By Melanie Schuman Rattigan
It's an empty room in the back of a local school. We clear out a few broken desks and small chairs and with experienced volunteers, we're constructing a clinic with three separate "exam rooms" in no time. Plastic tarps, sheets, rope, tape and a little ingenuity all help to create privacy for the doctors, nurses and patients.
The cervical cancer screenings and basic exams for women require a special team of practitioners from the states. It's like many of the other clinics Hearts in Motion does in Guatemala throughout the year and this is often the only chance these women have to get this examination. Each February, a group of old and new volunteers spend 4-5 days visiting different villages while the general medical clinic operates adjacent. Many of these same volunteers travel to Roatan, Honduras each September as well.
In Spanish, the word for pap smear is papanicolaou, which is also the formal name in English. A Greek doctor whose last name had a slightly different spelling invented the test: Papanikolaou. Either way, it's one of the hardest Spanish words I've learned.
I've often pre-screened patients for basic medical history - How many pregnancies or miscarriages? Any problems we should know about? Any birth control plan? (We ask this because injections are a popular form of birth control here and a woman doesn't ovulate for usually three months.) When I started traveling to Guatemala seven years ago, very few women used birth control whereas now it's not uncommon. It's also eye-opening to meet women in their forties who have given birth to nine or ten children.
Many have never had this exam and are frightened, but it's often more traumatic for their young children who wait outside. The process is less sophisticated than here in the states. Speculums, swabs and white vinegar are used to examine the cells in a women's cervix.
The vinegar causes abnormal cells to "light up." However, since there is no lab to process results, it is difficult to ascertain if the there is mild or high dysplasia. A practitioner with a trained eye can spot these abnormal, pre-cancerous cells or even cancer. We have cryo tanks on hand to freeze pre-cancerous cells and help prevent their growth. It may sound like very basic care, but it works. A translator walks a woman through the process as it happens. I've also done this and as a non-medical person, it's fascinating to learn at the same time
In 2008, the team did 111 cervical cancer screenings and 10 cryos. This February, we did 299 screenings and 16 cryos. While we are at clinic, surgeons are at the hospital in Zacapa are performing vaginal hysterectomies, removing ovarian and vaginal cysts and even tumors. In my first blog I wrote about the women with a 12-lb tumor that our team removed. While that may be one of the most dramatic cases our team has done, each exam in clinic is just as important in saving a life.