I had a choice to make: to eat the unidentifiable cooked insect that was being offered to me or not. I had just arrived at Curamericas Guatemala’s project site in Calhuitz, Guatemala after being picked up at 4:30am and driven up countless mountain switchbacks by the project’s head doctor. Needless to say, charred mystery bug was not my first choice for breakfast. However, the staff had offered it to me and I wanted to make a good first impression, so I went for it. I still have no idea what I ate, but it wasn’t so bad!
This summer, I will be spending 8 weeks in Guatemala working with Curamericas Global and Curamericas Guatemala. In partnership with the Guatemalan Ministry of Health, Curamericas runs five community-operated Casa Maternas (or birthing homes) throughout the rural highlands of Northwestern Guatemala that are open 24-hours a day, seven days a week. Additionally, the Casa Maternas provide a host of maternal and child health services including antenatal care, postpartum visits up to 2 years after birth, adolescent health education groups, and maternal care groups. Curamericas has also developed relationships with comadronas (or midwives) in their partner communities, who often accompany women to the Casa Maternas to give birth. This community-based care model provides women with a space to receive care from skilled medical professionals in a culturally competent setting.
During my first few weeks in Calhuitz, I had the opportunity to go on a 6-month postpartum home visit with a community health educator. After verifying some demographic information with the new mother, Nancy, the community health educator, asked her if she could remember four warning signals for an at-risk pregnancy, postpartum complications, and if her child was sick. I was struck by the interactive and almost quiz-like nature of the home visit. I was reminded that these postpartum visits may be one of the few opportunities that this woman has to learn about her health for future pregnancies and her child’s health. With the nearest hospital almost 4 hours away and often only accessible by a costly ambulance ride, being able to identify when you need to seek care is of the utmost importance.
For my practicum this summer, I am working with Curamericas on a barrier analysis to help the organization better understand what is preventing women in the communities that they serve from using a modern method of family planning. This analysis is designed to assess behavioral determinants within communities in order to create more effective programming to promote behavior change. I have been working with staff to develop a questionnaire for community health educators to take into the field during their postpartum home visits. Part of my job has been to go to each Casa Materna and train the health educators on how to administer the barrier analysis survey. Working with these educators has re-emphasized how difficult and important their work is for the communities they serve. With over 25 different indigenous languages spoken throughout Guatemala, most educators spoke at least three languages and will have to translate the survey into Chuj or Akoteko for the women while recording their responses in Spanish for me to analyze. I was humbled by their willingness to participate in this labor-intensive process on top of their already mountainous workload and their graciousness towards my sometimes clunky Spanish during our training. I was also impressed by their positive attitudes and willingness to let me, a stranger, come and teach them something new.
My favorite moment so far happened during my training last week at the Casa Materna in Santo Domingo. The training had started off a little rocky because the staff had some difficulty understanding my Spanish. Part of the training involved practicing the barrier analysis interview in pairs, with one health educator pretending to be the woman being interviewed and the other conducting the interview. When one of the male health educators pretending to be a woman who wanted to use a modern method of family planning was asked what he thought some disadvantages of using birth control might be, he replied “because sometimes it makes us fat.” We all laughed really hard and the group was more relaxed for the rest of the training.
In the coming weeks, I’m looking forward to more creative responses during our trainings, the data collection process, getting to spend more time with incredible Curamericas Guatemala staff, and eating more delicious tortillas than I thought possible.