JUNE 10, 2013 - Clinic Day One in Laguna de Perla, Nicaragua

PINCC Blog post by Tina Romenesko

The torrential rains during the night had left us without power, but the gas stove was humming as I entered the cozy kitchen of the Green Lodge.  Arlene and Wesley, our hosts,  were busy serving breakfast to the PINCC volunteers, six at a time.  Coffee, scrambled eggs with tomato and pepper, gallo pinto (of course), bread, guayaba jelly, and some of the most delicious pineapple I have ever tasted.  We were all done, and fully coffeed,  by 7:00 sharp and headed for the Clinic, where the patients were already lining the soggy and overcrowded hallways.  Some volunteers began setting up rooms while others began the interview process.  Fifty numbers had been distributed to patients, which meant we had a very full day ahead.  Many of them had come by panga (boat) from neighboring communities and represented at least 3 different ethnic groups that comprise the Pearl Lagoon region.  We weren’t sure if the interviews would be done in Spanish or English.  The people in this area speak both languages, as well as many ethnic dialects.  Our intake forms were in Spanish, but most of the interviews today were in a combination of the two.  It took me awhile to get the gist of the accent - in English.  I asked them to be patient with me as I tried to listen and spell their names and towns over the rattle of the continuing rain on the roof.  Most of us were standing in puddles or underneath roof leaks, but everyone pursued and communicated the important facts surrounding each woman’s reproductive health issues.  

We have brought Cytotechnician, Dr. Fatima Figueroa from Leon with us, which allows clinicians to perform a PAP test if the clinician feels that the view of the cervix is inadequate or incomplete.  This option gives patients the most accurate result, if there is any questionable tissue in the viewable area.  It usually takes weeks to receive PAP results - and follow through can be formidable as slides are often read off site, or even sent out of the region.  The problem today is the lack of electricity.  The microscope lights won’t be illuminating any slides until we have power.  Fatima and Sara, a medical student and pathology intern, stained 16 slides today, and hope to examine them tomorrow, but time will tell.  The power outage originated in El Rama - the regional capital - so it is imposiible to guess when we’ll be sending emails, enjoying air conditioning, or even powering microscopes.  If you see this BLOG ENTRY, we are back in business.  

I am always impressed by the volunteers willingness to do ANYTHING - and I mean ANYTHING.  No job is too menial when the team is in need.  Today I found myself doing interviews, educating clients in the hallway, donning rubber kitchen gloves and assisting Becca and Sallie in sterilizing instruments, and eventually was called upon to follow-up with clients that had been victims of abuse.  It is estimated that around 25% of women with HPV - the cause of cervical cancer - have been sexually abused before the age of 16.  The incidence of HPV rises with the age of onset of sexual activity, numbers of partners, and also the amount of stress the women endure throughout their lives.  For these reasons, our intakes include very personal and important questions that can raise difficult emotions and memories.  My role was simply to inquire, listen, and offer support and safety for them, however they needed it.  It is an honor to hold these women’s stories in confidentiality and with deep compassion.  

Seven hours later, when we break for lunch, we have seen 45 patients, performed a handful of cryos, and scheduled about half a dozen LEEPs for the end of the week when we HOPE to have power to perform them.  We have also given many women the good news that there were no abnormal cells in their cervix!  So many women came to the clinic with the C word, front and center.  They leave relieved, better educated, and empowered to improve their sexual health practices - physically and emotionally.  

PS:  Just got power!  Blog going UP!!!