In 1921 Matilde Hidalgo became the first woman physician to graduate from the Universidad Central in Quito, Ecuador. Hidalgo was also the first woman to vote in a national election and the first to hold public office. Author Kim Clark relates the stories of Matilde Hidalgo and other women who successfully challenged newly instituted Ecuadorian state programs in the wake of the Liberal Revolution of 1895. New laws, while they did not specifically outline women's rights, left loopholes wherein women could contest entry into education systems and certain professions and vote in elections. As Clark demonstrates, many of those who seized these opportunities were unattached women who were socially and economically disenfranchised. Political and social changes during the liberal period drew new groups into the workforce. Women found novel opportunities to pursue professions where they did not compete directly with men. Training women for work meant expanding secular education systems and normal schools. Healthcare initiatives were also introduced that employed and targeted women to reduce infant mortality, eradicate venereal diseases, and regulate prostitution. Many of these state programs attempted to control women's behavior under the guise of morality and honor. Yet highland Ecuadorian women used them to better their lives and to gain professional training, health care, employment, and political rights. As they engaged state programs and used them for their own purposes, these women became modernizers and agents of change, winning freedoms for themselves and future generations.