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Day 15- The NGO Wuqu’ Kawoq

Today we took advantage of the rainy weather to work at the Wuqu’Kawoq office. And it is about time to tell you more about this organization.

The Maya Health Alliance NGO Wuqu’Kawoq was created in January 2007 and it is now 10 years since its members pledged to provide all the necessary care to women in rural communities around Tecpán. For the little anecdote, in the Mayan calendar, “Wuqu’Kawoq” is the date on which the association was created.

The NGO Wuqu Kawoq says it is “global” by the composition of their team and local in their expertise and work. It is composed of 98% Guatemalan members and more specifically, of Maya origin.

The association was born from the realization of the lack of recognition of indigenous populations by the Guatemalan state. Since the end of the nineteenth century, the dominant political and social ideology in Guatemala was that of exclusive nationalism that did not recognize and respect the country’s cultural diversity. The Mayans were thus excluded from any right of citizenship to the extent that they were deprived of education in their own languages ​​and the right to vote if they did not speak Spanish. The situation remains mostly unchanged today. The NGO Wuqu Kawoq notes that there are power relations in Guatemala according to ethnic, social and gender relations. These issues are reflected in the access to health of the most disadvantaged populations, namely indigenous Mayan women, who do not speak Spanish and live in rural communities far from city centers.

For Wuqu’Kawoq members, choosing between culture or health is unacceptable and the goal of the NGO is to strengthen primary health care in rural Guatemala. This implies that it partners with indigenous communities, particularly with comadronas, to identify the health needs of populations. The association has decided to adopt a conscious approach, insofar as it promotes awareness by the Mayan communities of their living conditions and means to engage in their change so as not to reproduce new relationships. domination and dependence on their action.

So far we have learned a lot from members of the NGO fighting for the recognition of the rights of Maya women, the most oppressed population.

Day 14- Celebramos un futuro saludable*

This Wednesday, July 5th, we went to Paquip, a village within the municipality of Tecpán. After more than an hour crisscrossing the roads and the tracks, which divide the mountains, we arrived at the “Centro de Salud,” the municipal health center. It is a public building that includes a few doctors, a pharmacy and various cabinets.

We entered the building whose walls are of a pallor common to that of many hospitals. We advanced to the central hall where about thirty women, mostly Maya (given their traditional clothes), sat and waited patiently for their appointment. We were surprised to see only women who were either alone or accompanied by their children, in a mixed health center.

We then met Sandy, the Wuqu’Kawoq nurse we had interviewed yesterday. She comes once a month to the Paquip health center to animate family planning. During the rest of her time, she travels the roads of the region to achieve this mission in other villages. Sandy, 25, explains that she chose this job to improve access to health for her community members, especially women. She also defines her identity as “Maya Kaqchikel”.

Throughout the morning, appointments followed one another, without any moment of respite for the young nurse whose optimism and the patient mingle to best accommodate her patients. She explains that she works mainly on two aspects of women’s health in the context of family planning. The first is the prevention and detection of certain diseases, including cervical cancer, which is one of the most deadly cancers among Guatemalan women because of their many pregnancies. The second is the awareness of the use of contraceptives; the most common methods in Guatemala are the injection, the implant, the IUD and the pill. She also explains that if we mainly see women in the health center, it is often that husbands and families are not aware that the latter use contraceptives: “ellas tienen that esconderse” (they have to hide).

It is no less than a dozen patients that Sandy, assisted by a second nurse from Wuqu’Kawoq, received, listened and consulted during this morning. All this was done for free, to give everyone the opportunity to come to the center and see his rights respected (access to health and contreception). We attended a few consultations in this room furnished with a bed, desk and counter on which Sandy has installed the few pieces of medical equipment she needs.

The first person to enter the office was a 21-year-old woman. Like many women here, she carries her baby on her back with a large, thick, colorful cloth. The consultation is done in Kaqchikel, like all of those who will follow. The patient comes for a follow-up visit after implant placement 7 weeks ago. Sandy touched her arm, checked that the implant has not moved and also gave her the results of the Pap smear – to detect the presence of cancer of the cervix. All was well for this patient, who told she came to the center without anyone around her knowing.

