First Week Recap

Sorry for the delayed postings…  there were a number of limiting factors the first week including 1) no internet and 2) no time / energy.  Actually, I had a lot of energy, but by the time I made it back to our room it had been pretty drained by work and patients and trying to semi-proficiently speak Spanish.  All of that being said, the week was wonderful, educational, productive, and moving all at once.  I just want to give a recap of the week, because otherwise I risk being perpetually behind on this blog (which I know you all would find very surprising).  

Women waiting in front of the clinic to be seen.  One day I was seeing the last patient after 6 pm and I asked her what time she arrived: 8 am!!  They just sit without complaining.  So hard to believe that getting this care is that important to them. Makes you think twice about complaining.

We spent the week at a clinic in El Naranjo, which is a small town near the Belize border.  The clinic has the greatest nurse, Glenia, that was amazingly helpful to us all.  Sometimes we get really discouraged by the health promoters and nurses in the areas we work because some seem to go out of their way to avoid making more work for themselves (and thereby avoiding doing what is really needed in their communities).  The clinic and community provided a great way to start the trip.  They are all very aware of the problem posed by cervical cancer because a young woman named Flori died in the community recently (her story to come later – she really deserves a post of her own).  We worked Monday through Saturday and did pap smears on about 210 patients, a number of whom returned for biopsies or cryotherapy treatment if their exams or pap smears were abnormal. 

 Ismael and Lisa (cytotech) doing some teaching with the women about how pap smear cytology is done.

Puja inputting some data in one of our exam rooms - note the cryo tank, table without stirrups, wood steps up to the table (the patients make me look like a giant), and the educational posters.

By Saturday we really had the flow of the clinic down – Puja and Anne each have rooms where they do pap smears and VIAA (visual inspection with acetic acid).  With the help of Orfe (Ismael’s wife, works for Sew Hope full-time) and Glenia, I work all of the patients up before they go to the exam rooms.  We have an extensive history form, because a large purpose of this project is to get data about cervical cancer, HPV, and risk factors in the region.  We ask about everything from full obstetrical histories to whether they cook with fires in the home to information about childhood sexual abuse – as you can imagine it’s not exactly easy in a busy clinic, but we’re doing our best.  My Spanish is really being pushed to the limit, but it’s improving immensely and getting easier every day.  I am starting to feel like I can just ask or say exactly what I want, rather than simply trying to find a way to get my general point across.  When I’m at a loss, Orfe is always there to chime in, which is very reassuring.  Puja and I agree that often it seems she says the exact same thing as we do, but with less enunciation, and the patients answer immediately rather than staring blankly as they often do at us.  Like I said, still lots of room for improvement!

We stayed at a beautiful little motel-type place about 25 minutes from the clinic.  It was a sort of walled-in villa that was barely noticeable from the road.  They served us breakfast and dinner each day, and we mostly had the place to ourselves.  As our first week, it was such a help to have the freedom to all be together in such a relaxed atmosphere.  

Week 1 "hotel" near Naranjo

The days were long: usually breakfast around 6:30, returning after dark around 6 or 7, then sometimes data entry or other preparations for another couple hours after dinner.  And of course, no internet – I think this was actually the first time I’ve gone for a week without checking my email!  Overall, the week was a great success and I can say with certainty that there were women that we identified and treated with cervical dysplasia (pre-cancer) that now will not progress to cancer.  The treatments and screening (colposcopy) are often interventions they cannot afford if they even are diagnosed, so being able to provide it free is a huge gift.  I can’t wait to see what the next weeks bring!

Our 15ish seat van that is often piled high with luggage.  Every morning when we pack for clinic we look like a family going on a week-long vacation.