Sunday, November 15, 2009

Healthy Schools Programs


Through the Healthy Schools Program, Primeros Pasos brings health care and health education to rural schools and day care centers in the communities we serve.

Each day, a class from one of the schools we serve arrives at the clinic. The children each receive a medical and dental check-up and participate in an exciting and interactive health education program. The day not only provides students with immediate clinical care, but also tools for bettering their hygiene habits and preventative measures to improve their quality of life.


For more on health promoting schools, visit



Tuesday, November 10, 2009

How To Help


5 Quick Steps to Get Involved

Helping Primeros Pasos is easy- here are 5 quick and easy
steps you can take right now to support Primeros Pasos.
  • Join Five Times Five Hundred
  • Become a "Fan" of Primeros Pasos on Facebook
  • Join the Primeros Pasos "Cause" on Facebook and use it to "donate your birthday" to Primeros Pasos
  • Send an email to the Inter-American Health Alliance (if you live in the U.S.) or Primeros Pasos (if you live outside of the U.S.) to find out about fundraising opportunities.

Through the Inter-American Health Alliance/Primeros Pasos partnership, donors from the United States will receive tax-exemption as IAHA is a 501(c)3 non-profit.

Saturday, October 31, 2009

Primeros Pasos Women's Clinic- Part 2

Danielle Dittrich

News travels fast in small rural communities, and the word about the women’s clinic is quickly getting around. Women from the community women’s groups have been bringing their sisters, daughters and neighbors. Each patient exam has been taking about an hour, as it includes a full history and physical. The appointment also includes an explanation of female anatomy, how a Pap smear is preformed, and how it is used to check for the changes caused by human-papilloma virus (HPV) which can cause cervical cancer. Many of the patients have never had a pelvic exam or Pap smear so teaching has become a large part of every appointment.

Primeros Pasos’s mission includes increasing education about methods of disease prevention. Though it is common practice that Guatemalans only come to the clinic once already very ill, Primeros Pasos women’s education program is doing a great job promoting wellness and annual check-ups. Some patients have come in for symptoms of anemia related to heavy and irregular menstrual bleeding, however many healthy feeling women have come in specifically for their Pap smear and annual physical. Currently, the Primeros Pasos clinic has the ability to process a handful of laboratory tests in house. Unfortunately, the Pap smear is not one of them. Where as many of Primeros Pasos volunteers are being trained to identify intestinal parasites from stool samples, or run different blood tests, a Pap smear slide must be read by a trained cytopathologist. Therefore, the Pap smears are being processed at a lab in the city of Xela. Once a week I take my bundle of Pap smears to the lab in the city. Each Pap smear costs 25 Quetzales, which is about the equivalent of three American dollars. It’s amazing how three dollars can make such a difference in the lives of these women.

Cervical Cancer has been the hot topic the last two weeks. Rightfully so, as it deserves a lot more attention than it ever gets. In the United States, we almost never hear of deaths from cervical cancer because we have so many methods of early detection already in place. However, according to the American Cancer Society global cancer statistics report (2002), cervical cancer is the second most common cancer among women worldwide. In select countries, such as Guatemala, cervical cancer ranks even higher as the number one cancer among women with a reported rate of less than 10% of women receiving regular screening (Ministry of Public Health and Social Aid of Guatemala, 2003). Many myths and misconceptions about cervical cancer exist in the rural communities. The last two weeks I have helped teach phase two of the women’s education curriculum, which focuses on women’s health issues such as uterine, ovarian and cervical cancer. In the past many, most women have lumped all the aforementioned together as the same “women’s cancer” that is rarely spoken about due to fear and stigma. Through the women’s education program, the myths around cervical cancer are slowly being unraveled and addressed.

The patients are not the only ones inquiring about cervical cancer. The buzz among the Guatemalan medical students prompted a lunch lecture dedicated specifically to the topic. Upon request, I will now be running a weekly lunch lecture on the essentials of obstetrics and gynecology. The new group of medical students is inquisitive and hard-working. They have already made huge leaps and bounds in their time at the clinic. I am working closely with the two female medical students to teach them to perform women’s health exams. It is very culturally taboo for females to be treated by male healthcare providers for any issues related to women’s health or pregnancy. So although I am foreign, my presence is accepted because I am female. Each day I hope to slowly build my patients’ trust, which is the biggest thing that you can ask for as a foreigner in the Valley of Palajunoj, in a country like Guatemala that is still feeling the aftermath and distrust of a 36 year civil war.