The second patient was about thirty years old and explained to us, in Spanish, that she came to have her contraceptive implant removed because of the side effects that it caused. The conversation then resumed in Kaqchikel. Sandy and the patient got up and headed for the bed, covered by a white cloth and lit by the light of a window. A pale curtain ensures the privacy of the place. After injecting an anesthesia into the patient’s arm, Sandy began the operation. The scalpel opened the skin of the young woman on more than five centimeters for almost twenty minutes, to finally take out the contraceptive implant.

The third patient we saw came to be prescribed the pill, a form of contraception not widely used in Guatemala. She was 16 and came to family planning without her parents’ knowledge. Sandy took the time to explain in detail how the pill works and the effects it will have on her body. We admire this young nurse of 25 years, so devoted to his convictions.

The last woman who entered the room is 26 years old, she was accompanied by her husband who stays outside to take care of their baby during the consultation. This was the first couple we see in the health center. This was the first woman we met who comes without hiding her husband. With the help of a large needle, Sandy placed a contraceptive implant under the skin of her right arm.

Now we are back in Tecpán, to make our last interview of the day with Michel, a doctor at Wuqu’Kawoq. They are only 3 men working for the organization and Michel admits his admiration for the work done by Wuqu’Kawoq women.

* Celebrating a healthy future!

 

 

 

Day 13 – Second day following “Salud Mobil” Program

We wake at dawn for our second day with the Mayan communities, with a Wuqu’Kawoq nurse. These villages are much more isolated than the first ones we had visited: our journey was over an hour’s drive through the mountains, on narrow, sandy and stony paths. All 9 of us were packed in a car that can hold 5 individuals. The bends and the unevenness of the journey plunges us into a second and nauseated state, which we endured until the end of the day.

The program we observed was related to the “Salud Móvil” which uses technology (especially the smartphone) for the health service. We followed a “comadrona”, a local midwife living in these remote communities herself, in her three visits of the day. The role of the comadrona is to check, using various technological devices, the baby’s health. For this, the comadrona puts a phone on the belly of the future mother and connects to speakers. We can then hear the heartbeat of the baby. The application used is catered to the comadrona and patient’s language, Kaqchikel. At the beginning of the session, the comadrona asks a set of questions so as to complete the patient’s medical file on her application. She asks how many pregnancies she has lived, how many children she is a mother, how old she is, whether she has ever been to the hospital, whether she has had any health complications during her life, whether she is diabetic, etc. The question of contraception is not asked because it is difficult to address this topic, as explained to us by the Wuqu’Kawoq nurse. Moreover, the comadrona we followed was very religious. She is the mother of “11 children and a stillborn child”, and the subject of contraception is not discussed in the morning. All the information collected is recorded by comadrona on the monitoring application of pregnant women created by Wuqu’Kawoq.

“Each case is unique,” explains comadrona. Our morning confirmed it quickly.

The first woman is 41 years old. The brown mark chiselling her belly is the aftermath of a past caesarean. Maya Kaqchikel women go to the hospital only in case of a serious problem because the doctors do not speak their language and they are often afraid of such places. Most of the time, they give birth at home with the help of the comadrona. The Cesarean section of this woman seems to concentrate in her a particular story that allows us to glimpse the complications that she had to face. Thanks to the application contained in her phone, comadrona can access her patient accordingly.

The second is 14 years old. She is seven months pregnant and is happy to give birth to her first child. Her “esposo”, with which she is not married because she is not of legal age, is an 18-year-old boy living in a neighboring community. The books strewn on the ground and the signs taped to the walls teach us that the girl studies “language and communication” and learns English.

The last mother-to-be is a woman in her thirties. For this visit, no phone was used, the young woman prefered traditional medicine still practiced in some Mayan communities. The pregnant woman and the comadrona meet in a kind of sauna, called the Temascal. They undress both and the comadrona mass the body of the pregnant woman. After that, they wash themselves and a bunch of sacred herbs on the body. The comadrona explains to us that this method, long used by the Mayan communities, allows an optimal development of the baby and that the heat contained in the Temascal as well as the massages lavished on the future mother are all factors which will guarantee a better childbirth.

