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Helping women in Guatemala to stop feeling unworthy

Hebe Llerena
Country Project Coordinator, Guatemala

Ana Loyda Hesse
Health Officer

It’s been almost two years since we first started our activities aiming at raising feelings of self-esteem among Mayan women living in rural areas of Guatemala and this time we’d like to share some of the challenges, struggles and achievements we’ve met along the way.

An initial study gave us a picture in April 2010 – and it was a bleak one. Why did women feel themselves so unworthy in their families and in their own lives? How come they did not know that they have basic rights? A time for serious questioning and action arrived right away: how could we tackle this situation? Where could we start? All we knew was that there are a lot of things to do if we are really to make a change and deliver something useful which could help rural women improve their lives.

We still remember how uncomfortable and suspicious many of the female microcredit clients used to feel at the beginning every time we dropped by their groups to deliver our training workshops on maternal and newborn health. We still remember those eyes and faces kind of asking us: what are you doing here? What are you talking about? Why do I have to waste my time listening to you? And they were absolutely right.

First, never before had they attended education sessions and training workshops of any kind.

Second, words like “self-esteem” and “rights” were so utterly unknown to them that those questions couldn’t feel any less alive.

What to do? For starters, it really surprised us to find that female microcredit clients did not know each other …not even the names of the other women in their groups!! How could this be? Aren’t microcredit group banks supposed to be based on trust? How can they trust somebody they don’t even know?

So we first started breaking the ice with some easy group dynamics and common Guatemalan games such as my favourite fruit, making boats, and gestures which allowed them to introduce themselves and share some of their likes and dislikes in life. Hopefully, these games helped all of us (microcredit clients and project team members) not only to know each others’ names, but most importantly to socialize and feel comfortable around each other.

Next, armed with pots, pans, chopping boards and other kitchen appliances and nutritional yet economic recipes we kick started our family and child nutrition sessions. These were much easier now, not controversial, and yet important, aiming to improve skills and understanding about a healthy and varied nutrition for the family and children.

Traditional Cakchiquel recipes including dobladas de chipilin, tortillas de mosh, torta española (if you don’t know, look them up, they’re yummy!) and others were prepared. Socializing with the women, sharing a good laugh and getting to know them better while starting the fire, preparing and sharing the meals certainly helped us gain acceptance, confidence and eventually trust and eased our work towards more complex topics such as self-esteem.

It really hit us hard to see women’s feelings of unworthiness in life and in society and to witness how this had been sadly and unfairly engraved within them for generations – many times to the extreme of adopting a passive attitude and just letting the injustice or damage happen to them.

Five basic and important beliefs had to be discussed and considered within our groups:

• a) a woman has a value of her own because she is a human being – no matter how stupid or useless or ignorant a husband, father or even a mother may say the woman/wife/daughter is,
• b) they themselves are the most important persons in their own lives – and not their children, husband, and family as they were always taught,
• c) women are not guilty for all the injustices that happen to them – no matter how hard a husband/father or mother may try to blame or accuse,
• d) women should love and accept themselves the way they are – and not feel shame about their ethnicity or colour of skin, and
• e) women should not repeat the same mistakes or mistreatments with their daughters and sons – no more damaging daughter’s and son’s self-esteem with comments like Stupid girl! You cannot do anything right!

After a number of sessions these concepts have started to really sink in, raise questions and stir new thoughts. This has allowed us the first step towards changing women’s’ inner “unworthiness chip” and building a more solid and empathic relationship with them, which enabled us to tackle more serious topics such as sexual and reproductive health (S&R) and family planning (FP).

We knew there were many misconceptions and misunderstandings regarding S&R and FP topics as they are considered “taboo” in many rural communities. We still remember how some of the women (and men) used to blush, feel ashamed, and look down when talking about reproductive systems and genitals. But images had to be displayed, organs had to be called by their names, and women and men had to know their own bodies correctly if we were to address misconceptions.

We had to strive hard to deliver clear, useful, true messages without hurting sensibilities of any kind. All of the FP methods were explained in detail and advantages and disadvantages clearly and easily spelled out so that each of the women and men could have an accurate idea of which method was best for them and their partner. Teaching with respect for our groups’ views and thoughts (no matter how inaccurate or outlandish they might have sounded to us at first) and with simple vocabulary eased the tension and allowed us to break through the resistance. Newly attained knowledge continues to be assessed and refreshed with dynamic techniques and materials.

