PIES de Occidente

As I've mentioned, I've been volunteering with PIES de Occidente. PIES stands for Promotion, Research, Education and Health (in Spanish, obviously) and has a number of women's health programs that have been really interesting to learn about, and pertinent to what I'll be studying just soon enough.

PIES isn't really used to having volunteers, which has worked out well for me. This means that I pretty much get to dictate my own schedule and decide where I want to go and what I want to do. This also means though that if I don't talk to the right person on the right day, I'll miss the boat and spend the whole week in the office. So, I've learned where the schedules are kept and am comfortable enough with the staff to ask if I can tag along. I'm usually most "helpful" when I'm in the office, so I try to balance those days with going to the communities.

PIES has a small staff: Cristina, who I spend a lot of time with, is the director of Communications; Marta, my initial contact, is the director of programs; Dona Esperanza, Dona Angela, Dona Angelita and Juanita, are the midwives and facilitators for the majority of the programs; Pattie, Dtra. Aurey, Emily, Raul and few other miscellaneous people that I'm not really sure quite yet what they do. I know some work in a small back office on their computers a lot. Since PIES also operates 2 clinics, I think one or two of the women are also doctors. I feel really welcome amongst all these people by now. It's a nice atmosphere in the office, they eat together, snack together, chit chat and when every one is in the office (maybe once a week) it has a nice homey feel. I'm the only foreigner, so I get to practice my spanish much more then when I was at Primeros Pasos and actually feel like it's improving - which is a great feeling.

PIES has a few programs that it appears are dictated by what funding comes around, although I'm not really sure how it works exactly. One of USAID's main focus in Guatemala is Maternal and Child Health, but I haven't quite figured out how large of a role they play in guiding organizations, like PIES's, work. In 2000, due to the high rate of maternal death, Guatemala instituted a law that all midwives had to have a certification card. Each month they have to attend a training, and they have to attend a full year of training before they can receive the card. To keep their card, they have to continue attending each month and take a test as long as they work. When a family registers their child after it's born, the government requests the name and number of the midwife, and the family can get in trouble if the midwife isn't registered. This incentivizes the family to only work with a certified the midwife. I've gone to a few of these trainings (including the one with the "interesting" games) which has been informative - I knew little to nothing about the complications of giving birth - and culturally insightful. These have also given me the opportunity to go to small towns, see small health centers and understand how things get done.

PIES also has a domestic violence program, including two radio shows every Friday that touch on a different topic related to domestic violence. Marta estimates that 70% of all Guatemalan women have suffered some form of domestic violence. These groups bring together groups of women to begin raising awareness around domestic violence and teaching communities that it is not part of a normal relationship and should not be tolerated. I was able to go with Marta one day to Concepcion, a town where they want to start a group. We went to the Justice of Peace and Police Station to see how many women had reported cases (a relatively new thing in Guatemala) and what their status was. Not suprisingly, the majority of the reports (11) were done at the Justice of Peace then at the Police Station (3). It was unclear what action had been taken other than a report filed.

The two other main program are the Comites and Mayan Medicine. Pattie, works with the Comites. The idea behind this program is that each town have an Emergency Committee that is trained and knows what to do in case of an emergency in the town. PIES works with them to find the women to form the group, help them understand their roles and what to do in case of an emergency. I only attended one of these training sessions and am not sure how they are working. I've heard that they are hard, primarily because the women themselves don't really understand why it's needed if they've never had one before. But that's another topic for another time.

I've learned a lot about Mayan Medicine since working with PIES. This is mainly because Cristy has needed the most help, transcribing the interviews I helped her with 2 months ago. She is making a documentary on Mayan Medicine (an a brochure) for Guatemalan medical students. The idea is that they need to understand it, and acknowledge it, even if they don't practice it or believe it. Their patients are going to come in having tried it first, and it will scare people who already hate hospitals even more if they don't try to work with it. PIES has already started by giving talks to the doctors at the main Medical Schools, with hopes that they will make one class part of the curriculum and increase acceptance and awareness. The 15 min documentary will be distributed in a few schools to help begin this process.

I haven't written much about PIES because it doesn't really feel like I've "done" much. As I reach the end of my time in Guatemala, it's starting to process. I'll write more about it, and these different groups that I've visited over the next week.