We ended this day with a video interview with the comadrona, who told us with great sensitivity her story and passion for her job. She takes the opportunity to light a fire of pine needles at the foot of the religious altar, which alone furnishes the room, large and dark, in which we realize almost an hour of maintenance.

Jour 12 – Entrevista con Yoli *

A new week began today, and we had to find Yoli, the “Program Manager of Salud Móvil” at the Wuqu’Kawoq office to do an interview. For the occasion, Yoli had put on her best traditional outfit. She began by explaining to us that she has been working in the organization for seven months. Then she described the ins and outs of the program she has to supervise. In Maya communities, a “comadrona” takes care of pregnant women throughout their pregnancy. In the area around Tecpán, there are nearly 150 comadronas and Wuqu’Kawoq collaborates with 42 of them, offering them a phone with an application to monitor the health of patients and future children. The comadronas also use the app if they discover certain complications that require the aide of Wuqu’Kawoq’s doctors. In case of emergency, the comadronas call Wuqu’Kawoq and the patients are taken directly to the Chimaltenango hospital with an attendant who translates Kaqchikel once there. In fact, most public health workers do not speak Kaqchikel and it is very common for women in indigenous communities to be discriminated against and perceived as “ignorant.” The companions of the salud móbil program are therefore also psychological supports for these women who are generally afraid of the hospital, and have never  traveled to the city. For Yoli, the most important thing is to give the necessary attention to the patients, which they often do not receive from the hospital staff.

The afternoon was just as studious. Laura and Elea stayed on the roof of the house, armed with their cameras while Chorkin and Penelope worked in the warm apartment. But our host, Esperanza, Queen of Tecpán, who is not immune to anything, was able to grasp the abnormality of the situation and came in the evening – under cover of a tea and a hot dish – to find out more on our strange activities of the day …

  • Interview with Yoli

Day 9 – Holiday? And yet …

June 30th. Last day of the month. We learn that this day is a holiday because it is the day to celebrate the end of the civil war. Wuqu’Kawoq’s offices are closed. Would we be forced to rest?

… No, still too attached to our French/American calendars, we take advantage of this day to make our appointments and film two interviews!

At 10 am, we found Esperanza at home, not far from Tecpán. She explained that she was forced to move out of the city because she could not pay her rent of 1400 quetzales (around 175 euros). Her house was built in 1 month, it borders the great “Carratera Interamericana” which connects Mexico to Latin America, including through Guatemala. Sounds impressive, right? And yet, this “Carratera Interamericana” is just a part of the “Carratera Panamericana” that connects Alaska to Argentina over 48000 km long …

Esperanza is a teacher of home economics at “basico” level, that is at the high school level. She came from a low-income background but managed to climb the ladder thanks to various aids and opportunities that she was able to seize (grants, associative aids, loan, sponsorship by a couple living in the United States, …). She lives alone in this small home. Her brother, who lived next door, recently moved because he did not have enough money to pay for this place. She has (or had) a husband and a son who no longer live with her. She is a woman of character, educated and independent who stands in front of us, ready to answer our questions. For the occasion, she put on her traditional dress. She will changed after the interview because “it’s more convenient to walk in sneakers! “.

After 1.5 hours of interview and a coffee offered by our host, we gave ourselves a break to go to lunch in a restaurant nearby. Anxious to show us a maximum of things, Esperanza leads us through the Mayan communities behind her house. She stops in front of a huge gate, and rings. “A former member of Guatemala party lives here,” she says. The fortress opens on a huge field, dozens of children play with impunity. Green grass, swings, huts, swimming pools, basketball courts, tennis and football … The contrast with the outside is striking, shocking. Facing us, the former deputy – all smiles – invites us to enter. The man uses this space as a recreational place for the young people he asks for 125Q for the day. While we did not see much, we observed it was occupied by youth from the United States, and the space was cut off from the rest of the area.

At 3pm, we finally take the direction of the restaurant. The meal is bland and expensive. (We would have preferred the opposite.) Fortunately, our appetites were replenished quickly by intellectual food. Esperanza introduced a friend of hers, a lawyer by profession, who is heavily involved in access to the rights of Guatemalan women. The sun began its race towards the night. We took advantage of this softened brightness to film our interview outdoors. Her words are most relevant. Even though she has not even prepared her interview, the lawyer takes every question to her heart and answers it with crazy precision: she structured her remarks, quotes key figures and articles from the Constitution, went through sociological reminders before exposing the facts. The night falls a few minutes after the end of our interview. The lawyer offered to give us a ride back home. At 7pm, we finally arrived at the casa, after this long day, we felt both exhausted and accomplished … Hooray for holidays!