We are currently focusing on respiratory and diarrheal diseases as they are the principal causes of death among children under five in these villages. Women and men learn how the disease or infection starts and develops and how it should be prevented or treated. Like with child nutrition, practical application of knowledge attained is always encouraged and demonstration of preparation of oral saline solutions at home was no exception.
As has been the case to date, all of our dynamics and learning methodologies (story telling, games) and training materials (puzzles, roulettes, drawings) are not only adapted to our groups’ knowledge and learning needs and interests, but always aiming to raise expectations and hunger for further learning and knowledge.

Watching the women feeling more assertive and confident of themselves is definitely our best prize so far. Hearing them say they are now aware of new information which they can fearlessly share with their daughters and granddaughters is, for us, truly inspiring.

Seeing Mayan women’s eagerness to learn more and more despite all of the other demands on their time and energy is also our most sincere call at work, as it makes us dream and believe how simple life and society could be if we were all to have the same freedoms and liberties.

Women and their families in the Dominican Republic have new knowledge and skills to run businesses and stay healthy.

In Peru our mobile clinics have given quality medical attention to tens of thousands living in remote villages.

And in Guatemala we have trained midwives to safely deliver newborns and have helped women to strengthen their own “micro” businesses for greater independence.

All of these are your successes as the supporters who sustain this vital work. So thank you.

But there have been challenges for us as well. During these tough economic times when the needs of women in the developing world are so great, donations have been harder to come by than ever before for us. If you can, at this critical time, please show your support for a woman in the Dominican Republic, Peru, or Guatemala as a present to someone who has helped you, or just as a general gift.

Thank you again for what you do for women and their communities. We at Impact First wish you a happy and safe holiday season and a wonderful 2012!

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Transparency?

The Ontario Council for International Cooperation (OCIC) (which, if you are involved in the non-profit sector as a student or professional, you need to become a member of!) recently asked me to write a description of some good practices at Impact First related to the Istanbul Principles on CSO Development Effectiveness.

These principles have been developed by Civil Society Organizations (a term we don’t hear too often in Canada but intending to refer to organizations like Impact First and many other types as well!). In particular, I was asked to write about what Impact First does with respect to the 5th Istanbul Principle – Transparency and Accountability.

Here was my first crack at it:

“This principal is key but one that many organizations continue to struggle with. If they tell you otherwise it may just mean they’re not very transparent! Transparency and accountability start within an organization. Everyone needs to be brought on to a more or less equal playing field. Your communications team needs to know the truth about the struggles you’re having with a certain project before they go out and talk to donors about it! Your field officers should know the truth about how things work at head office.

“This is not easy, and there is also the need for discretion and privacy. At the end of the day, knowledge and information need to be shared and not buried. At Impact First we, together with our partners, are constantly striving to improve our culture of learning and growth, to respond to community needs as well as critiques, and to admit our past mistakes so that we don’t repeat them.”

But that was way too long, since this needed to fit on a small banner for OCIC’s website.

Here was attempt #2:

“At Impact First we build transparency and accountability from within. Our staff and volunteers are entrusted both with information about our successes and about our short-comings. We work with our partners to ensure that the public, and especially our beneficiaries, can get an honest and well rounded understanding of what we do.”

There was lots more that I wanted to add to both of these descriptions though. They both weren’t able to convey very much and felt really limited.

OCIC suggested that we try again, but with something more specific to Impact First.

So I got asked a few questions to help me out:

1. “Our staff and volunteers are entrusted both with information about our successes and about our short-comings.”
a. How is this info shared? AGM/annual report/meetings/website/etc.? How often?
b. Do you have a formal structure/policy as to how this is all shared?
c. Do staff and volunteers participate in M&E?

2. “We work with our partners to ensure that the public, and especially our beneficiaries, can get an honest and well rounded understanding of what we do.”
a. Through what means?

