During the course of their studies, most students are required to develop projects and presentations about sexual and reproductive health. In the latter years of study, students start to prepare for more career-oriented studies and they are keen to learn more about how an organization like Famia Planea Aruba (FPA) operates.  As an NGO, FPA is a great source of support where students can learn more about the nature of social work including counseling, management, and get hands-on experience. The FPA team also support students to learn about its mission and vision, as well as management and structure nationally and internationally. It is an opportunity for them to learn that FPA is a of the International Planned Parenthood Federation (IPPF).  Students, Zavannah and Xian, are currently studying social work as one of their majors at the EPI vocational school. “FPA is one of our favorite organizations to work with, they are very accommodating to our deadlines and provide tailored information. We have already done various projects with them and we still choose FPA every chance we get”, Zavannah says. FPA offers internship opportunities for both vocational and university students. This experience can have a huge impact on a student, and some often go on to become part of the team.  “When we do school projects with FPA we can really get a view of what our futures as social workers can look like. We always receive answers to all our questions, they have always have their mission and vision statements at hand which for our projects are very important”, Zavannah adds. “We can always count on FPA to provide visual materials as well. We sometimes have to finalize our projects with different presentations and we can always ask for pictures, videos and graphs to make our project wonderful”, Xian comments. FPA places great value on its ability to inspire and support young people with their studies and future careers such as social work where they, in the future, can help and support others.

In a country as diverse as Trinidad and Tobago, with 1.4 million varying hues and heritages, there still exists an arduous uphill climb for certain key populations. Conquering this apex of equality seems to be evasive as Government policy, general public perception and lack of education remain strong winds of opposition.  For persons like Brandy Rodriguez, Healthcare Navigator at the Family Planning Association of Trinidad and Tobago (FPATT), the struggle is both real and personal. In 1999, Brandy began her transition to womanhood and since 2006 has been working with FPATT in their HIV programme for the LGBTQI Community.   “Back in 2004, very little was said about HIV infection, transmission and prevention. In fact, if there was any information, it was misconstrued and meant to stigmatize the LGBTQI community. I was fairly new to the transgender community, so I made it a mission to research and find out the truths behind HIV and how I could protect myself. I then felt like I had to share what I found with others who were searching as well,” she said. That’s when FPATT asked Brandy to join their team in educating the LGBTQI community on the scope of healthcare that was available to them and guiding them to these resources within the public healthcare system. Since there was so much stigma surrounding the community, many of its members often stayed hidden under the shroud of comments that the gays and lesbians were the cause for the rise of HIV within Trinidad and Tobago. Even if a member of the LGBTQI community wanted to test for their HIV status, they would never dare to go into a public Health Centre, simply because of the fear of being judged by the healthcare professionals.  “It’s a simple case of this. When a transgender or non-binary person walks into a Health Centre or hospital, and the triage nurse has to fill in a form that asks for gender, the only two options there are Male and Female. So usually, the non-binary person knows that if they want to access that healthcare, free of judgement, they would have to dress as the gender that would bring the less undue attention. At the end of the day, the healthcare provider does not receive accurate information about the client, and the client doesn’t receive the scope of assessment and treatment that may be necessary. So part of what I do, is to simply accompany the client to the appointment so that it’s a less stressful experience and they don’t feel like they are alone,” says Brandy.    Advocating for greater support Apart from a great lack of healthcare professionals that are willing to treat with the LGBTQI community non-judgementally, the community also lacks social support. Most of the members of the community face barriers in housing and employment, which means that they are easily swayed into earning their livelihood as sex workers. Over 95% of skilled and employable persons within the LGBTQI community have turned to sex work because they are constantly denied employment within other industries.  “When I began my transition, I was fortunate to have the support of my family; they understood my heart and my need to be my authentic self. Not everyone has that support and so some either migrate or are left homeless because of the fact. Having to work within the sex industry means that they are now at greater risk for HIV or other STIs. My job as an Educator and Navigator is to promote condom use and ensure that they make use of FPATT’s regular HIV testing. If they do test positive, we then have that conversation about U=U, which means that if they (their HIV viral load) are undetectable, they will be untransferable, and then get them to that place of undetectability,” she states.  Brandy explains that being undetectable means that the client’s viral load is suppressed and they are living healthy lives. Since HIV infection has long been touted as a death sentence, the Educators work hard to ensure that 90% of persons who identify to be HIV Positive enrol in the FPATT Programme and 90% of those persons living with HIV (PLHIV) understand the importance of being adherent, through consistent treatment, healthy eating and rest. The Programme also offers sexual and reproductive health education on prevention against HIV re-infection and other STIs in the belief that SRHR interventions are preventative, cost effective, and would save lives and resources that would otherwise be spent on higher-level care. In addition, clients are navigated to medical practitioners and counsellors who can address issues of gender-based violence and mental health.  The Family Planning Association of Trinidad and Tobago has for many years advocated for sexual and reproductive rights of the LGBTQI community, ensuring that it remains a safe place for HIV testing and counselling. It holds a vision of a world where gender or sexuality are no longer a source of inequality or stigma, which is why every year, FPATT offers a total of 920 tests, 48 group sessions and additional one-on-one sessions accessible by all persons living within Trinidad and Tobago.  Following an assessment by PAHO, FPATT is poised to become a full service HIV treatment site, offering antiretroviral treatment (ART) as well as psychosocial services for persons affected by HIV. The Association’s goal is to stop discrimination and stigma against PLHIV and ultimately end the spread of HIV within Trinidad and Tobago by 2030.   

