ACAM TO LAUNCH NEW SCREENING PROGRAM IN 2018
Lucia, one of our newest midwives, caught me in the hallway at the ACAM Center. Her eyes glistened as she said, “I received my stipend today, and I just want to tell you that there are no words to thank you.” Lucia recently completed a course on cervical cancer screenings that was taught in Xela with seven of her midwife colleagues from ACAM and our Guatemalan physician.
The course required studying a 150-page book that outlines challenging concepts such as specificity and sensitivity, dilutions for disinfection, and the epidemiology and pathophysiology of cervical cancer. Our project physician, Valeria, helped the midwives prepare for the course with weekly, four hour classes and practice exams over the course of three months. My midwifery colleague, Mallory, and I also helped them by guiding them through practice pelvic exams in preparation for the course.
Maya Midwifery International provided the midwives with a small stipend to compensate for all of the time it took them to prepare for and complete the grueling five-day course. The course itself was a combination of clinical practice and written exams. It is difficult to describe how challenging this course was for Lucia and her midwife colleagues. Many of them have an extremely limited educational background– some just attended primary school. For example, concepts like cell and virus are completely outside of their vocabulary. To put this into perspective, last year, I met a physician in Guatemala who had taken this same course and she did not pass.
Five of Lucia’s colleagues from ACAM also passed, including one midwife who was even able to become certified in cryotherapy. She was the first indigenous midwife in Guatemala earn this type of certification, so we are now able to treat pre-cancerous lesions on the spot, once we have the needed funds to buy the cryotherapy unit.
Lucia’s voice choked as she went on, “I never thought this would be possible. I had always wanted to become a doctor, but we had no money for me to study, my father was alcoholic, and with 8 children, there was never enough food. When I was asked to come and work at ACAM last January, it was a dream come true, for me [to become a midwife].”
“I had a dream in September,” Lucia said, “a month before the course, in which an old man appeared and said to me ‘why do you want to study to be a doctor, you already are a doctor.’ Then, at the course, after doing her pelvic exam and cervical cancer screen, a patient said to me, ‘Thank you doctor.’ Now, I know that I am not really a doctor, but it made me feel so good for her to say that. I want so much to be able to serve my people, and now I can.” Lucia continued, “I know how hard it must be for you to sacrifice and come here to help us learn, and I just want to say that there is no way that I can ever thank you.”
Now, it was my turn for tears. “You know Lucia, there is no way I can ever express to you my gratitude for the heroic effort you put in to successfully complete this course, and your desire to help your people. I am so proud of all of you and of the work you are doing. It is me who needs to thank you.” As we hugged, our wet cheeks touched.
Lucia is only one of the reasons that I am here. I am equally proud of all of my ACAM midwife colleagues who struggle against all odds to bring new skills to their communities.
At the end of the cervical cancer screening course, one of the teaching US physicians, an OB-GYN, spoke about a patient that the ACAM midwives had referred to Xela. The patient, who was from a remote village, had been seen previously by the midwives at the ACAM Center. They knew from her symptoms that that something was seriously wrong. They had to make several phone calls to encourage her to come to Xela and be examined by the doctor during the course.
“Seeing this woman really upset me,” the physician said. “She is only 42 years old and has three children. She has advanced cervical cancer that has spread, and she is dying. I want you all to know that it is not enough to simply to walk away with this diploma. Taking this course gives you all a great responsibility— you need to go out to your communities and do this screening so no one has to die this way.”
With the heart and soul that is their mark, our midwives have already shown how seriously they have taken on this responsibility. In 2018, we will begin a cervical cancer screening program. With a shared language and culture, Lucia and her ACAM midwife companions, will reach many women in their Maya communities and save many lives. It is a privilege to witness the empowerment of these midwives and to accompany them on this journey.
Author: Mary Ellen Galante