Here were my thoughts:

“I have to say it’s a pretty tricky assignment to try to get an understanding of the concrete ways in which any NGO ensures transparency and accountability at a length that can fit on a graphic for a website! Maybe a more marketing-minded person would have an easier time with this than I do. But honestly, it is kind of ironic almost, because to me transparency means explaining the details and nuances of situations, not just the short ‘slogan’ or ‘sound bite’ that marketing folks are so good at. So this very format that is being used to share my comments goes against transparency in many ways!

1. Transparency among staff and volunteers isn’t hard for Impact First because we are so small. What would be hard would be keeping information secret! It is also my general philosophy that people need to learn from mistakes and that anyone volunteering or working with us should have that opportunity. So for example, if there’s a problem with one of our partners, I will let our volunteers know the basics about that situation just so that in their future careers they don’t repeat those problems or if those things arise they are better prepaired.

So basically the information sharing mechanisms are just informal conversations that happen as lessons arise from our work. There are no formal structures around this sharing since we are so small. There are policies but for our size of organization they aren’t really what drives transparency in practice, they just formalize our philosophies so that if there’s turnover the ‘culture’ of transparency won’t get lost.

2. We hold annual planning meetings for our projects in beneficiary communities to openly share information, get feedback, and orient future work.”

The process of deciding the final wording is still on-going. I am giving the poor folks at OCIC headaches by now I’m sure! But I thought, what better way to walk the talk of transparency than to throw these issues up on our blog and open them to your consideration.

So for now I’ll leave you with this:

What are transparency and accountability really about? How can non-profits make them happen in practice? What more would you like to see from Impact First in this regard? How can we do a better job at of embodying this principle?

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Boosting the Skills of Indigenous Midwives in Rural Guatemala Pt. 2

Hebe Llerena
Country Project Coordinator, Guatemala

When we set out at Impact First to train a group of new traditional midwives in Guatemala we had a training plan, but it needed to be adapted for the reality of the situation.

A number of challenges had to be tackled in order to guarantee success for these eager-to-learn women. Some lacked self-confidence, having never had an opportunity like this to participate in professional training. Some faced jealousy and envy from existing midwives (and their reluctance to share their knowledge and practices). Some were illiterate (and felt the frustration and lack of confidence illiteracy usually brings). Some had jealous husbands (not permitting any extra time for literacy or midwifery lessons). Some grew discouraged when it seemed like there was too much new information and they would never learn it.

It was clear: bold, innovative, and effective strategic decisions and actions had to be taken if useful and groundbreaking results were to be delivered.

From initial knowledge assessment to tailor-made training programs, from more intensive 5 hour training sessions to the first ever mentorships among existing and would-be midwives, fresh approaches were taken to training Guatemalan midwives. We increased the number of hands-on practice sessions from the typical 2 to 10; we made self-esteem trainings a key component of each module. And we helped midwives to understand and define their roles: those of leaders, counsellors, supporters, and educators (on health practices, family planning, preparing for medical emergencies).

Through persistence and various meetings with the local Ministry of Health, the newly trained midwives were eventually granted permission to observe deliveries at the National Hospital of Chimaltenango (the highest level hospital in the area) to reinforce their hands-on practice sessions. All of the work involved in getting this permission paid off!

Newly trained midwives had the opportunity to:

• work with mothers expecting to deliver
• observe traumatic deliveries such as anencephaly (babies born missing a large part of the brain) and complicated caesareans
• work with single mothers experiencing depression and despair (in Guatemala access to mental health and counselling services is limited so this is another role midwives must learn to play)
• receive newborns under the supervision of doctors at the hospital
• assist nurses and doctors when translating from Spanish to the Mayan language Cakchiquel
• learn from the inside what the delivery ward is like where most pregnant women suffering from high-risk/emergency situations are referred



• feel respected as skilled and important to the Guatemalan health system

Together Impact First’s team has not only closed the gap between the theoretical teaching and the clinical reality and delivered a major improvement in midwife training. Most importantly, we have focused at the community level with the belief that improving the quality of care there is the first step to ensuring healthier women and children.

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Boosting the Skills of Indigenous Midwives in Rural Guatemala Pt. 1

Hebe Llerena
Country Project Coordinator, Guatemala

Qualified and well-trained traditional midwives are critical to hard-to-reach rural communities in Guatemala.