At her desk in the small, quiet office, sits an extraordinary Cuban physician and educator, whose accolades are second to none. Today, she is neither writing nor teaching on the advances in medical science, but rather, she is focused on her mobile phone. Engaged in a video call, she listens attentively to the person with whom she speaks. She shuffles in her chair, only for a brief moment, as if to make herself more comfortable and even more attentive. To Dr. Camejo, this is not just a job, this is her way of being present for a community that is in dire need of her help.   Four days a week, Dr. Mabel Camejo conducts TeleHealth, a telemedicine service initiated by the Family Planning Association of Trinidad and Tobago (FPATT) specifically for the Venezuelan and Cuban migrant communities. Her clients consider this service a god-send, as it allows them to book 30-minute consultations over WhatsApp video call. During the call, Dr. Camejo assesses and diagnoses her clients’ illnesses and prescribes medication if needed. If the client needs to be examined, she refers them to the FPATT clinic for hands- on assessment.    “My patients love it here. Many of them just don’t have the money or time to come in to the clinic for an appointment. If they have to take time off from work and that means no income for the day, but it’s easy when they can pick up the phone and send a message or take a call to get the same advice or treatment,” she notes.   Dr. Camejo recalls how technology has advanced since her practice in Cuba over 10 years ago. “In Cuba, the doctors go to the patient’s home so that we can chat with the whole family about how they can help the patient recover – whether it means reducing stress in the home, or cooking with less salt or sugar. There, we have to be the doctor for the entire family. Here, now in Trinidad, we get to do the same with TeleHealth. On the consultation call, we can address the whole family so that everyone understands the recovery path forward,” she said. “When people need help, you just have to help” With over 30 years of practicing medicine, Dr. Camejo specializes in gynecology, pediatrics and post-natal care but says that most of her migrant clients come in with a much wider range of ailments.  “Breast cancer is one I see very often. Then there is polycystic ovaries, diabetes, vaginal infections and even osteoarthritis. These women have been managing chronic illnesses that need constant and consistent treatment but because they cannot get medicine in Venezuela, they have to leave what they know as home to come here to Trinidad. It’s their only chance to survive,” she lamented.   Current policies in Trinidad and Tobago have prevented the migrants from accessing the public health care system unless they need pre-natal or emergency healthcare, so many of them with existing chronic illnesses have no other choice but to seek private care, which can be almost half of their weekly salary. However, FPATT’s mandate is to fight for equal Sexual and Reproductive Health Rights for all persons living within the nation’s borders and that includes the communities that need it the most.  In January 2020, FPATT launched an 8-module Zoom series for the migrant community that focused on the topics that were most critical to helping them integrate into their new home and culture. The structure was based on the IPPF’s One Curriculum, but designed to suit the needs of Trinidad and Tobago’s unique context. Dr. Camejo spoke from her expertise in Sexual and Reproductive Health, highlighting the use of contraceptives for planned pregnancies and the importance of regular pap smears to reduce the risk of cervical cancer.  “It’s information that they desperately need. They are in a new country, everything is different, including the systems, the culture and the food. They appreciate faces and voices that are familiar, sharing information that could save their lives,” she said. “This is what I love to do as a doctor. Since I was a little girl in Havana, I would watch my father speaking to his clients and he would be so careful with them and they would be so grateful that he came to see them. I feel the same way when I get to share and communicate with my clients. When people need help, you just have to help.” Dr. Mabel Camejo has been with FPATT for over 3 years and looks forward to serving the local Venezuelans and Cubans as long as she can. A migrant herself, she understands the intrinsic and changing needs of this community and continues to help FPATT tailor its services to ensure that equal opportunities in sexual and reproductive healthcare are afforded to all.          

