By Sallie Weissinger, PINCC Volunteer, June 2014
There's more to volunteering for a PINCC mission than doing our work by the book or, in our case, by the manual. According to the manual, our mission is to train local doctors and nurses to diagnose and treat women for low and high grade lesions, thereby preventing cervical cancer. But our real job description is far richer and rewarding than the official one. On a PINCC trip, we are learners and students, as well as medical experts and teachers. We relish that richness, as we soak up information about the cultural, political, social, and familial structures in the regions where we work. We're especially interested in learning about the health care resources that support (and, in many cases, don't adequately support) the in-country clinicians mastering PINCC techniques. Meeting the clinicians' patients and learning about their histories, hardships, and challenges is always interesting and at times humbling. The same is true of getting to know our clinician trainees' backgrounds. Every day we work with them, we become more impressed with the dedication of the local doctors and nurses. They cope with personal and professional demands and pressures we simply haven't encountered. Their stories and experiences leave us open-mouthed and even awe-struck.
Someone who fits this description is nurse midwife Selmira Aguilar, a mother in her 30s, who trained with PINCC in Kukra Hill, in the Kukra indigenous region on Nicaragua's Caribbean coast. The day after completing her five-day, intensive training in diagnosing cervical lesions, Selmira did not go home for the weekend, to hang with her family. She and five other health care providers left on a 14-day trip to visit 13 remote hamlets, places too small to have access to health centers for some of the 16,000 inhabitants of the catchment area in which she works. They left on horseback and mules, packing their clothes, medical equipment and supplies. They packed hammocks to string up on trees, but left prepared to sleep on the wet ground if trees weren't available. Even so, they clung to the hope that, in the midst of the monsoon season after a day of trudging through mud on dirt paths, there'd be the occasional school or church for sleeping dry.
Their plan called for eating food prepared by the villagers on the way and setting up the 13 clinics wherever possible: in some hamlets, clinics would be set up in churches and schools. In other places, Selmira told us she and her colleagues planned to improvise clinics in people's homes or, if necessary, hang sheets on ropes attached to trees. One way or another, they would provide a full range of services: PAP tests, HIV testing, routine vaccinations, pre-natal care, well baby care, and general medicine. In time, once she becomes certified by PINCC in VIAA – visual inspections with acetic acid- she will add it to her medical repertoire, so women won't have to wait months and months to receive their results. With VIAA, they will get their results within minutes.
Following her first week of training, the PINCC trainers were favorably impressed with her skills: she's fast-moving, quick-thinking, accurate, energetic, and animated; most importantly, she's a good clinician and a good communicator. And, in the words of one of the PINCC team, "she has a generous heart."
As we write of her visit to the hamlets outside of Kukra Hill, Selmira should be returning from her 13-day trip. On our next visit in November, we will be sure to learn more about her time on the road as a medical provider in this remote part of the second poorest country in the Western Hemisphere. That's when she will once again be a PINCC trainee, and we will return as her trainers. But we will also switch roles, learning from her about dedication in the face of discomfort, generosity in the face of scarcity, and perseverance and commitment in the midst of pouring rain and omnipresent mud. And all of this while riding horses and packing with mules. For sure, the learning goes both ways!