By Tina Romenesko

The chairs were two deep in the hallways when we arrived at the hospital for our second day of the mission.  By 11:00, we had interviewed 30 patients and were well into seeing them in the treatment rooms.  There are usually 4 treatment rooms running at one time – each one lead by one of the four medical professionals on our trip.  Pam, Ilana, Ann, and Karen.  Our mission is to teach the Nicaraguan staff and ideally graduate them to teaching their own staffs in outlying hospitals how to perform the cervical screenings and remove pre-cancerous lesions on their own. Sadly, most of the clinics don´t have the equipment needed to remove the lesions, either by freezing them (cryotherapy) or excising them with a live wire (LEEP).  Training is one issue and funding equipment to do so is another.

I again began the day doing intakes and found that I was much more comfortable with the vocabulary and questions.  The true challenge came when one of the patients told me yes, she had been abused by her husband, that he had been killed, and she had lost a son to suicide. The previous day all answers were emphatically negative.  We paused. I took a big breath, held her hand, and told her how sorry I was for her pain and loss, making a note for her to see the psychologist before leaving. This woman´s story wasn´t unique – along with poverty comes violence, loss, and struggle.  We finished the interview and I handed her a sheet in Spanish that explained a little about female anatomy and the treatments we were offering that day at the clinic.  When I walked into the data entry area, I burst into tears.  I wasn´t expecting it.  I couldn´t stop crying.  But of course, eventually, I did.  Feelings here are very close to the surface, it seems.

This woman had  waited over 4 hours in the hallway to be seen.  I was able to intercept her afterward and escorted her to Jenny – the director here in Nicaragua – to set up a psych consult for Thursday  I pray that she shows up and gets some professional emotional support. Her screening showed no abnormal cells.  Finalmente.  Un poco de buena suerte.  She gave me a big hug and the traditional kiss on the cheek.  I asked for another and hugged her again as we said goodbye.  Tears in both of our eyes.

In the afternoon, I adopted another new role.  Hand holder.  This role is very important and not language dependent.  Each of the DFW volunteers can share a story of connecting with one of these patients as she received a LEEP or Cryo.  Wiping away tears.  Squeezing hands. Sharing pictures of home on their iPhone.  Talking about our kids.  Coaching the patient to find their breath and exhale….. This job of hand holder is not to be minimized.   One patient pantomimed to the volunteer that she could feel her heart in her hand, supporting her and holding her fear. Compassion crosses all barriers of language, when we are open to truly and vulnerably connecting.

Imagine getting on a bus at 3:00 a.m., arriving at a big hospital by 7:00 a.m. (the time they are told to arrive) , and sitting in a sweltering hallway for 2 hours before the medical staff even arrives.  My last patient on Tuesday was seen at 3:00 p.m.  She had to catch the 4:30 bus back to her pueblo and probably hadn´t had anything to eat except for the couple of cookies I encouraged her to eat along with the glass of water that washed down her ibuprofeno. We handed out sodas and crackers.  Many volunteers shared parts of their lunch with women that had been waiting for hours.  There was no protocol except to follow your heart.  Some volunteers even brought toys and crayons for waiting children.

When we got back to the hotel, we were all exhausted, but felt good about the work we had done for DFW and PINCC, and for the connections with these very brave Nicaraguan women.

Nicaraguan dancers arrived around 6 and we were treated with 3 traditional dance performances by local young people.  They were amazing and full of celebration and  laughter – just what we needed after the long day.  We then ambled down the street to Carol´s favorite family owned restaurant for soup and postre de tres leches.  The soup was delicious, served in giant bowls with giant spoons that looked more like spoonRESTS than soup spoons.  We encountered numerous new root vegetables and potatoes in the broth which was made with a huge variety of ingredients including sour orange.  Yum.

After dinner some of us found our way to the rooftop again and were treated with double fireworks. Arriba (to the east) was an amazing display of lightning that traversed the sky like words written in cursive (a direct quote from Marie Cruz).  Abajo we heard the boom and crackle of fuegos artificiales or fireworks.  I thought they might be coming from down on the beach, a preview for tomorrow´s national holiday.  NICARAGUAN MOTHERS DAY!