A passionate advocate for comprehensive sexuality education, Jonathan is Famia Planea Aruba’s (FPA) IEC coordinator and manages the scheduling, guiding, and delivery of school projects. As part of this role, he works closely with students to help support and shape their projects.  “We are approached almost on a daily bases, throughout the school year, by students needing appointments for their school projects. These projects can vary from information about sexual and reproductive health and rights to the internal structure of FPA as an organization. That is why it is very important to first ask what kind of project the student has been tasked with. Questions such as school, grade level, course name, number of students, project goal and due date are among just a few of the primary questions that must be asked when scheduling a school project”, Jonathan says. FPA has developed information packages that are topic-ready for most of the general projects. These are used as an information base, while the presentation and appointment are tailored to each individual student.  “We will sometimes receive multiple students or groups for the same project, this is bound to happen when an entire class receives the same project, it is then up to me to make each appointment different while providing the same information. Digital presentation is usually my tool of choice. This provides me the possibility to incorporate all the necessary information, but I can always make a few tweaks to personalize each presentation”, says Jonathan.  During project weeks at most of the schools, the FPA office can be busy with visiting students.  “After the start of the COVID-19 pandemic most of the school project appointments became digital meetings. Removing the human contact can sometime provide new challenges for both the students and us. This demands that the student be more prepared than before with sharper questions, since the traditional conversation that usually leads to more questions is different when using digital methods, but we will do our best to help the student in every way possible”, Jonathan mentions.  

Famia Planea Aruba’s (FPA) online store is a successful social enterprise initiative, which is now one of their most innovative approaches to healthcare provision. Developing and managing a fully operational digital store with the added option for live chat and product guidance and information has enabled FPA to expand its reach.  Marvin is an experienced IT specialist who studied Computer Engineering Technology at Valencia Community College in the U.S. An integral member of the team, Marvin maintains FPA’s website and manages the online stock availability, delivery schedules, and public information. He is also responsible for their social media platforms.  FPA’s expert and dedicated team work from the heart to ensure they are able to adapt and deliver healthcare digitally.   “When returning back to home base in Aruba, I decided to help out in different companies and projects to further the digitalization of all platforms on the island. FPA started with just a small website back in 2010 and has grown into different projects and a very up-to-date website and online store”, says Marvin. “I take pride in helping FPA being a very technology forward organization.”

Jeanira, 37, is a doctor’s assistant and has two young children aged two and 12. She has been a member of Famia Planea Aruba (FPA) for many years but only recently learned that FPA provides healthcare for all ages and stages of life – particularly young people.  “I am a mother of two wonderful children, a two-year-old boy and an almost twelve-year-old girl. As any parent does, I have to accept that my little girl is no longer so little and growing much faster than I am ready to accept. I do however try my best to be very open on accepting of her growth and changes in the hopes of helping her become her best self. About a year ago I had begun researching the best way and time to start talking to my daughter about her upcoming body changes, sexuality, and puberty in general”, Jeanira says.  Provision of sexual and reproductive healthcare for all, regardless of age, is at the core of FPA’s work. Over the years FPA has developed different information packages specifically aimed at reaching and supporting young people, families, and educators.   “There is of course endless information on the internet, but this is not always the most helpful since I now had the difficult task of filtering out what I saw as appropriate or not, as well as choosing trustworthy sources”, explains Jeanira. “During my search, a family member mentioned that she had seen a video on social media about puberty that was in our native language. After finding the video on FPA’s Facebook page and watching it myself first, I was over the moon. The video is fun, educational, featured local professionals, and related to my daughter’s age. I love the fact that I could introduce the video to her and let her watch it in her own comfort zone, just in case she was not in the mood to talk to me about the topic at hand or have me stare at her while she learned some of the most impactful changes heading her way. At the end, it did stimulate conversations and questions for a few days after and I truly made it easier for us to talk about some of the topics that can sometimes be a little hard to approach.”   Jeanira encouraged her 11-year-old daughter to use FPA’s OPEN program. “When my mom first told me she found a video for me to watch about puberty I was a bit scared. I do talk to my friends about some stuff, but talking to my mom sounded a bit awkward. My mom and I do talk a lot but I was still worried that it might get too deep. I didn’t think the video would be so funny”, Xiqiën remembers. “My favorite part was to be able to recognize some changes that I am going through right now. There are some changes that I would like to skip but I know it’s all part of the growing up process.”  “I’m so thankful that FPA had the idea to make such a fun video for us to learn from. There was some stuff that I already knew, but I also learned some new things. I did ask my mom a lot of questions after the video, mostly because they said that everyone is different and I really wanted to know how my mom is different from me. I don’t feel quite as worried to talk to my mom about these things anymore, I know that she will try to help.”