El Salvador 2012 trip diary: Reflections

By Patricia Spross

Today is Wednesday and I woke with a migraine.   So I stayed home to sleep in my dark room until it passed.  Waking in the early afternoon, I take this time to reflect on my first day at the clinic.  Nearly 60 women were treated in an energetic setting of Salvadorean doctors whom PINCC has trained to teach the screening procedure (maestras).  Also present were about 15 to 20 doctors and nurses being trained by the maestras to perform the vinegar procedure.   Clinic support staff, PINCC MD´s, PINCC/DFW volunteers, patients, and their small children added to the mosaic.  Carol coordinated the PINCC team, watching, listening, directing, to make sure that the goal of training the maestras to become trainers themselves was met.  In a previous life, Carol may have been a battlefield general, perhaps Joan of Arc…

Once more, what struck me most about our day were the women.  I was delighted to have the opportunity to conduct PINCC´s medical screening interviews for 5 women before the exams took place.  Sitting with each woman for 15 minutes, interviewers were obliged to ask the usual questions, name, address, etc.   These were followed by a series of probing questions on sexual history.  Affirmative responses to any question on sex abuse steered these women to a session with a psychologist that same day.  The crowds made it difficult to find a private spot for the interviews, but in tropical El Salvador, every building has a large patio or courtyard where a quiet conversation can take place.

The screenings required a fair bit of Spanish, and it was a challenge.  Yet, each woman was patient and kind, and we both persisted until all the questions were answered.   The faces of the women were serious as they revealed a history of abuse, or anxiety over an abnormal PAP result.  Two women spoke of financial dependency on their husbands, which prevented them from leaving.  This reaffirmed that the micro businesses we saw last week can truly give a woman hope and an opportunity to free herself from abuse.

All of the patients with whom I spoke were grateful for the high quality medical care they have received for years from this PINCC-supported clinic.  Some of the women awaiting a procedure to remove abnormal cells were frightened to tears.   When asked whether they had come to the clinic every year for screening, all responded affirmatively.  It was wonderful to be able to honestly assure a tearful woman that the doctors would most likely be able to resolve the problem that day with a minor procedure.   PINCC, with donations from organizations like DFW, has supported these women in obtaining consistent, high quality care to prevent cervical cancer.

Of all the economic and social stresses that poor Salvadorean women experience, their health can be an area where they enjoy some peace of mind.   It has been extraordinary to see first hand that our donations have helped make this happen.