Because they are at the front lines from the very beginning of life, they are the first to manage health needs of women and newborns. They have a major and traditionally recognized importance within Mayan cultures. Because they show no fear when facing patriarchal situations, both at women’s homes and within communities, they are the first to promote gender equality and women’s empowerment. They are usually the first to offer psychological support to pregnant mothers, an invaluable assistance when mothers’ self-esteem is damaged. Midwives are also the first to raise awareness about care during pregnancy, healthy sexual practices, and family planning – all highly needed help for women who routinely have their rights denied.

Well-trained traditional midwives are the cornerstone when talking about community health, as the vast majority of women in rural Mayan communities continue to prefer giving birth at home. Midwives are therefore the first to provide routine care during uneventful deliveries, the first to identify and manage complications of childbirth before they become life threatening. Should a delivery turn into a real life-threatening situation, midwives are ready to provide decisive assistance and aid (especially at late hours as is usually the case with emergencies), implementing emergency plans. If midwives cannot manage such emergency/high-risk/life-threatening situations, they are the first to provide immediate referrals to hospitals or better prepared health providers.

However, qualified and well-trained traditional midwives are tremendously scarce.

According to a recent report from the international donor and research community, quality education and training, effective regulatory frameworks, and functional midwife associations are all of critical importance.

On top of these factors which are all interrelated and interdependent, Impact First’s breakthrough in training delivery and the results achieved on the ground confirm and make us believe that quality education and training satisfying both theoretical knowledge and hands-on practice needs or deficiencies are definitely the bases for success, as they are the starting points for skilled midwifery practice.

Eight new midwives recently graduated from training by Impact First in San Martin Jilotepeque as part of our Rural Guatemala Hope Project – a province-wide achievement which had not taken place for the last 12 years. They are: María Paulina Armira, Fernanda Atz López, Rosa de María Guerra, María Cirila Culajay, Rosario Camey González, Sara Elizabeth Chocoj, Alejandra Gomez and Balbina Lorenzo.

Tomorrow I will explain the rocky road to becoming (and to training!) a midwife and some of the things I learned along the way.

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Student Questions Pt.2

Note: read yesterday’s blog first if you haven’t already, then go for this one.

3) In your workshop, you mentioned that ‘microfinance is not for everybody – those who do not qualify for microfinance will end up dropping out, and therefore, they are the ones with the greatest needs’. How have you tackled this issue?

It is not an easy one for sure. Our program is not reaching the destitute, that is, homeless people, or those with zero assets. In the communities we have focused on, which are tiny villages, everyone at least has shelter and food, so they are at a place where they have the basics and can start thinking about a micro-business. In fact, they all pretty much have micro-businesses anyway, but we help them to grow and diversify.

Of course we also are working to make sure they have new knowledge about running a business, staying healthy, and access to key services. If you’re interested in how to work with the extremely poor I suggest that you look into the work being done by Fonkoze in Haiti. From their reports it sounds like a very interesting model for a context that is very different from the ones where Impact First works.

4) As an implementer of microfiance, how have you built trust with your clients?

Hire local staff. Really local. People don’t realize that not only might it be a better idea to not have a Canadian running everything, it might even be better to not have a Guatemalan from the nearest city. That person doesn’t have anything to do with a woman in the countryside regularly, so there can be additional challenges there, even if they are subtle ones.

We hire loan promoters who are indigenous women, who dress the same as our clients, speak the languages, have only a slightly higher level of education than our average client, and can just generally put people at ease. In many communities where we work there is a rightful mistrust of foreigners. These are people who may have been taken advantage of by resource extraction companies, other NGOs that haven’t done a good job in the past, government programs that they don’t want or value. So we have to fight past a lot of baggage before we can even think about actually giving out the first microcredits. But we have had great fortune with our clients. They are extremely diligent and responsible. They take our work seriously and do their part. And again, that all happens because we take time at the beginning to make sure the situation is right for microfinance.

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Student Questions

I often get university students wanting to interview me for an international development or political science class project. So when this happened yesterday I had the idea, “Here is some honest dialogue, it might be interesting to others too.” So today and tomorrow I will post in blog entries with the some questions about microcredit and my answers:

1) What has made you contribute to microfinance? How did you get into this field?

