How refreshing it was to wake up every morning to a light cool breeze and the birds singing like the recordings one hears while in the tropical area of a zoo! In the evenings it would cool down gently and it was never very cold at night. During the days it was usually a humid 80 degrees. Wednesday it might have been around 70 with gusty wind.
After starting the day with 5 or so Paps with breast exam (I could never keep track), Kathy told us the 16 year old girl was back and said she had had a fever that night. At first, Deb was concerned but when we talked to her the girl seemed much better with no temperature. We explained to her how the medicine should get rid of the infection within a week and to go to the local clinic if she wasn’t better within 2 weeks. However, it was obvious that she was doing better already after 12 hours on antibiotic. Also, the Peds doc had been able to examine her baby that morning and found him to be a healthy baby. So, we loaded her up with formula and, after seeing her grandma, said goodbye.
As Deb and I saw more patients, the wind got stronger and almost pulled the tarp that divided the classroom in half out from under the desks holding it down. The ladies were getting nervous so once we reached our 3 PM deadline, I recruited several of the amazing local volunteers to help. Somewhere they found some heavy rocks and two guys retied the tarp to the roof where it had been torn by the wind.
It was a pleasure to work with these amazing local volunteers from the church for the whole week. Doña Carmen stood all day for the whole week at the door to the Women’s classroom and did a superb job of handling patient flow. Also, she would go find Kathy or Sister Susan for us if we had a question or take patients down to Salvador for an ultrasound. She was a dear friend by the end of the week.
Another important volunteer for the Mujeres room was our local nurse in training, Ana. Ana is 23 yrs old, speaks only spanish, and has a young one of her own at home in the capital of San Salvador. We would have been lost without her help, especially due to one key word: Pap smear. The very first appointment on the first day I used “pappinicolao” for pap smear (what I use when interpreting in the US) and the poor woman gave me a blank stare. Afterwards, Ana informed me that they use “citologia” in El Salvador. That is one of many examples that I could give you of Ana coming to the rescue for Deb and I. Ana became our go-to person for any cultural or salvadorian language questions.
Now back to Wednesday: Ana was able to find us a bigger slide box so we could do more than 30 pap smears since there were only 30 slots in the original box. Thus, Deb and I tried to be more efficient at seeing patients. It was quite a challenge to do 30+ paps before 3 PM. We both disliked how we could not spend more time with the women. We also knew by now that the women really appreciated getting their pap smears done by a female doctor (especially Deb since she was so quick and gentle). Many would tell us of painful pap smears by male doctors in the past.
It is important to note here that Deb was impressed by the country’s women’s care. Most women were getting a pap every couple years and a variety of birth control options are available for free. Also, for the women we saw who had a serious women’s health issue, the treatment they received or were receiving was usually what Deb would have suggested. The only area we were surprised with was the fact that only a few women had had a breast exam. Pat, a NP who has worked in El Salvador for many years, told me how the health department places more money in prevention care for uterine health since there is a higher occurrence of ovarian and uterine cancer for women in El Salvador than breast cancer. Hopefully, the local clinic is not overwhelmed after I told every single patient to perform self-breast exams and to go there if they find anything suspicious.
After 3 PM, we had several women bring in their 80+ years old mothers for breast exams. The older women were dressed in simple calico or gingham dresses with traditional aprons. Though they were hard to understand, they were so sweet and grateful for the simple breast exam. One woman who was lifted onto the exam table by her youngest daughter (out of 11 kids) was just skin and bones with barely any breast tissue. Deb, without blinking an eye, gently did a breast exam. When I interpreted Deb’s words that the breasts were fine, the woman lifted up her long, worn hands as if in prayer and said “Thank God! Thank God!” (Another tears in the eyes moment) Then, there were hugs and kisses all around and several “God Bless you.” May God bless her!
After cleaning up, we had a few minutes (for once) when it was still light out to watch the kids playing in the compound. The children loved to pose for anybody with a camera as you can see in the pictures below. Then, I headed over to the eye glasses distribution room to interpret as they were completely overwhelmed. It was terribly comical to see the men walk out with sunglasses that were ones we would call “granny glasses.” They thought the big sunglasses with the side shields were the coolest thing!
I helped interpret for Sister Marilee who was finding glasses for an older women. When I asked if a certain pair of glasses fit well, she said, “Yes, now I can read the Bible again!”
Next, I helped Sister Marilee find glasses for one of the local volunteers who I had met before. We were joking around with her and Sister Marilee showed her these really flashy glasses thinking the volunteer, who has a vibrant personality, would like them. However, the woman looked at me with a “what the heck” look on her face and said, “I need glasses that will get me a boyfriend!” Her comment was so out of the blue that the three of us laughed quite a bit. Sister Marilee then found some more conventional glasses. One of my favorite things about speaking another language is that one can relate to someone else from a different culture! That sounds so cliche but my most special memories from this trip are from when a patient and I could empathize with each other, even if it was laughing over a pair of glasses with too much bling that it would scare the boys away.
It was such a pleasure to be in Ojos 3 for an hour or so and see the delight on so many patients’ faces when they found a pair of glasses that made reading possible again (near and far away). It was such a joyful room!
And so the day came to an end around 6:30 PM with everyone seeming a bit more refreshed after a cooler, smoother going day. The wind had died down to a light breeze and the sun set as we loaded up onto the bus
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