Women Making a Difference

Elena Hurtado, Guatemala

Elena Hurtado interviews a mother in Cuilco, Guatemala. Source: URC-CHS

Elena Hurtado is an applied anthropologist and public health specialist who has dedicated her career to serving the health needs of Guatemala's indigenous populations. Energetic, creative and passionate about her work, Elena's devotion to the art and science of health communication and the design of evidence-based interventions has been a driving force and cornerstone of the USAID/Calidad en Salud Project for the last eight years. As Senior Technical Advisor and Behavior Change Expert, she has led the design of several key national strategies for maternal and child health, nutrition, family planning, and HIV/AIDS and managed community mobilization activities and behavior change interventions in support of the Guatemalan Ministry of Health (MOH). Recognized both nationally and internationally as an accomplished researcher, health program evaluator, and behavior change expert, Elena's greatest passion is direct contact with the communities she serves: It is rare to find Elena behind a desk for too long.

Elena's commitment to serving the poor in Guatemala was inspired by her father, a well-known physician who pioneered medical anthropology in Guatemala, a country of rich cultural diversity. As a result, Elena grew up very appreciative of cultural pluralism and multilingualism in Guatemala; she was as conscious of the frequent acts of stigma and discrimination inflicted upon the marginalized indigenous population.

It was not until she obtained direct experience working with the poor that she decided to study public health. After graduating from Tulane University with a degree in anthropology and psychology, Elena began working as a research assistant at the Institute of Nutrition of Central America and Panama. There she was offered a challenging assignment: go live in San Pedro la Laguna, an indigenous town situated on Lake Atitlán, to assist with an ethnography -- specifically the observation of maternal and child activities.

Elena lived in this indigenous community for almost a year and completely immersed herself in the culture. She describes her first experience observing a birth as inspiration for her future career:

"One day as I was walking in the town, a traditional midwife approached me and asked if I happened to have cooking oil in the little room I rented nearby. I did and ended up accompanying the midwife to the house where she was attending a woman experiencing prolonged labor. The room was dark, the woman had her clothes on, and the midwife had a flashlight in her hand to check the woman's birth canal under her clothes where she applied the oil I had brought. Several female relatives were holding the woman's legs and telling her what to do and the husband was sitting on a chair on top of the bed, supporting the woman under her armpits. Suddenly someone knocked at the door. It was the doctor from the health center who had been called by another midwife. The relatives asked me to please go speak with the doctor and explain to him that all was well and that he was not needed. I went to the door and did as I was told, but when I came back to the room, the scene had changed dramatically – the woman was lying on her back; the husband and chair were not on the bed, only the midwife was at the woman's side. Once I assured them the doctor had left, they all went back to their previous positions. I was very moved by this and many other similar incidents. I had witnessed local practices and had sensed the fear of invasion of their customs and privacy in the families. At the same time, I was unable to advise them during complication and set out to obtain the skills needed to assist with this effort."

Elena eventually pursued a graduate degree in public health at the University of California in Los Angeles with a clear purpose to return to Guatemala to improve the health and nutrition conditions in the country and has never looked back.

Elena joined the USAID/Calidad en Salud Project in 2000, where she led the design of the Integrated Health Care for Women and Children at the Community Level program in Guatemala and developed the overall training strategy for more than 14,000 volunteers and 4,000 midwives to complement the MOH's strategy to extend health care coverage. She has spearheaded numerous research studies, including the national study on growth monitoring and promotion at the community level, which led to a change in national norms.

Elena's many years of applying research findings to improve health led her to realize that behavior change communication (BCC) was the perfect marriage of anthropological research and action. A hallmark of her work has been to apply key principles of anthropology to promote change in health through a broader "health promotion" approach using participatory techniques and community organization. The results have been impressive.

She designed and implemented two successful national BCC strategies in support of the MOH – one for family planning and reproductive health and the other for childhood illness – and has been responsible for creating and developing the capacity of the MOH's own BCC unit (PROEDUSA). With Elena's support, PROEDUSA has produced a large number of high-quality, high-impact print and audiovisual materials and integrated packages of job aids to help health workers communicate key messages more effectively to indigenous and illiterate populations. These innovative materials have served to inspire BCC materials now used worldwide.

Moreover, Elena is currently leading a quality improvement strategy in maternal and neonatal mortality at the community level – an innovative strategy to reduce maternal mortality in Guatemala.

Elena also consulted with programs throughout Latin America as well as in Kenya and India, has served as an adviser to the National Public Health Institute in Mexico, and been a mentor to countless public health students in Guatemala and abroad. She has balanced these professional accomplishments with a fierce commitment to her husband and three sons. Elena Hurtado's thirst for knowledge, her commitment to the improved health of Guatemalans, and her contributions to key national strategies truly set her apart.

Story provided by the USAID/Calidad en Salud Project managed by University Research Co., LLC

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