In the
middle of clinic Tuesday afternoon, Puja and I quietly celebrated another surprisingly
anticlimactic moment: our 1,000th patient. Coming into this project, our goal was to
screen 1,000 women with pap smears, which (somehow) seemed reasonable. A few days in, Puja and I worried with more
than a twinge of disappointment that we’d be lucky to even reach 500. However, increasing productivity combined
with some huge patient loads in La Libertad and consistent clinics at the rest
of our locations propelled us forward.
It must be mentioned that all of this was made possible by the weeks of
work by Ismael and Orfe, who visited the communities, educated the women,
organized the accommodations, determined the schedule, and arranged
transportation for women from more secluded locations – and that’s just the
start of the list. In talking to them
now, it seems they also felt they would bear the bulk of the blame if things
went awry at any step in the process. I
can’t begin to explain how instrumental they were in making this project a
success. The way they do their rather
thankless job with quiet confidence and dedication is humbling.
I was
doing pap smears Tuesday as I noticed we were approaching number 1,000. When Puja ultimately passed that patient my
way, I asked her to come in and help me.
She hid her annoyance surprisingly well as she glanced at the line of
patients awaiting her attention – we had a pretty well-established system where
we tried to help the other as much as possible, but only asked for help when we
really thought it was important. As she
entered, I asked her to put the numbered stickers on the patient’s papers and
she realized the significance. She gave
me a smile, and a quick high five, before slipping back out of the room to
attend to the subsequent patients as I proceeded with the pap smear.
At the
beginning of the trip, my focus was pretty firmly set on reaching that goal of
1,000 patients. It was an attractive goal:
it seemed very tangible (again, not sure why it sounded so reasonable, but it
did), and it would also give credibility to the research we were doing while
making a significant difference in the communities. Looking back now, however, that number seems
less important. I know that may be easy
to say now that we’ve reached it, but I can’t help but feel that the other
successes were more important. I was
talking to Ismael tonight about this, and it seems that the message we spread
was of utmost importance. This message
was one of hope for these women – hope that they can receive the interventions
they need, hope that there are people that value their health, hope that their
local health care system can improve, and hope for curative treatment, if
necessary. More broadly, we tried to let
the women know that we cared about hearing their stories and were pained by the
countless injustices they have experienced. The time we spent talking to patients about
their lives taught us so much about our own and also how to effectively work in
the communities here. I heard repeatedly
from patients who had never found someone willing to hear their pain from
previous abuse, abandonment, and death.
We tried to empower the women to work toward a better future for themselves
and their daughters by fighting against some of the things that have repressed
them in the past (abuse, illness, uneven distribution of power). I’m aware that it’s easy to speak against
these things and rally around change, but actually affecting it is much harder. At the end of the day, even making a
difference in how one woman feels about herself seems worthwhile.
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