Prevent and Detect Cervical Cancer in Guatemala

WINGS has provided 57,132 cervical cancer screenings since 2001. While we are beginning to see that more women know such a screening exists and are interested in getting screened, we are always challenged with two aspects of Guatemalan culture: religious conservatism and ubiquitous machismo. Our staff recently was reminded of these hurdles in two specific situations.

For the last year, WINGS has partnered with a large and well-established local banana farm to offer twice monthly cervical cancer screening to their numerous female employees and female family members. The farm owner requested that we only provide cervical cancer screenings and not offer any other reproductive health services. Each time we arrived for these clinic days, we were welcomed and we had hoped that as we gained this farm owner’s trust, we might eventually be allowed to offer additional reproductive health services to the employees and their families. This hope was halted rather abruptly this fall when conservative family members insisted that the owner cut ties with WINGS.

Thanks to encouragement from other non-profit groups and community members, we are currently working cautiously to re-establish the relationship.

In November, we met Luisa Maria, a 27 year-old mother of three who came to a WINGS mobile clinic to get an IUD (intrauterine device). As with every long-acting contraceptive method we provide, we offered to screen Luisa Maria for cervical cancer for free. While she did not have any symptoms that might have concerned her, she agreed, noting that it had been 4 years since her last screening. She was surprised to learn that her cervix showed abnormal cells that were too advanced to treat with cryotherapy treatment and we would have to refer her for colposcopy. As we explained all of this to her and answered her questions, her husband, who was waiting outside the clinic with their youngest child, became increasingly agitated and impatient. When he demanded that his wife leave the clinic because she was taking too long, our staff stepped in to calm him.

Luisa Maria’s case is one that we see often. Many of our patients come to us not only without the support of their partner, but often with resistance from their partner. This resistance is usually expressed in some form of machismo and can be an unsurmountable barrier. WINGS works every day to educate and empower women to have a voice in their own health and decision making.

We are so grateful to you for supporting WINGS and the work we do to confront these and other challenges. ¡Gracias!

As the Medical Director for WINGS Guatemala, I have the opportunity to talk with other medical providers in Guatemala about the incredible work that we accomplish as a relatively small NGO (non-governmental organization). Recently I participated in a forum with various organizations working in cervical cancer detection and prevention. During this gathering, we discussed trends that we are seeing in the field and strategies that we have used with success.

WINGS uses a screening procedure called VIA (visual inspection with acetic acid) which gives immediate results in the field and allows us to treat positive cases with same-day cryotherapy. We use this process because of its low cost and its rapid results. Many of our patients travel long distances to reach us and we know that requiring them to come back in a few days or even weeks to get lab results would be nearly impossible. VIA has been shown to be as sensitive as a pap smear in detecting abnormal cervical cells. For any cases that show more significant abnormalities than we can treat, we make referrals for colposcopies or treatment as needed.

One of the more remarkable pieces of data that arose during our recent forum was that many medical providers are seeing fewer positive cases of abnormal cells. We are interested to see if this decrease is simply a momentary dip or if the data will eventually show that cases of cervical cancer are truly declining in Guatemala.

From January to July of 2017, WINGS screened 2,431 women for cervical cancer with 64 positive results or 2.63%. These results are in line with what we would expect for the normal range of positive screenings, however, they do show a slight decline from last year.

We will keep you posted on the results that we see in the field and hope that you will continue to support the work we are doing to save women’s lives in Guatemala.