Day 7 and 8 – A Necessary Historical Detour…

We took advantage of Tecpán during the last two days, as Wuqu’Kawoq’s activity was rather calm. Under the infusion of local cinnamon-flavored coffee, Elea and Chorkin began editing, cutting, editing, re-editing, redrawing and putting together the first images we have taken since our arrival. For Penelope and Laura, they began the preparation of individual interviews to come (for this, we let you wait until the next article …).

Nous voulons surtout profiter de cet article pour vous parler du Guatemala, de son histoire et de sa population. Le Guatemala est le pays le plus peuplé d’Amérique centrale, avec plus de 16 millions d’habitants, dont la moitié vit en dessous du seuil de pauvreté national. La précarité touche davantage les populations autochtones du pays. De fait, près de la moitié de la population est Maya. Leur nombre exact est sujet à de larges controverses dans le pays, dans un contexte où les discours nationalistes tendent à sous-estimer la proportion des communautés Mayas dans la population totale. Toutefois, pour comprendre comment le Guatemala est devenu un territoire avec une telle diversité culturelle, linguistique et ethnique, un détour par l’histoire du pays est nécessaire.

Les historiens datent à – 2000 avant Jésus Christ la naissance de la civilisation Maya. Durant cette époque, petits villages et communautés agricoles se sont dispersés sur l’actuel territoire du Guatemala, construisant alors des sociétés organisées et autonomes. Toutefois, l’arrivée des colons espagnols en 1524 bouleverse l’histoire de ces sociétés, alors devenues « indigènes ». Se met en place un système de « repartimiento » basé sur le travail forcé des peuples autochtones dans les fermes et les mines des colons. La structure sociale et politique de l’époque est organisée selon un système de caste et les Mayas sont les premières victimes d’une hiérarchie sociale qui place les colons blancs au sommet.

Le 15 septembre 1821, après trois siècles de domination coloniale, le Guatemala, le Nicaragua, le Salvador, le Costa Rica et le Honduras deviennent indépendants et forment ensemble Las Provincias Unidas del Centro de América. Toutefois, cette union se brise rapidement et le Guatemala devient un Etat-Nation indépendant en 1840. Dès lors, la construction de la Nation guatémaltèque se fait par l’exclusion et la discrimination des populations auto: « le modèle libéral considère l’indigène comme un problème qu’il faut supprimer afin de mener à bien un processus de civilisation » (reference). Tout au long du 19ème siècle, des politiques publiques sont mises en place afin d’assimiler ces populations et/ou de les utiliser comme main d’œuvre pour travailler dans les plantations de café, dans un contexte où le pays cherche avant tout à construire une société unitaire et centraliste. On assiste à une institutionnalisation du racisme qui va marquer tout le 20ème siècle jusqu’à aujourd’hui.

En 1945, ont lieu les premières élections démocratiques. Suite à un coup d’Etat militaire en 1954 mené par la CIA, le pays entre dans une période de troubles politiques et sociaux. Rapidement, une guérilla éclate et se généralise à l’ensemble des communautés autochtones. Opposant l’organisation de guérilleros Unidad Revolucionaria Nacional Guatemalteca et l’armée nationale, cette guerre civile marque l’histoire des années 1960. Le gouvernement militaire répond à la guérilla avec une brutalité extrême : disparitions forcées, violences physiques, mutilations et exposition publique de cadavres. La guerre atteint son paroxysme avec le coup d’Etat du Général Efraín Ríos Montt qui, après avoir lancé l’état d’urgence, ordonne une campagne généralisée de destruction des communautés Mayas jusqu’aux zones les plus marginalisées, faisant des dizaines de milliers de morts et plus d’un million de réfugiés. Il faut attendre le début des années 2000 pour que le général Efraín Ríos Montt soit jugé pour crime contre l’humanité et génocide.

