Each day becomes a little more frightening. We continue to be shocked at the amount of cancer that we are finding - 2 to 3 cases each day and numerous cases of severe dysplasia.  This information is getting around and the lines each morning are growing. This morning we all looked at each other wondering how we'd manage.
I've worked with a lot of people in my day but this team is incredible. Each person seems to realize that what we are doing is the beginning of a very meaningful cancer prevention program here. Our 2 students, Puja and Lauren are functioning at a level far beyond their years. While always treating each patient with the utmost respect, Puja managed to see 67 patients today and Lauren took on a room of 400 women, triaged and kept the day running smoothly. Lisa and Mani work throughout the day non-stop keeping up with getting us results.  They are so passionate about what they are doing.
Orfe has done all of our intake and managed to get complete histories from 90 patients today.
In the midst of it all, we managed to spend all the needed time telling families and patients words they didn't want to hear as well as giving hope to many patients since we have the tools to treat their pre-cancerous lesions.
It was one heart-breaking story after another.   But in the midst of all the chaos are the individual stories. Each story recounts the lives that so many women here face – abuse, neglect, injustice.

Even in the crowded room this morning, my eye went to a tired looking pale woman sitting in a corner.  We have become so accustomed to what we are seeing that I immediately knew she was one of the victims of all of the above.  She came into my little room first and brought a friend.  I glanced at the history that Orfe had so carefully taken – 8 children, husband died last year year….Then,  she recounted the story that I wouldn’t believe if only I had not heard it myself.  Soon after her husband died she began noticing bloody discharge.  She came for help but the nurses told her that you can’t have an exam if you have discharge.  Finally, when the smell became so bad that no one wanted to be near her, she went to the main hospital in the Peten.  There, the doctors examined her just 2 months ago and told her she had a fibroid.  They told her it would be best if she only at tortillas and beans and this might help.  Finally, 2 months later she returned and they told her that her biopsy showed cancer.   At this point, she broke into tears and told me that she had nowhere to turn, no money for travel, no options.  But yesterday, she heard of our group and she gave such thanks to God because she knew that we would be His hands, that we could cure her. She looked me straight in the eyes and held my hands begging me to care for her.  The tears streamed down my face as I heard more about her 40 pound weight loss and lack of appetite.   I looked at her pale hands and knew without examining her that it would be too late.  So how do you tell someone who has complete belief that you are the “hands of God” that the neglect she has received cannot be overcome?
Wiping my eyes, I calmly told her that we now I’d examine her.  In the back of my mind, I frantically prayed that perhaps her weight loss was the result of the “diet instructions” from the doctor.  But as she bravely laid down and I began my exam,  it was all I could do to not weep and run.  In med school, we learned about “fungating” cancers but rarely have I seen one.  This cancer seemed almost to be “evil”.  The stench was so putrid; the foul liquid from it poured from her fragile body.  My mind raced thinking about the virus that some man had infected her with at a young age, about the lack of any prevention program here and about the complete lack of help she received when she sought it.   I doubt that the doctor really thought there was no problem.  Did he just not care or did he know that there would have really been no treatment so why concern her family with this diagnosis until they really had to know?

So while hundreds of women sat outside, we stopped to somehow be the “hands of God” that she sought.  I thanked God that Puja and Lauren would somehow be able to manage the throngs of women and keep the program going. How did we get so fortunate to have 2 brilliant, resourceful women such as them on our team?

Orfe and I had her son come in and we did our best. We all talked about life and death and why God ever creates us and why such tragedies could happen.  All I could do was truly thank God again for bringing Orfe into her lives with her quiet understanding and great wisdom.  We talked about how whether we live 20 years or 80 years, it is but a blink in the scheme of the universe.  We talked about how it is really in how we live our lives, how we bring purpose and how care and love each other that matters.  The only hope I could give them was the promise that Orfe would continue to visit with her; bring her pain medicine and help with whatever comes along.  And I asked her to help us get this word out to all the women and the men that this is a completely preventable disease and that it can be stopped.  She happily asked us to record her testimony and put it on the “internet” for all to see.  The fact that she was finally being heard seemed at least to give her a small bit of consolation.  Whether she lives 2 weeks or 2 months is less important than that she dies with dignity and that her family knows that someone cared.