On Friday we traveled with the nurses and doctors to a health post in Northern Masaya where they were hosting a health fair. Around 8 AM, a single truck rolled into Centro de Salud ready to go. Originally, I thought just a handful of nurses and doctors would be coming with us. I was wrong. Just about every doctor, nurse, administrator, and even Jugo, our trusty janitor (and the 3 interns) hopped in or on the truck ready to roll. I rode on the back of the truck along with 12 other persons clutching onto the truck, the supplies on the back of the truck, or other people on the back of truck as we whizzed around the back roads and main highway in Masaya. The breeze was phenomenal, even though my hijab kept flapping and flying in the wind, often slapping Onyema or Garrison in the face. Now I understand why everybody here enjoys sitting on the back of trucks. If only it were legal in the States.
As usual, once we arrived to the health post I worked with the gynecologists in the women’s reproductive health room. This time, I was actually prepared for what I was going to observe: pap smears, biopsies, IVAAS, and even some mammograms to test for potential lumps in breasts. I grabbed a seat next to the stack of supplies ready to observe the day away. Little did I know that when the doctors asked me to pass pairs of gloves to them, I would be putting on a pair myself. The doctors turned to me and said, “get your gloves on”. Initially I was confused; why am I wearing gloves to sit and observe a bunch of pap smears and biopsies? I didn’t realize I’d spend the afternoon actually doing these pap smears and biopsies until the nurses handed me a metal clamp and shoved me in the direction of the woman lying on the bed in front of me. Oh god. Why didn’t I pay more attention earlier? Why am I being trusted to do this? I took a huge breath of air and stepped to the foot of the bed.
- Obtain metal clamp: check.
- Put it in and twist it sideways: check.
- Widen the cervix via the metal clamp: check.
- Apologize to the woman for any pain felt during the widening stage: check.
- Confuse the woman with my broken Spanglish: check.
- Scrape the cervix with a thin wooden utensil and swipe the collected fluids on a plastic petri dish: check.
- Spray and swipe the petri-dish with a formula to keep the fluids in place: check.
- Cautiously secure and close the petri-dish inside of a cooler to get inspected by fancy technology in the clinic later that day: check.
- Look confused for my next step and lose all credibility from the woman lying on the bed: check.
- Doctor steps in and reminds me to prepare the acid for the biopsy: check.
- Acid prepared, cotton balls soaked and inserted in the cervix, and countdown from 60 seconds begins: check, check, check.
- After letting the acid sit for 1 minute, remove cotton balls, and carefully inspect the cervix for white spots: check.
- Clarify that there are no white spots, inform the woman she doesn’t have HPV (Alhamdullilah!), and carefully remove the metal clamp: check, check, check.
- Apologize more for any pain felt during the removal process: check
- My first successful Pap smear and biopsy: and……check!
No women were hurt in the process…well…kind of. But that part doesn’t matter. What really matters is the experience and what I’ve learned throughout it. I finally got my hands wet with some experience in a field of medicine I would like to pursue later on. Okay, sorry, bad joke. I wore gloves. But you get my point.
Pap smears, biopsies, and even more pap smears later, the topic of discussion in the women’s reproductive health room eventually turned into (you guess it!): my hijab. I’ve found that during my time here in Nicaragua, it’s always the women who are more intrigued and fascinated with it. I smiled, and shared the ideology behind the hijab. I could tell the women were still a little perplexed when they scrunched their noses and whispered “but do you have hair?”. Entertained, I asked them if they’d like to see it. They about fell out of their seats. I closed the door and finally satiated their yearning to see just exactly what was hiding under the flowered-printed scarf of mine. After a chorus of “oooohs”,“aaaahs”, and “que bonita!”, I think they finally understood the purpose of hijab. Once again, I drew the link between modesty and hijab in Islam and Virgin Mary’s veil in Catholicism. The connection clicked. The gynecologists and nurses in that subdivision of the clinic are such sweethearts and have been nothing but supportive and informative throughout my journey in understanding the work involved with pursuing a career in women’s health.
Conducting pap smears, biopsies, feeling for lumps in the breasts of elderly women, and even verifying to the nurses and doctors that yes, I did indeed have a full head of hair…my 4th week of work in Masaya had successfully came to a close!