Dr. Judith Reichman TODAY contributor • Profile • E-mail

In my weekly column I usually answer a question related to a women's health issue. However, I just returned from the highlands in Guatemala, where I was visiting Save the Children's programs in this portion of the country, and I wanted to share my experiences. (I am on the Save the Children board and have been trying to visit many of our national and global programs. This is the first one I've gone to in Central America.)

Guatemala is an absolutely beautiful country, blessed with gorgeous verdant mountains that dive in and out of the clouds, interrupted by rushing streams that cascade down from the peaks. Cornfields are planted in every available space (including areas that I felt were totally inaccessible). This country was once the heart of the Mayan empire. The population, currently 13 million, includes Mayan descendants, Garifuna natives and Caucasians. Although Spanish is the official language, there are 23 languages spoken in the highlands. In order to speak to those we visited, our group from Save the Children's country staff needed to translate from Eishal (the most common local language) to Spanish to English.

In 1996 Guatemala signed a peace accord, but prior to that it had a 36-year armed conflict. All of this is evident in the 11 years it has taken to develop its economy and the current widespread societal and economic disparities, extreme endemic poverty and a legacy of societal violence. Save the Children has multiple programs in this country, and is working with USAID, private sponsors and the Guatemalan government. Their programs vary from helping with food security issues (50 percent of children under the age of 5 in this country are chronically malnourished and this number increases to 70 percent in the central highlands), education, health needs, adolescent reproductive health and family planning.

I arrived in the central highlands after a brief stay in New York City, where (aside from taping the “Today” show) I joined 1,200 guests celebrating the 75th anniversary of Save the Children. We all knew why we were “honoring” Save and those given awards for their admirable work in helping create lasting change for children in need. (The honorees included Presidents George Bush Sr., Bill Clinton and Melinda Gates.) The evening was terrific and the attendees, who had already donated considerable money to support Save’s programs, left with a sense of appreciation and dedication. But the literal jump from celebratory speeches and films presented in that gorgeous tent set up at Lincoln Center to the “field,” where poverty, illiteracy, disease, and childhood and maternal death are so prevalent, was a huge shock to my sense of reality and experience.

Save the Children's impact on Guatemala
I visited schools and observed Save the Children's education programs in action. The illiteracy rate in Guatemala is 69.9 percent for those over 15 (only Nicaragua and Haiti are worse in Latin America and the Caribbean). In several areas that I visited in the highlands, more than 70 percent of the women were illiterate. Most children don't make it past the sixth grade, and 50 percent of Mayan adolescent girls don't attend school.

To help combat this problem, Save the Children has programs in 57 communities in Guatemala's rural highlands and has developed child-oriented methods of education that promote Mayan culture. In addition, their programs benefit more than 15,000 children in this area. I was wowed. Prior to the programs, children were taught by rote, not encouraged to honor their cultural traditions and were not nourished in mind or body in their schools. Absentee rates were horrific. I watched children stand up at the front of the class and take turns teaching one another under the expert guidance of young teachers who had gone through special education programs. One of the programs I attended was “respect the corn” day, where first-graders acted out Mayan traditional plays about corn, were taught how to count by sorting corncobs, made corn out of Play-Doh, and created Mayan symbols of corn, all which were hung proudly in the room. At snack time the children sit outside with their teachers and (after they washed their hands in the clean-water sinks we had created) eat plantains and drink a “milk” mixture made with soy and boiled water (many of these children have a genetic lactose intolerance).

I also visited health programs. Guatemala is among the worst countries in Latin America and the Caribbean in terms of life expectancy, infant mortality and maternal mortality. Death during and right after a delivery (usually from hemorrhage) in the mid-highlands area, according to local health records from 2004, is 277 maternal deaths per 100,000 live births. (These numbers may be inaccurate since 90 percent of deliveries occur at home with a traditional birth attendant, and many births and deaths are not even recorded!) That's at least three times the national average. In the cities in this area, only 14 percent of women of reproductive age are using contraceptive methods (we don’t have numbers for rural areas).

One of the programs to help fight teenage pregnancy and lack of family spacing is called the “breaking the cycle” program. I visited one such group in a local hospital where adolescent leaders were gathered to learn about and promote education on reproductive health. There were wonderfully illustrated information booklets about deciding what one wanted to do in the future, whether sex should be postponed, and how, if one decided to do so, to engage in sex safely. I was so impressed by this group of 10 girls and two boys. The maturity, empathy and gratitude these adolescents displayed was amazing. I'm not sure I'd see the same dedication among 14- to 16-year-olds here in the U.S. There are 96 clubs like this one, and each of these adolescents then goes on to become a peer counselor to 10 to 12 other adolescents. The hope is that they too will become counselors to their friends, exponentially affecting the life and reproductive choices of entire communities. The most memorable adolescent was a 16-year-old girl. After her mother left home (she was an alcoholic and on the street “somewhere”) and her father remarried (he didn't want to have anything to do with them), this young girl had to take care of her younger brother, and despite a stipend for rent from their father, they lived alone in a shack. But this young woman was a leader in her school, a spokesperson for reproductive health and mentored 10 other teenagers. Her personal goal was to become a physician (that's the part I really loved).

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