The morning went quickly because lots of women came in to see the obstetrician, but I struggled to get my brain back into Spanish mode. I hadn't slept all night, after being on the buses for 16 hours, and hadn't had the opportunity for breakfast. I also had barely spoken Spanish for three days, as it is easy to get by with only English in Montanita
. Naturally I couldn't wait for lunch and you can imagine my disappointment when it kept being delayed more and more. However, when it was ready at about 2.30pm it was worth the wait. The parteras had made an extra special effort for one of the doctor's birthdays. They presented us with a huge, whole fish each, that they had wrapped in banana leaves and cooked over the open fire, with a mixture of herbs and lemon juice. We ate this delicious meal, with rice, yuca and a salsa that they had made from tomatoes, onions and herbs. It was delicious and again, my companions sucked everything from the heads; eyes and brain included. I have noticed that they keep the remains of what I haven't eaten sometimes, for them to eat when I have left. Not that I ever leave anything that we would class as food, usually just fish heads and chicken bones that they laugh at me for not eating.
We didn't have much time in the afternoon, as our lunch was so late, but one patient will remain in my thoughts. She was 52 years old and came in with her daughter, who was heavily pregnant. To start with I thought it was an antenatal appointment for the girl, but it soon became clear that the mum comes in regularly to be checked over. She had a really deformed breast, which had transformed beyond recognition. I can't describe it, but if you typed advanced breast cancer into google, this is what you would see
. She described that she was getting lots of pain, and I would imagine there was a high incidence of infection, as some of the skin was blistered and broken. Miriam explained that she had been attending the clinic for a year, but refused to attend a hospital for treatment. She only let Miriam see it, and refused to let Miriam refer her to another doctor for cancer care. Miriam explained the risks and how bad the symptoms were, she offered to go with the lady to the hospital, but the woman refused. The daughter pleaded but nothing was going to change her mind. There is a belief here that when you attend the hospital for cancer treatment, you still die anyway, but in the meantime they make you worse with all of the drugs. She was an indigenous woman too, so I am sure part of the lack of trust of hospitals and doctors stems from this difference in cultures. She only wanted to see Miriam for pain relief and Miriam could only plead with her, but to no avail. It was desperately sad as she may not see her new grandchild for long, because she can't access the health care here, even though it is available to her. I presume her daughter has grown up with a bit more health education in schools, and is a bit more used to hospitals, and to see her begging her mother to try to save her own life, was one of the saddest moments I will encounter here. (Or at least, I hope it doesn't get worse than that).
I came back to the volunteering project with mixed emotions, as I am enjoying my time here but didn't know how much more I would see with only one more
. It also takes a lot of time (more than I have) to really understand the customs and beliefs that are deeply engrained in a culture, I feel like I am only scratching the surface. Thankfully I was welcomed back with open arms and was quickly caught up with plans for Miriam's birthday party. Like the other party, the staff in the clinic had bought a cake, cola and lots of beer, and had set up a sound system to enable them to dance later. The members of the ministry of health also attended, and everyone seemed to enjoy the birthday festivities. After an hour or two, my brain switched off totally and refused to try to translate anything else. I was exhausted from my long bus journeys but felt relieved that my first day back at the clinic had gone so well.
After a ridiculously long, and uncomfortable bus ride I finally arrived back in Archidona, after visiting Montanita for the weekend. During the journey we were stopped numerous times for police checks and on one occasion we needed to all get off the bus for a bag check, and frisk search. We noticed that everyone got their bags checked and frisked before starting the journey too, but Antje and I were just waved through at that point. When I arrived back here, I was welcomed by torrential rain, and needed to get a taxi back to the clinic, with half an hour to spare before I was expected to show up to work.