Tuesday, June 11, 2013



Of the 45 women we saw today, the oldest was 71-year old Emma Fox.  She learned independence and resourcefulness at any early age- she was four when her mother died and she went to live with an aunt.  

Emma and her husband worked hard to support their eight children, all of whom have lived to adulthood.  "He was a good man," she said, "but he is gone now."   To keep the family going, she "did a little bit of everything. I bought coal and lumber and sold it for more money.  I dried shrimp and sold it." And she raised her children, proudly noting that three of her daughters are nurses.

Talking comfortably during the PINCC interview, Emma provided full information about her medical history.  The interview questionnaire asks sensitive questions to help the clinicians assess a woman's risk of developing dysplasia that can lead to cervical cancer.  Sample questions include "How old were you when you had sexual relations for the first time?" and "How many sexual partners have you had?"  Many women wince as we ask these questions, but not Emma.  She said, "You have to tell the truth to keep your health.  If you lie, they can't help."

But when I asked her the final question, Emma lost her confidence and her eyes teared.  I told her that she'd be having a breast and pelvic exam and that she'd be in stirrups for the cervical exam with vinegar.  I explained that a local doctor or nurse would be giving her the exam, and U.S. nurses or gynecologists would be training them.  I asked if she would sign the release form, but she didn't want to because she thought only U.S. doctors would be doing the exam.  She didn't want people from Laguna de Perlas, people she knows, attending her.  We offered to let her choose her own local nurse, she thought about it, signed the form, and then sat down to wait her turn.  WHEW!

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