Trip Reflection 2008 – Maria Lina Diaz M.D.
Maria Lina Diaz M.D., FACOG, The Cleveland Clinic
During the 2008 mission we were so proud to open the Cervi-Cusco Clinic. A comfortable, hygienic and beautiful facility to offer the women of the Andes a chance for survival was finally a reality. In developing countries, cervical cancer is the 2nd cancer killer of women and our presence in the Cusco region for several years was the only hope for many women of ever being screened for this killer disease. In this region, women are unfortunately unable to be screened for cervical cancers with a simple pap test. Too many limitations stand in the way and the result is an overwhelming number of preventable deaths.
The women of this region are so special. Their beautiful coppery skin becomes prematurely lined due to the harsh environment and perhaps from the untold many hardships that their dark brown eyes cannot totally conceal. The women stand proud, many in their traditional garb- bright colors and unusual hats, woven blankets with precious doe-eyed babies carried across their backs.
My patient on this particular morning appeared much older than her stated age. Her felt top hat was carried proudly above her long dark braids. The colposcopy I had just performed was worrisome and I was sure the pap (her only pap in 54 years) would surely reflect that she needed treatment to prevent progression to cervical cancer.
She did not speak Spanish as is the case for so many women of the region. Their language is Quechua, an ancient oral language that dates back to the Incas. Through an interpreter I tried to tell her she would need treatment. The interpreter stated the patient wanted to know how much the treatment would cost. Proudly and with a bright smile on my face I held up my right hand making a zero with my thumb and index finger.
The patient burst out crying, surely in appreciation and amazement of our generosity I smugly thought. Through the interpreter the sobbing woman told me she did not have 300 soles.( roughly equivalent to $100 dollars). “No, no” I said and looked at my right hand still in the air with the zero. I blinked and looked at my hand again realizing that the remaining three fingers were upright. I had seen the zero; the patient had seen the 3 fingers and interpreted the fee for saving her life as 300 soles.
I started to cry myself realizing the horrible misunderstanding and how desperate and anguished this woman must have felt being asked to pay a price to save her life that she could not afford.
She smelled smoky like a campfire, no doubt from years of cooking over an open fire, but I hugged her and apologized. I explained again that the treatment was free. The interpreter began to cry, this time I realized in true appreciation for what was being done for the women of her region.
Blowing our noses and wiping our tears with donated Kleenex, we made arrangements for the patient to return for results and treatment. I learned a lesson that day. How many misunderstandings and conflicts are not recognized due to individuals’ miscommunications and misinterpretations?
Two worlds came together that day, each of us carrying our own reality and our own reference points. We saw the same hand but drew such different meaning.
Walk a mile in your neighbor’s sandalias.. Perhaps it is not a coincidence that the words humility and humanitarian start with the same letters.
Maria Lina Diaz, M.D. – 2008