A mixture of personal interest and chance. When I finished my undergrad I applied for a bunch of different stuff. After a few weeks I got restless and bought a one way ticket to Scotland. One day I got a call about a CIDA internship that I had almost forgotten applying for. A few weeks later I was living in rural Guatemala and seeing microfinance for the first time. To be honest, at the time I was more interested in Guatemala than in the microfinance, but I had heard good things so I definitely wanted to learn all I could about it too. Over my time there I saw some great “successes”, as well as a number of “failures”. You learn a lot from both of course. That internship led to other jobs in community development in Latin America and eventually led me to Impact First International. This is where I have learned more about Microfinance Plus – offering a bunch of other services to microcredit clients to fight poverty on multiple fronts. I am convinced, from everything I’ve seen in the field over the last few years, of the value and cost-effectiveness of this strategy.

2) What are the most rewarding and challenging areas in your career, respectively?

The single most rewarding thing is to visit a group of women who are running their own meeting. These are skills they didn’t have just a year or two before, and it’s exciting to see them begin to assert themselves more! This is a true pleasure.

It is challenging that everything at a smaller NGO like Impact First is about… money! There are so many great things we can do but resources are always a concern for us. I have a great deal of respect for my colleagues who are fundraisers. Honestly and ethically creating messages that will engage donors is a real art! But that is not my personal passion, although I know how important it is. Way more of my time than I would ideally like gets dedicated to that area though. On the other hand, it is a great opportunity, working at a smaller NGO. You get to multitask and develop professionally in a diverse range of areas. That is something the big charities don’t offer you as much. Also there is no real office politics and backstabbing to worry about when you are such a small team, which is a definite plus!

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The experience of training a health promoter in rural Guatemala

Ana Loyda Hesse
Health Officer

Ana Loyda Hesse is a registered nurse and part of Impact First’s local team in Guatemala. Among Ana Loyda’s duties is the training of traditional midwives and community Health Promoters (called “Health Guardians”). Health Guardians have a range of responsibilities including helping with childhood vaccination campaigns, stocking of local Health Posts (the most basic access point for attention offered the Guatemalan Ministry of Health), watching out for signs of malnutrition and other childhood and community health problems, and providing trainings and referrals to improve good health practices in a wide range of areas and to combat prevalent destructive behaviours like domestic violence.

Bags full of hope and a strong desire to learn and to help their communities was all they brought to the classroom on their first day of training as community “Health Guardians” (Guardianes de Salud) last October. Describing each of these 12 trainees would take a long time. Suffice it to say, they had were all very different from one another: some being outgoing and bold, others with the usual shyness of rural Mayan women from my country. More than 10 years without note-taking, reading books, or attending classes at school meant that their eagerness to learn was the only thing they had in common. And yet, there they were pushing me as the trainer to give them more than just the health related lectures we had planned.

I had the opportunity to initiate the process of their training as Community Health Guardians by teaching them some basic health-related concepts and their roles within their respective communities. And in so doing, I learned that what we know from personal experience is priceless and has no comparison. Together we discovered how important it is to value and respect community habits and traditions – something they had to learn very well if they were to promote change.

We can't develop our communities until we trust each other

In terms of health, respect for good habits and traditions within communities and elimination of those behaviours which are harmful were subjects stressed during trainings. They learned that they had to act very respectfully in case some traditions had to be eliminated from their communities, and they learned they had to do it by educating and demonstrating to their people why such harmful practices had to be eliminated – not just by imposing change.

I believe this initiative, jointly designed by Impact First and the local Guatemalan Ministry of Health succeeded in reaching the right group of people with the abilities and skills needed in order to offer solutions within their own communities. I say this not because I was the trainer and not because of what was taught to them throughout the trainings. I say this because I sincerely believe that these 12 people who graduated as Health Guardians in May 2011 do have a special commitment and a special value for their communities. It could be witnessed every Tuesday and every Thursday when 10 female Health Guardians had to leave their household chores and their sons and daughters at home, and 2 male Health Guardians had to leave their farming (and the day’s pay) to come to the nearest town and attend lectures and workshops for 5 hours. Why? What for? Just to learn how to serve their communities with quality and warmth.

Ana Loyda and one of the new Health Promoters at the graduation ceremony

Having the courage to start from scratch and graduating with their heads held high, being recognized by community leaders as real drivers of change in each and every location where they will operate, is just another proof of their dedication.

