Hi all! Our names are Rachel Dihle & Christina Li. Rachel is a 2nd year Clinical Nurse Leader student at the University of Virginia and Christina just graduated from UVA with a degree in Psychology. We are working on a project here in Guatemala regarding perceptions of Mayan women and their reproductive health. We have been here in Guatemala for a little over three weeks now. For the first three weeks, we spent our time in Xela, Quetzaltenango loving Spanish school at Celas Maya. While at Celas Maya we were able to study hard to improve our Spanish significantly, as well as learn about the culture here in Guatemala. Jessica (our in-country program director) and Amanda (who works with Jessica) were able to give us great insight and information about the culture and health within Guatemala as well as help tremendously with the formulation of our survey.
Celas Maya Days
We arrived at the Lake Atitlan Region to begin our project a few days ago and met with our mentor, Leticia, today to formulate a plan for our research. We will be traveling to 5-6 different cities around the lake within the next 2-3 weeks to discuss reproductive health with individual Mayan women. Our current mission statement is as follows:
“Within our research project on women’s reproductive health in Guatemala, we hope to survey individual women directly to gain knowledge regarding what kinds of education, services, and access to treatment they have received within the reproductive health care system. Through this, we are striving to compare the information received from women with what is said to be offered by organizations in order to understand if the services offered by organizations are being utilized and/or understood by women, and whether there are services that women would like to receive that are not available.”
A little history regarding women’s health in Guatemala:
Women around the world, specifically in the developing world, struggle to find information and access to reproductive health resources. Guatemala is the most populous country in Central America and the country continues to have a high fertility rate (an average of 3.6 children per mother, 4.5 for indigenous women) and one of the highest infant mortality rates in Latin America. The high rates of infant mortality are impacted by the high fertility rate, low levels of education, limited access to information about reproductive health, the relatively lower percentage of women who use a form of family planning (54.1%), and the percentage of women with an unmet need for family planning services (20.6%).
The fertility rate remains high particularly in indigenous communities because of many long-standing cultural customs that male household heads with many sons are highly regarded by community members and males will often abandon their female spouses for seeking family planning services. Women have long been in a subordinate position in Guatemalan culture and continue to lack decision-making abilities because of the ‘machismo’ (male dominant) aspect of the culture. Civil war and decades of political and social turmoil have lead to many human rights issues in Guatemala with violence against women and the social stratification impacting the indigenous population being important and ongoing challenges for the developing nation. Many Guatemalans are also influenced by religious beliefs with the majority of the population practicing Roman Catholicism, Protestanism, or traditional Mayan beliefs. Many individuals see high fertility as a blessing and do not believe in family planning methods due to religion.
The literature has studied the lack of family planning resources available in Guatemala with a specific focus on the rural and indigenous community. However, Guatemala also lacks services in other realms of women’s reproductive health (WRH) including unsafe abortions, early disease prevention and screening (including cervical, uterine, mammarian, and STIs), maternal and infant health, as well as intimate partner violence and abuse. Reproductive health services fall under the Ministry of Health’s Maternal and Infant Program but remain limited and focus mostly on prenatal, birth, and postnatal care. The public healthcare system is divided into three levels: hospitals, health centers, and health posts with hospitals being the largest with only one or two per region. For example in terms of disease prevention and diagnosis, pap smear tests to detect cervical and uterine cancer are available outside of hospital, but testing for sexually transmitted infections are only available in health centers and hospitals. Breast cancer screening is also limited and is only available in hospitals. Access to these very important tests is not widely available and even more geographically limited to indigenous population who do not have the resources to travel to hospitals.
The University of Virginia-Guatemala Initiative (UVA-GI) has been collaborating with several towns in the Lake Atitlan region of Guatemala inhabited by people of Mayan descent over the years. Most of the indigenous populations in the area that we will be studying receive their care from the small health posts, which do not provide many of the essential reproductive health services women need and access to contraception and family planning facilities is limited by distance and lack of information. We have developed a survey that we will begin administering orally to women tomorrow with the help of Letecia. We are very excited! We will post another blog with the results of our project! Hasta Pronto!
Rachel at Volcán Tajumulco
Christina at Monterrico