When I was growing up in California, I often felt disconnected from my extended family in Mexico. The language barrier was enough of a challenge, but the distance I felt was also the result of the drastic differences in our everyday experiences. The obstacles I encountered as a young woman in the US felt very tied to the country in which I lived. Once I became a teenager, however, I realized our experiences weren’t as different as I’d assumed in my youth, especially when it came to accessing sexual and reproductive health care.

When I learned that the struggles my aunts and cousins were having looked very much like my own, our inability to access health services became something that tied us together. We complained to each other about the challenges we faced, and shared stories that were both triumphant and tragic. It was during these conversations that I discovered one of my aunts was a nurse at a small clinic in Tultitlán de Mariano Escobedo.

Esperanza Vasquez Garcia has spent the last 20 years witnessing the impact of an underfunded health system in a location where care is desperately needed. She spoke to me about why women have such a hard time accessing vital health services and the importance of young people being adequately informed about their sexual and reproductive health.

What brings women to your clinic?

About 80 percent of the women who come to my clinic are between the ages of 13 and 45. They are looking for reproductive health services. Some come in for pap smears or treatment of an STD, but most of them are looking for contraceptives or pre-natal care.

What barriers exist for women trying to obtain these services?

At my clinic, we don’t have enough staff to provide services to the large numbers of women who come in, and we don’t have enough resources to meet the needs of all the women who ask us for contraceptives. If we had more resources, we could be giving out twice as many contraceptives, but we do what we can with what we have in order to make information and services available to women.

Why are these resources lacking?

Funding is a problem. We have a very small and strict budget. When more people started coming in for sexual and reproductive health services, it began to cost the clinic more money. The administration was forced to choose which services are more important. It was a very difficult decision. The government and others should provide more funding for sexual and reproductive health services because there need is certainly there.

In addition to more funding, can anything else help meet this need?

Comprehensive sexuality education is so important, and it has to start at home. Parents should teach their children about contraceptives. At school, they need to teach young people about contraceptives and also make them aware of the services in the community that can help them to be healthy and avoid unwanted pregnancies.

Young people don’t receive adequate sex education in school, so they grow up to be uneducated about these things as adults. We do have sex education, but the information is very basic and limited. Young people learn about the reproductive systems of men and women, but they do not receive much information about contraceptives or how to use them.

Why isn’t sex education more comprehensive and widespread?

The attitude here is that learning about these things is rude and immoral, but not being educated about sexual and reproductive health causes big problems. Many women don’t know how to use contraceptives and they’re embarrassed to ask how they work. So, we see a lot of women who come to us when it’s already too late. They’re already pregnant and need pre-natal care.

Written by Tina Vasquez, a freelance writer and editor from the Los Angeles area.