We just finished our third day in Cacaopera. Many patients have traveled for miles to visit us for treatment. There have been numerous LEEP's and cryo's which have enabled our doctors to train the local medical team. The trainees need to observe many cases of diseased tissue in order to recognize it in their practices.
The local public health employees have done a great job to improve the health of their communities. One group arrived today with their doctor, their nurse practitioner, and their psychologist! The doctor, like many here in El Salvador, was trained in Cuba.
Yesterday, we had a patient who had been deported from the US. She preferred to speak in English, and overflowed with stories of her troubled life and the difficult living conditions in El Salvador. The young woman seems to have no place in this world. She has no documents for the US, and none which allow her to work in El Salvador. This lost soul spent time talking with us while waiting for her cryotherapy. She seemed grateful to have someone listen to her.
Today, the services of the PINCC support team, i.e. non-medical volunteers, expanded to include child care. One young mom came with her 2 year old who sobbed pitifully during her exam in the ante-room. His body was tense with fear, and nothing could soothe him. He finally calmed down when his mother rejoined him after her exam. But his young mother was very nervous at the prospect of the cryo treatment that the doctors had recommended. Another PINCC volunteer supported the mother until her turn for treatment came. During her cryotherapy, the little boy sat quietly in the waiting room watching the scene. People delivered lunches in huge baskets. Stray dogs smelled the food and roamed the hall until shooed away. Doctors and nurses rushed to treatment rooms discussing their cases. Patients chatted while waiting their turns. Most entertaining were the young children who drew with the colored pencils that one of the PINCC volunteers had brought. Sitting next to my young charge, I also enjoyed the bustle of the clinic at midday.
Off to a smooth start on our first day in Cacaopera, El Salvador! The town is in the poorest region of El Salvador, and the region most impacted by El Salvador's war. The clinic's team was well- prepared for us, and the trainees eager to learn. Veterans of 7 PINCC trips, Carol and Cheryl, were very impressed with how well organized everything was. We saw 20 patients, which allowed us to unpack the PINCC suitcases and sort things out without pressure. Salina, a medical student on our team, had the time to teach the patients some anatomy. Although the patients were quiet during the talk, Salina had an impact because several women approached her afterwards with questions.
As always, the patients were lovely, and grateful for the care. Among the older women there were harrowing stories of war experiences. One woman delivered her baby two months early when a bomb detonated a few yards from her home. The baby survived, but the mother was left deaf for several years. Another woman had worked as a nurse for wounded guerillas. Another woman had beautiful green eyes, a rarity in this country, but not in her village. There must have been a European ancestor who brought those genes to this remote region. It is an honor and a wonder to hear these women's stories during the patient interview.
It is rainy season here. We need to be vigilant about using the stinky mosquito cream. Our hotel is high in the mountains, surrounded by clouds in the late afternoon. What a joy to be here with such a wonderful team of women, in this forest full of colorful birds and tropical vegetation. Tomorrow is another day of adventure; we expect to see 40 patients, so there will be lots of stories to share.
Today began with the news that one of our nurses' cousins had died in Managua. She was in her 30s and had been diagnosed a year ago on the first PINCC visit to Laguna de Perla. She left 4 children motherless. This sad news reminded us of the significance of our mission. 300,000 women are diagnosed annually with preventable cervical cancer worldwide. In my 35 year career in the U.S. I have diagnosed only 4-5 women. It is rare because we practice prevention.
The clinic and patients from a village, Orinoco, who came by panga today for cervical cancer screening.
Photographs of Nurse Elcia and Doctor Maria Inez, that I worked with today.
A truck parked outside the clinic.
The cryo therapy unit was successfully repaired today so we treated 2 women with pre cancer.
First day at work—7:30 til 4—curried shrimp and rice for lunch. Lots of bottled water. Hot sunny day outside. Inside AC when electricity was on. I worked with a Spanish speaking family practice doc—25 wks pregnant—Cuban trained. There are 4 docs here who went to Cuba at age 18 and trained for 10-15 years before coming home to Nicaragua.
Well, the last day has now officially come…Friday. What happened to the time, the two weeks of the trip? This time here has FLEW by!!
The work here have been long days; some with sunshine and heat, others are humid along with down-pours. Regardless of the weather, every day our group has strived to work hard; to teach the clinicians in Pearl Lagoon to maintain cervical cancer screening without PINCC returning; educating members of the society about cervical cancer; working in rooms filled with many women with limited air conditioning; keeping up with all the paperwork, computer work and medical records; cleaning and stocking each room. Everything in the past 2 weeks has made the experience here be a total thrill!!
The local 'Pearl Lagoon' folk, the PINCC crew and the staff at each hospital have been totally amazing! I will miss each and every person…it brings tears to my eyes to think that tomorrow I will fall asleep in a hotel room all alone somewhere in Houston awaiting a flight back home to Wyoming. I have become so close with everyone here that it will be heartbreaking to leave.
The simplicity of the lifestyle here in Nicaragua is one thing that I will miss more than I can say. People tend to walk slower taking in the beautiful day, sunshine and life in general. Once the locals get to know you, they will smile as you pass with a simple greeting. Children are riding their bikes, playing baseball, and running around their houses with friends. One thing that I have noticed is that children here seem very happy and content. The mothers are very attentive and the older siblings are second hands to help tend to the youngsters.
On a regular day I have noticed that horses wander down the dirt roads. Cows wander in the fields. Chickens roam around each house. Dogs lay in the sidewalks. Hummingbirds feast on the beautiful flowers growing all over. The 'farm lifestyle' is one thing I will miss the most. Children walk to school each day in groups, dressed in classy uniforms. White shirts, green bottoms, skirts for the girls and pants for the boys. All carrying backpacks…smiles greet us each day.
Our day ends with our group separating prior to dinner. Some go back to the room to rest, others socialize. We all reconvene for dinner at a local restaurant…changes each night. The late night walks back to the hotel have been exhilarating. Cool breeze and calm…a perfect way to end each day. The power has only gone out a few times this week, but overall we have been sleeping in air conditioned rooms throughout the nights.
Even though it is a goodbye for some of us, the rest of the crew will be continuing on to El Salvador next week. I have heard so many great things about El Salvador and in some way…I'm slightly jealous I'm not going!! I can't wait to hear all of the stories of next week. It will be a great adventure and I wish everyone safe travels! Thank you again PINCC for a great learning and travel experience. One I will never forget!!