temporary Clinics”.  This is part of the ‘new normal’ and, as the name states, will be community-based points of services that WINGS will temporarily “take over” one day each week, and where our nurses will offer services.   We are working on agreements with 6 different Health Areas (department-level authority of the Ministry of Health) for a total of 23 clinic sites in Alta Verapaz, Chimaltenango, Suchitepéquez, Totonicapán, Quetzaltenango (highlands and coast), and Huehuetenango. We are evaluating the possibility of an additional 3 clinic sites in Sololá, though the situation around COVID-19 in that department is a bit more difficult for now.  We are also finalizing the purchase of new equipment (including two vehicles) and supplies so that we may have the capacity to operate this way, with smaller teams distributed throughout the country, for at least the rest of the year. 

In August, once (we hope) the curve begins to flatten, we will begin hosting small-scale pop-up clinics.  These clinics will be staffed by one or two nurses and, where transport is required, a driver.  The most critical part here will not be our own willingness or capacity to offer services in rural areas, but whether local leaders will allow us to come into their communities.  Our Field Promotion team will soon begin conversations with Municipal Women’s Offices so that they can help us get “invited” back into communities by local authorities.  We are quite aware of the different dynamics and politics that take place in rural communities, oftentimes not in sync with government mandates, and so we will do our very best to comply with their rules as a way to safeguard our staff.  The last thing we want to be considered is a source of contagion and be kicked out, or worse.       

Finally, some of you may be wondering how we will be able to promote and schedule all these different services.  WINGS Field Promotion team has begun experimenting with new ways to communicate with communities and partners.  One way is through virtual talks and presentations. Another is through radio spots, which we have begun recording in Spanish and some Mayan languages represented within our diverse staff.  Some of these spots will differ from the traditional 30-second commercial spots and will be podcast-style interviews.

As you can imagine, there’s a lot of excitement, but also anxiety and nervousness.  The Executive Team at WINGS has been talking about this with some frequency lately, and we are taking steps to work with our staff on these emotional issues as well.  I am sure that tense moments await us, but if we remain observant, if we communicate in the most truthful and transparent way possible, I know we will thrive.  As long as our WHY remains our northern star, WINGS will be a better, stronger institution, and will be able to provide even better reproductive health services and education to many more vulnerable women, men, and adolescents.

Please keep us in your thoughts in the weeks and months to come.  As we begin reopening we will happily receive all the positive energy and vibes we can get. And as always, thank you for your support!