Leaping the Hurdles In Reproductive Health

Sue Patterson is the founder of WINGS, a reproductive health non-profit organization in Guatemala. She previously served as a Peace Corps volunteer in Colombia and in the U.S. Foreign Service. During her 25 year tenure, she served in Chile, Iran, Guatemala, and Italy. She currently serves on WINGS’ Board of Directors.

How does family planning and reproductive health contribute to poverty alleviation in developing nations like Guatemala?

Sue Patterson, WINGS

Limiting the number of children in a family is critical to reducing poverty. Preventing adolescent pregnancies ensures that more girls stay in school and receive the education they need to improve their job prospects. Birth spacing enables both the mother and each successive child to receive better nourishment during pregnancy. While the mother is breastfeeding, this nourishment is critical for both physical and mental growth in young children.

The issue of good nutrition during a child’s first 1,000 days of life is of utmost importance for preventing physical and mental growth stunting, and reducing vulnerability to contagious diseases. Chronic malnutrition is dire in Guatemala, affecting 50 percent of children under five. Guatemala has the fourth-highest malnutrition rate in the world, according to UNICEF. It also has the highest birth rate and one of the highest rates of maternal mortality in Latin America.

Ultimately, more pregnancies lead to poorer health for mothers and children and less educational investment and opportunities for each child. That, in turn, contributes to the cycle of poverty.

You founded WINGS in 1999. Since then, how have WINGS’ goals and operations grown or changed?

Over the past last seven years, WINGS’ staff has grown from 11 to 44 full-time employees, and our budget has tripled. Our programmatic scope has grown commensurately with this expansion. We now have educational programs targeted at women, men, and adolescents, as well as large subsidies for all contraceptive methods. One of our new programs trains Guatemalan women to advocate for their reproductive rights under Guatemalan law. We also have a strong program aimed at preventing cervical cancer, which is the leading cause of cancer-related deaths for women in Guatemala.

We also extended our programs’ geographic scope to cover a larger portion of Guatemala, with a particular emphasis on low-income, rural and primarily Mayan indigenous communities. We now deliver these services in six Mayan languages, since many rural Guatemalan women do not speak Spanish and our subject matter is a difficult one for indigenous women to talk about.

WINGS also frequently provides capacity building trainings to local NGOs, Guatemalan government representatives, and health service providers.

Reproductive health services tend to be more politicized than other public services, both in the U.S. and internationally. Is this a significant challenge for WINGS? What are the biggest challenges that WINGS faces in implementing its mission?

WINGS faces a wide array of challenges in Guatemala. Tragically, the Guatemalan government has never really understood the importance of family planning in the provision of health care, education, and other services to the Guatemalan people. As a result, the country’s population has grown from 2.9 million in 1950 to over 14.5 million today. In addition, the Catholic Church in Guatemala is very conservative, preaching directly against contraception. Many Evangelical churches preach similar messages. Additional barriers include a lack of knowledge about family planning, geographic isolation, difficulty in accessing methods, and pervasive poverty.

All of this is complicated by common “machismo” attitudes: many men believe that the more children they produce, the more “macho” they are. Many men also believe that their partner’s contraceptive use—or even interest in contraceptive methods—is an indication of infidelity. With indigenous Guatemalans making up half of the country’s population, there are also social-cultural barriers, including the fear of ethnic discrimination and cultural dilution. And there are inevitable linguistic challenges that result in a country with 22 active Mayan languages.

WINGS offers youth and adult-specific programming. How do young people respond to your programs? In what ways do the attitudes or belief systems of young people differ from those of Guatemalan adults?

Our youth program trains young people to become peer educators, which enables them to reach out to family members, community members and others with vital reproductive and sexual health information they otherwise might not receive.

These young people have become leaders in their communities. When they enter our program, they are very timid and shy. Over time, we see these adolescents mature, become more confident, build their communication and teaching skills, and improve their attitudes towards others. Many of the parents of our peer educators have told us they wish they had received the same information when they were younger, saying that it would have changed their lives.

The attitudes of young people in Guatemala do differ from those of adults. Although young people often have the same misconceptions about reproductive and sexual health, once they are exposed to factual information and given clear and accurate explanations, they are more open to questioning old ideas. Many young people express a wish to have fewer children than their parents, and the birth rate in Guatemala is gradually decreasing, from about five children per woman ten years ago to a current rate of four children per woman.

Do you think those differences have implications for Guatemala’s future?

Young people have a more worldly view as a result of TV and the internet. They want more things than their parents did and want to provide a better education to their children than what they received. They see the direct link between the number of children and the ability to achieve these goals. It is heartening, and hopefully, this new generation will make a difference that will keep their country afloat.

You have worked internationally both in diplomacy and development. Where do you see intersections between the two fields and their respective aims?

The principal aim of diplomacy is to protect the national and security interests of the United States. To carry out this mission, diplomats do their best to represent U.S. interests and policy positions abroad, and influence other nations to support them. Our security is endangered by poverty, environmental degradation, water shortages, massive refugee flows, food shortages, and other destabilizing events, no matter where they take place.

Supporting development in underdeveloped countries is a key component of U.S. diplomacy; USAID plays the leading role for the U.S. government in providing development assistance. Developing countries that have a democratic government, a lower birth rate, greater gender equity, a more equitable distribution of income, a more advanced education system, and a higher rate of income generation are much more stable countries and thus, present little or no risk to the United States.

Feature photo:  cc/IMs BILDARKIV

Louise McLarnan
Louise McLarnan is a staff writer for The Review and is an MPP student at the Harris School of Public Policy. She is interested in international development and human capital investment.