Hearing the Health Guardians express how they feel empowered by their new responsibilities, and seeing them anxious to serve, does give me some personal satisfaction. However, learning that my knowledge does not have much value if I don´t apply it in my life in the benefit of others is definitely the best lesson I got during this training process.

As a Guatemalan woman I know we have many limitations in my country, and this group of newly trained Health Guardians in San Martin Jilotepeque has taught me these limitations are only opportunities to go out and fight for the betterment of our communities.

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“So what do you do?”

I went to a conference in the US about a month ago and certain events there got me thinking about the non-profit sector and the state of international development. It started like this:

I pulled up at the border and the rolled down my window.

Border Patrol Guard: “Where are you going?”

Me: “To New Haven Connecticut.”

Border Patrol Guard: “And what are you going to do there?”

Me: “I’m going to a conference.”

“What kind of conference?”

“A global health conference.”

“A what? What do you do for work?”

“I work for an international NGO.”

“A what?”

“An international non-governmental organization.”

“Isn’t that just called ‘a business’?”

“Not exactly. We’re a charity.” [In fact charities are still registered businesses but I didn't want to get into all the nuances right now.]

“So what do you do?”

“We do health programming in developing countries.” [I didn't want to mention microcredit because I suspected that would require more explanations and it was a simpler task to stick to "health programming".]

“I don’t get it, what exactly do you do?”

“We provide services to poor women.” [I don't like the term "poor" because it isn't easy to define and in many ways the women we serve may be richer than a lot of financial-resource-wealthy Canadians but I use the word in cases like this because it holds popular meaning.]

Boarder Patrol Guard with a very perplexed look: “I’m running out of questions here. I still don’t understand what you guys do.”

“It’s a charity.”

“I’m not that good on charities…”

“OK. Well we give basic health education and health services to women in developing countries. Does that work?”

“Yeah sure. Go ahead. Keep up the good work.”

In the old saying, the field of “rocket science” is used as something foreign and confusing, even the basics of which the average person would not be able to comprehend. It’s scary and it’s so remote that we can do nothing with the term but chuckle at it and scratch our heads.

I found the above interaction so interesting for the simple reason that I don’t think of Impact First as any of these things. But here was someone who clearly did, and this was no act just because he was required to ask me questions. In fact, his reaction to what I was telling him only became fully clear because he was required to keep asking me questions. If this interaction had started in a social setting he would have dropped it and pretended to understand what I do a lot earlier on.

The world of difference which existed between what I was trying to tell this gentleman, and what he was hearing, seemed immense. And frustrating.

This brought me back to a topic I often consider with respect to our sector, and more specifically the work of Impact First International. Do people “get it”? And if so, what do they get? What are the key differences between us as an international NGO or a not-for-profit, and other businesses that people seem to “get” more readily? Is it really just that I didn’t use the right words in this conversation, or do the challenges with understanding international development run much deeper?

In many ways it seems that the non-profit sector can tend towards not only its own vocabulary, but also its own symbols, and ways of doing things which may confuse and alienate those on the outside.

This was a theme which also came up multiple times at the conference that weekend. I heard engineers and graphic designers complain about the challenges of dialoguing with people in the non-profit sector. They stressed the need for new collaborations – bringing different processes and working styles together to achieve synergies. There were also a number of examples of apparently successful uses of social business models. Maybe we aren’t so different after all!

In fact, at Impact First, we help women to strengthen and diversify their own small businesses. These are women who seek to make profits (but at a very local and responsible level). And they do pay interest on their microcredits, which helps support the program’s administrative structure and to pay for additional services like health education sessions and medical attention. This is one way in which, if done very carefully – responding to women’s needs and tailoring services to each community – sustainable and effective development can be achieved.

It is the responsibility of each of us to be open to new learning and collaboration with people from different professional backgrounds and with distinct expertise. I think that international NGOs can and should do a lot more to spread accurate and transparent information about our work. What works, and yes, even what doesn’t, because in practice, not everything succeeds! True story.

I continue to do my best to meet the challenges of communicating the realities of international development as I see them. I firmly believe that we can be honest and not oversimplify diverse situations. We can express how important and viable organizations like Impact First are, through language that people who may never have been to a developing country can both understand and find engaging.