Les années 1990 sont synonymes d’une décennie d’illusions selon les historiens nationaux. La signature des accords de paix en 1996 et la fin de la guerre civile ont donné des espoirs à la population guatémaltèque. Cependant, l’instabilité gouvernementale, la corruption, la violence urbaine et le crime organisé continuent de fracturer le pays. Les politiques néolibérales ont des conséquences désastreuses pour les économies locales. Aujourd’hui, 34% de la population vit sous le seuil de pauvreté extrême, faisant du Guatemala l’un des pays les plus pauvres du monde. La pauvreté – un facteur d’exclusion parmi d’autres au Guatemala – se concentre dans les communautés les plus marginalisées. Or, la marginalisation, comme construit social, est le reflet d’un passé colonial puis nationaliste. Exclusion, racisme et discriminations contre les populations Mayas témoignent d’une hiérarchie sociale toujours déterminée par des critères culturels et raciaux.

Toutefois, l’action de la société civile guatémaltèque et l’activisme des communautés autochtones donnent l’espoir d’une évolution vers un meilleur respect de leurs droits fondamentaux.

Day 6 – Discovering the Salud Movíl Program

Today was our first time visiting the remote Mayan communities with Maye, a nurse from the NGO. We left the office of Wuqu’Kawoq at 7:30 to take the direction of Panavajal. We quickly move away from paved roads to take rocky paths and constantly redesigned by the rains. The car went downhill when we arrived at the top of one of the mountains that make up the area around Tecpán. On the horizon, three volcanoes rise while the greenery of the cultivated fields lines the foreground. Along the main road are glimpses of the villages that are isolated and difficult to access. 

While she is used to taking the bus and then walking, Maye guided the driver of our car to the house of the first patient of the day. She has been a nurse in Wuqu’Kawoq for less than a year, as part of the Salud Movíl program. It incorporates the use of a phone application used by nurses from local communities, so that they can call Wuqu’Kawoq in case of emergency. As part of this program, Maye tracks patients from Mayan communities who are pregnant or have just given birth.

Usted no debe tener que elegir entre su cultura y su salud.

The first patient was Leticia M., who is 23 years old. We met her as she sat on her bed, where she gave birth 24 days ago to a little boy who did not have a name yet. Maye conducted her consultation in Kaqchikel, took Leticia’s blood pressure, and cared for the baby. We admired Maye’s sweetness, as she took the time to explain to the young mother Wuqu-Kawoq’s health assistance program and listened to each of her needs.

Maye asks all her patients to rate on a scale of 1 to 5 – symbolized by happy and dissatisfied faces – the quality of the health services provided by the public authorities. The responses do not reach more than 2/5: the main argument is due to the impossibility for these women to be understood because they rarely provide services in Kaqchikel.

We encountered difficulties to justify our presence with the second family, especially because the husband of the patient labeled us as “gringos,” in view of our skin color, and was unreceptive of our arrival. The patient, 28 years old, was about to give birth to her sixth child. Once we left their home, one of which was more isolated than the previous, Maye explained that she found the consultation difficult because of the presence of the husband. Without saying another word, Maye explained that “here, men often decide for women”.

We then went to meet a third patient, who lives in a less rudimentary house. The presence of windows and the volume of the room were all indications that allowed us to make this last observation. As in other houses, religious symbols were the only decorations of the room. We meet Maria V., who gave birth just two days ago to her second child. She was accompanied by her older sister and their children. They played in front of us and around our cameras. The consultation, still conducted in Kaqchikel, was enlivened by the laughter of mothers and children, while the fathers took a quick break for lunch before returning to work in the fields.

For the last consultation, we walked down a winding path that lead to the home of a young woman and her mother, who is 16 years old. In a room furnished with a bed, a wardrobe and a cross, Maye carries out her last examination of the day. The young woman was expecting a baby for mid-August.

We returned, exhausted by the day but inspired by the work and energy that Maye, 25, dedicates every day to these marginalized communities.

  • Défilant

Day 5 – Lights, Camera…Action!