Wednesday, October 28, 2009

Women's Clinic at Primeros Pasos

by Danielle Dittrich
Vanderbilt School of Nursing

Quetzaltenango, Guatemala

The past two weeks have been an absolute whirlwind. After overnighting in Antigua I took a small bus for five hours up the winding mountains into the western highlands, finally arriving in Quetzaltenango. Quetzaltenango was and still is a principle center of Maya Ki'che and is often referred to by its Ki'che name Xelaju and abbreviated to Xela. Xela is a large city seemingly disconnected from the surrounding cities but by small winding dirt roads which the revamped and repainted yellow school buses ride along. Most women in the city still dress in traditional Mayan clothing, which becomes even more prevalent as you head out into the country side. Every morning we take the unmarked school bus from the bus stop at the Calvario Church into the mountains of Tierra Colorada Baja. Outside the church, venders sell flowers freshly cut from the mountains and beans and eggs out of street charts.

Now is the perfect time for me to be at the Primeros Pasos clinic, as many exciting changes are going on around me. Originally a pediatric clinic, the Healthy Schools Program is one of Primeros Pasos largest components. Health educators go out into the local community schools and teach about prevention of infection and communicable disease. By participating in this program, the children receive free healthcare at the clinic. For the schools that are too far from the clinic, Primeros Pasos has a mobile clinic which runs at the end of the school year. The end of the Guatemalan school year is now approaching so we have been hiking into the mountains with backpacks full of medications and medical equipment. As we are about to hit a lull in pediatric consults, all focus is on the new women's clinic.

The women's clinic will run in conjunction with the women's groups that have recently started up in the community. Similarly to the Healthy Schools program, women that participate in the women's group will receive free care. The objective is for patient to invest in their healthcare through commitment to health education. In the afternoons we have been hiking into the mountains to teach the women's groups and to talk about the new women's clinic. The women's education group has three phases: The first phase focuses on nutrition, hygiene and traditional medicine. The second phase focuses specifically on women's healthcare topics such as cervical, endometrial, and breast cancer, pap smears and self breast exams, pregnancy and prenatal care, menstruation and menopause. The last phase focuses on self esteem and leadership. In this phase, the women have a choice to start a community wellness project or to become a health educator. We are hoping to find the next group of women's health educators from this group. Each day of the week is a different women's group meeting in a different community, all in different phases of the program. The women at the women's group range in age from teens to grandmothers. Most women bring along their children, tied onto their back and over their shoulder with a traditional woven clothe. The first groups are entering the third phase; it will be very exciting to see these women become leaders. You can easily tell the difference between the timid participants of groups in phase one as compared to the outspoken individuals starting phase three, who eagerly ask me inquisitive health questions and willingly discuss women's issues.

On the first day of my clinic orientation I already had a patient. I had been told that many mothers had been asking for help when they brought in their children, but I had not anticipated for things to happen so quickly. Unfortunately, all the clinic supplies were still in the apartment, so I did the best I could with what I had. I guess you can say the women's clinic unofficially opened the first day and officially opened two days later and I have had at least one patient every day since. A new group of medical students have just started their rotation at the clinic. Two of the six medical students are females and I will be training them in the basics of obstetrics and gynecology in the primary care setting. It will be exciting to see them grow into the role of provider over the course of their eight week rotation. I can already tell that everyday will be a new adventure.

You can help build the women's clinic; just go to http://primerospasos.org/women_s_health_program.html

Monday, October 26, 2009


Artículo sobre Primeros Pasos en El Quetzalteco

Article on Primeros Pasos in El Quetzalteco (English Translation to Follow)
http://www.elquetzalteco.com.gt/22.10.2009/?q=breves/solidaridad

Adult Health Education Program -“The Stairway to Good Health”

Miriam Lopez and Elizabeth Murphy

The Stairway to Good Health Program continues its work with over eighty women in the communities of the Palajunoj Valley. Your browser may not support display of this image.

The women's program is composed of timage015.jpghree phases.

The first phase deals primarily with preventative health: starting with ten weekly sessions on Nutrition, Hygiene, First Aid, and Natural Medicine, and afterwards continuing with monthly meetings on topics chosen by the participants. Special emphasis is placed on the fact that it is better to invest in healthy food and good hygiene habits for the family rather than having to invest in expensive medications to cure family members.

The second phase consists of ten more weekly sessions on Self Esteem, Gender, Civic Participation, and Leadership. The principal objective of this phase is to help the women realize their own value and that of their gender, and to empower them to allow their voice to be heard in their own family and community.

Upon finishing the second phase, participants are given the options of planning and organizing their own project, or training to become health educators..

We continue working in the communities of Xecaracoj, Tierra Colorada Baja, and Llano del Pinal.

The Xecaracoj group is beginning their second phase with nineteen women, although they already started a project to train women who sell the school snacks in Xecaracoj.

In Tierra Colorada Baja and Llano del Pinal they are now attending monthly sessions on the first-phase topics that they chose, including: Menopause, Uterine Cancer, Diabetes, etc.

Responding to the request of various women that repeatedly asked for the opportunity to enter in the program, we have initiated a second group in Tierra Colorada Baja. The new group is composed of women from various communities that are more than willing to travel to the clinic in order to participate. This group of 33 women has shown a great deal of enthusiasm so far.