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Clinging to Life

Hebe Llerena
Country Project Coordinator, Guatemala

Rural Guatemala is full of contrasts.

Poverty stricken communities lie in all four directions – and yet, women and men do not seem to be afraid. A fragile situation where not being able to afford even the basics like thin tortillas and plenty of light-brown coloured cups of instant coffee just to trick empty stomachs become mothers’ greatest fears. And yet, many of the mothers carry their everyday battle with bravery and hope, and on their own.

Mayan women in rural areas, treated as second class citizens (and to whom anything can be done as their rights are openly denied), are in fact often the strongest and smartest. For rural Mayan women breadwinners and heads of households face their struggle and carry their back-breaking jobs with no literacy or education (yet, they calculate and return change faster than a calculator); with no economic resources (yet, they are productive and pay taxes); with no business training/support/services (yet, they dare and risk, learn how to manage a micro-business on the run, innovate, and generate employment for others in their communities); with no notions of self-esteem – yet, they carry life standing tall and brave; and, on top of it all, under life-threatening conditions (many times caused by deplorable domestic violence and male dominance) – and yet, what else is left for them?

Keeping faith and hope strong in spite of injustice, oppression, discrimination, and so many adverse circumstances is definitely the most striking and touching (and yet, painful and upsetting and frustrating, for all the impotence one feels when witnessing situations like these) contrast of all in rural Guatemala. Though the strategy of dreaming may be considered as a human attitude/reaction in search of survival, it is many times sad (and yet, moving) to see that women follow this instinct the most.

Impact First International’s “Rural Guatemala Hope project” builds on this female strength and nature, as it is based on the simple idea of complementing microcredit with basic health education and services in order to catalyze a stronger and more sustainable change for women and their families.

Microcredit does give a woman the starting point towards economic independence – for herself and for her family. The thing is that in her struggle for a better economic situation, she easily forgets about herself and about her health and dedicates all of her back-breaking efforts to the welfare of her children, husband, and the rest of her family – her greatest dream and best of hopes.

The sad thing is that in denying herself, and postponing her health, she many times falls sick and suffers in silence (CAD $3 is better spent on children’s food and not doctor’s fees).

Impact First’s Rural Guatemala Hope project strives to tackle this vicious cycle by improving the health status and well being of women and their families. Our stepping stones to date include the following:

• 246.000 people accessing quality basic health care services within their remote rural areas, and benefiting from a more precise attention and treatment due to light medical equipment (such as nebulizers, fetal doplers and glucometers) being used for the first time in these rural parts of Guatemala.

• Health Guardians trained and reaching remote previously unattended, and delivering healthcare services including assistance during health/vaccinations campaigns; active search of children under 5 with signs of malnutrition; proactive diagnosis (people suffering with infections, etc.); first aid assistance; family planning counseling; domestic violence prevention assistance; etc.

• New midwives and Health Guardians driving change as social leaders, helping to ensure the existence and implementation of health emergency plans within communities – a crucial strategy which had lapsed into disuse in all of these communities.

• Women learning for the first time that they have human rights and sexual rights including the right to say “no” and to decide the number of children they’d like to have, and when.

• Women becoming aware that no one has the right to make them feel guilty, useless or ugly.

Achieving each and all of these results has not been easy or smooth. Producing deep changes around sexual rights, women’s rights and self-esteem has indeed demanded a lot of effort – as these were unknown concepts when the project began. “El derecho a la cocina” (the right to the kitchen, i.e. the “right” to clean, cook, wash, keep the kitchen and house tidy), as one Mayan woman put it when asked what women’s rights she knew or heard of, was all she knew and the way it’s always been…

Personally, I must say I try to learn a lot from these hard-working women. The sacrifices they make in their own lives just to fight for their children – as a woman’s children are reflections of herself and life in generations to come – are very moving. And we must continue every effort to support the leadership that brave women like these take, to awaken this inner survival instinct we tend to lose in our comfortable lives.

Getting that human nature instinct back will benefit us all: in this case, Mayan mothers being able to change their daughters’ destinies (the right to the kitchen is no more), and ourselves by making of our lives something better and more meaningful.