Last Cacaopera blog entry, by Patricia Spross

Attached is the  photo of Dr. Garcia, the head of the Cacaopera clinic, with the cryo equipment donated by PINCC.

Last days in Cacaopera

PINCC doctors and nurse practitioners focus on training the local medical team on how to treat the patients.    When they guide the medical exams, their main focus is ensuring that the local doctors learn how to perform IVA, cryotherapy and LEEP's.   The sustainable part of PINCC's mission is to make another PINCC visit unnecessary because the local team is fully trained. 

Volunteers often say that they receive back much more than they give.   So for my final blog entry, I want to express thanks for the gifts that PINCC has given me:

·         Meaningful work, and the feeling of being needed

·         A motive to improve my Spanish

·         An opportunity to support the cause of women

·         The recognition that my life has been full of extraordinary gifts

                A PINCC volunteer without a medical background lives in a parallel world from the trainers.   We stay on the periphery of the medical and training process.   In fact, some of us are squeamish about getting close to a patient's nether regions.   We interview and comfort the patients, hold the babies, input data into the computer, set up the exam rooms, and perform unexpected tasks such as chasing runaway patients, visiting the local pharmacy to buy pregnancy tests, or using our best handwriting to create "graduation" certificates for the local medical team.    This is nothing like a normal day at the office, and is enormous fun!         

Having studied several languages, I rarely have the chance to immerse myself in a second language.   That love of languages gave me my first entry into PINCC's world.   They needed Spanish- speaking volunteers, so I took a risk and signed up in spite of my limited Spanish.    Two years ago, during those months of waiting to travel with PINCC, I read only Spanish novels borrowed from the public library.   Those first books were hard because my vocabulary was weak.   So I wrote down the many words I did not know, and looked them up in a dictionary.   The excellent telenovela "Pablo Escobar – El Patron de Mal", was my tutorial for spoken Spanish.    Language learners usually struggle the most to speak, especially adults who are embarrassed to make mistakes.  But I forced myself to speak Spanish in my neighborhood stores.   As I have always found, native speakers kindly endure the fumbling efforts of someone trying to learn their language.   And now that I have completed my third trip with PINCC, I enjoy simple chats with anxious patients about our families, our gardens, and food.   And my vocabulary of Spanish gynecological terms may exceed my English vocabulary on the same subject!

But perhaps the most important gift bestowed by traveling with PINCC, is the opportunity to support the cause of women.  I was a young teen during the 1960's, and the women's movement spoke strongly to me.    A phrase from that era, "We are all sisters" still resounds.   As a Catholic schoolgirl from a religious family, I ached to participate in the fight for equality.   And in my small way, I have always fought for the cause.  But a female professional in the banking industry needs to tread carefully because we are a minority.  Banks are hierarchical organizations where only in recent years have women begun to achieve a critical mass.   Only when we are present in numbers can we be our best selves, and speak freely of the challenges of trying to succeed in our professions, while having and raising our children.    I connect the experience of our struggle for equality in the US with the struggle now underway in El Salvador.

Patriarchy still reigns in the poor communities of rural El Salvador.  Women clearly have made inroads in the medical profession, and the majority of our trainees were female doctors.  Yet, silence among women has allowed patriarchy to flourish.  A critical mass of women needs to give voice to the things that impede them from being full participants in society.   While taking the patient histories, we PINCC volunteers ask the Salvadoran women about forbidden topics such as childhood sexual abuse and violence in the home.   When a patient minimizes her suffering by responding that she endures only verbal, but not physical abuse, a PINCC volunteer can observe that verbal abuse is also very painful.  This acknowledgement may be a seed of strength that can be nurtured through the psychological counseling that is now available to many patients.  Some Salvadoreans ruefully acknowledge their culture of machismo.  Acknowledgement is the first step on the long journey toward change.  The PINCC team was happy to see the poster in the clinic which offered support to victims of family violence. 

So I will keep coming on these trips as long as PINCC will have me.   The wonderful women I encounter will always pull me back.   The women may be illiterate, but the intelligence and courage often shines through.  Like all mothers, they think of their children and want a better life for them.   And sometimes they feel safe enough to open up about the pain in their lives, and we listen as tears fill their eyes.    But for the luck of birth, it could be one us speaking softly of lost children, abuse, or the grinding poverty of life in rural El Salvador.   We are all sisters.

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Patricia Spross
patricia.spross@gmail.com