Harsh reality in San Salvador

There were some tears shed at the San Jacinto clinic in San Salvador
yesterday.

A 33-year-old woman with five children was found to have stage 2
cervical cancer by one of our team members. In our nurse practitioner
Cheryl Brown's 13-year career, it was only the second cancer she'd
found during an exam.

For all the preparation we have before traveling with PINCC, it still
felt like I was punched hard in the stomach when I heard the news. I
choked up. And for some reason the weather turned dreary for the only
time in the week, with a brief period of lightning and loud thunder.

The patient's tumor has grown slowly, probably for about 20 years. Do
the math as to when she was infected with the virus that causes
cervical cancer.

The patient took the news stoically at first, then burst into tears.

The news for us was especially frustrating, and exemplifies why
PINCC's work is so critically important.

The patient told us she had a pap smear 7 years ago, but never got the
results. The medical professionals on the trip tell me her pap would
have almost certainly shown pre-cancerous tissue on the cervix. This
cancer could have been prevented, and that's why prevention is the
first word in PINCC's name.

She was referred yesterday to the country's ONLY gynecological
oncologist. Even with a fast-track referral from our high-profile
visit (more about that later), her future looks challenging. She may
see a cure, but it'll be a tough road in any event.

In the U. S., there are at least hundreds of specialists in
gynecological oncology. Wealthy Central Americans fly to L.A., Miami,
Houston, New York or elsewhere for treatment. No such luck for our
patient. She has one option, and we can only hope for the best for her.

Our 319 patients in El Salvador yielded 3 cancers. That's just a
hair under 1 percent.

In the U.S., there are 2.2 cervical cancer deaths per 100,000 women.
In El Salvador the comparable statistic is 37 per 100,000.

In Nicaragua, where we're flying as I write this, the stats are even
worse.

We're going from a gritty, crowded city of 2 million to a rural area
with maybe 12,000 in the town we'll start in -- Jalapa (HA' LA PA).

El Salvador has limited resources for everything, but Nicaragua is the
second poorest country in the Western Hemisphere. We'll see what we
find in Jalapa, where PINCC has been before.

More later ...

-- Larry Shushan, PINCC Volunteer