Today was our first day of filming. The weather was nice, we took the opportunity to walk in Tecpán to identify scenes of daily life. On the way to doing so, we discovered “the oficina of the mujer”, the municipal office of Tecpán dedicated to women. We timidly decided to walk through the door and were received very warmly by the City Manager. She explained that this office has existed since 2010. It aims to make women aware of their rights and obligations, and to help them cope with precarious economic and social situations, by setting up workshops where they learn the basics needed to create their own projects. It emphasizes the role of the family as a stable circle to ensure respect for women’s rights and the good upbringing of children. According to her, being a “una soltera”, an unmarried woman, does not allow women to give a good education to their children. We wondered if this vision is linked to the strong prominence of religion in Guatemalan society. The director was pleased to participate in the production of our documentary through a filmed interview.

Once the energy of the central place is captured by our objectives, we decided to use more distant streets. In front of a bakery, a group of Mayan women and children drew our attention. We tried to start a discussion with them but we realized that they only spoke Kaqchikel. By a sign language straight out of our imagination, we managed to get their consent to film them. The baker, meanwhile, seemed both surprised and proud to be at the forefront of our images. She then began to clean her shop and beckoned us to film the interior. As a thank you, we wanted to buy her fresh pastries, but to our amazement, it is she who gifted them to us to show her gratitude for having been filmed.

It is remarkable to see how sharing and exchange of simple things can create instant links between individuals.

Tomorrow will be a great day for us, we will be following one of the nurses of Wuqu’Kawoq to a rural community outside of the city.


Day 5 – Lights, Camera…Action!

Today was our first day of filming. The weather was nice, we took the opportunity to walk in Tecpán to identify scenes of daily life. On the way, we discover “the oficina of the mujer”, the municipal office of Tecpán dedicated to women. We timidly decide to walk through the door and are received very warmly by the City Manager. She explains that this office exists since 2010 to make women aware of their rights and obligations, to help them cope with precarious economic and social situations, by setting up workshops where they learn the basics needed to create their own projects. It emphasizes the role of the family as a stable circle to ensure respect for women’s rights and the good upbringing of children. According to her, being a “una soltera”, an unmarried woman, does not allow women to give a good education to their children. We wondered if this vision is linked to the strong prominence of religion in Guatemalan society. The director was pleased to participate in the production of our documentary through a filmed interview.


Once the energy of the central place is captured by our objectives, we decided to use more distant streets. In front of a bakery, a group of Mayan women and children drew our attention. We tried to start a discussion with them but we realized that they only spoke Kaqchikel. By a sign language straight out of our imagination, we managed to get their consent to film them. The baker, meanwhile, seemed both surprised and proud to be at the forefront of our images. She then began to clean her shop and beckoned us to film the interior. As a thank you, we wanted to buy her fresh pastries, but to our amazement, it is she who gifted them to us to show her gratitude for having been filmed.

It is remarkable to see how sharing and exchange of simple things can create instant links between individuals.

Tomorrow will be a great day for us, we will be following one of the nurses of Wuqu’Kawoq to a rural community outside of the city.

Day 4 – “Eso es para no olvidar”

This Sunday was like any other in Tecpán. The market settled in the center of the city while the great Catholic Church filled with its faithful believers. We walk between the colorful stalls to buy food for the coming week … and especially for tonight, because we invited the person we live with, Esperanza, and her son Nicolas to dinner.


As the wind hits the house’s roof loudly, we wait patiently for our guests who have traditionally dressed for the occasion. The gratin plates are gradually emptying and Esperanza leads us into a discussion of the political system of his country. According to her, a military government would be the only one able to calm and pacify Guatemala. The corruption – “como vosotros en Europa” – is bad for the country and Nicolas explains that from now on, 18 years old, he can be part of “los hombres de la Ronda“, an informal group of men who watch the villages during the night. Esperanza brings us a radio to cheer up our evenings. Animated by Latin rhythms, she begins to present us the history of the different objects that furnish the living room: the traditional vases worn on women’s heads, the metal iron, a stone mortar and pestle, a Mayan statuette , stag horns as a souvenir of her trip to Madrid (“de la basura de Madrid”). With a nostalgic air, she explains to us that keeping all these objects allows her to safeguard the heritage of the Mayan culture; “Es para no olvidar nuestra historia“. In this regard, Esperanza seems pessimistic in saying that, certainly, in a few years, the Mayan culture will disappear.


 

 

 

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