Salud Reproductiva - El Salvador!

We have had a busy several weeks! From Pap smear campaigns to diabetes campaigns, traveling clinic with the physician, cultural events with the elderly, government-run nutrition events, and more.

One project spans almost the entirety of our stay - we have been leading a series of reproductive health classes for 4th-9th graders. Last year's group was invited to give a session on reproductive health, in response to rising rates of adolescent pregnancies. We were invited back again this year, for 4 sessions!

Our first presentation was to parents. We presented our plan -


Anatomy
Puberty
Sex
How to say 'No'
Fertilization
Embryology
Contraception
Violence in Relationships/Inappropriate Touching (for younger kids) /Rape(for older kids) 
STDs
Condom Demo

We were expecting many questions, especially as this community has religious groups traditionally very opposed to certain themes we wanted to address. But the parents thanked us for coming in to talk to their children, and we were given the green-light. Surprised, but pleased, we began to prepare. This was a reminder that you can't predict a response, positive or negative! We all want the same thing - the health and wellness of adolescents

We expanded on material created by last year's group (we especially loved their skits and the conception puppet show - thank you Julie, Angela, Steve, and Mike!) and began to expand with information from the CDC, WHO, Planned Parenthood, written resources provided by FIMRC, and other valuable websites and books.

So far we have delivered the 3 primary sessions. We prepare them in Spanish, with cultural editing from our wonderful Spanish instructor Liseth. The 4th session will be entirely devoted to student questions, which we collect at the end of each class. 

Examples of questions include "How are twins developed?", "How do you know who is the one?", "If haven't had my period for 3 months, could I be pregnant?"  "Are the condoms at the Unidad de Salud (health center) safe?" "Why is sex bad?" "When can we start having sex?" "What is gonorrhea " "What are the symptoms of HIV?" And the list goes on. We've been attempting to answer most of these questions in our 3 primary sessions, with the 4th session available for the rest of them. 

This project led to an adventure as we ventured into the community pharmacy to see what contraceptive items are available for local adolescents. 

The following are available over-the-counter in this particular pharmacy:
Male Condoms
Oral Contraceptives
Monthly progesterone shot

I held the oral contraceptives and shots in my hands and thought "It's that easy? You just walk in? No prescription at all" These over the counter products do cost money. I'm under the impression that if an adolescent went through the government, it would be possible to get free contraceptives, as well.

Plan B, Emergency Contraception, is also available in El Salvador pharmacies, although not in this community. It is called Postinor 1 and costs $15. 

It is not the largest difference between the US and El Salvador, but it stuck with me. I'd known, logically, that these items were available over the counter. But you don't realize what that means until you just walk in and buy them. What does this mean for access? For 'control'/yearly physicals? While available, are they being utilized? We've run into a variety of myths surrounding contraceptives, whether hormonal, barrier, or 'natural', and usage depends heavily on clearing some of these myths (see prior blog entry on the use of condoms)

As we give our weekly 'charlas' at the school, we've tried to keep in mind that we can't dictate culturally what is acceptable, but we can present facts as we know them and try to clarify myths surrounding reproductive health. This week, we give the same presentation to the parents, which should be educational all around!

Emily and Nabil puppeteer the sperm and the egg traveling to one another in Day 2 of "Salud Reproductiva" 

 Emily with her "Anticonceptivos" Poster!

Nabil explaining how to read a pregnancy test


Nabil's condom demonstration (in Spanish)

Adventures of the Tourist Kind:
We hiked up a volcano! Here we are about to be blown away by the wind, at the edge of the volcano crater (created by the last eruption)

Here is a panoramic shot of our view from near the top. It was 12 kilometers of uphill-downhill, but well worth it - we could see San Salvador, Guatemala, and Honduras! 

Equipo El Salvador, signing out