At first impression, Ruth Alfaro appeared physically healthy and strong. She is a mother of two grown kids and a happily married housewife. Ruth graciously welcomed us into her home, which is situated atop the hills of Nueva Esperanza in Villa Maria, along the outer edges of Lima. We sat comfortably on her couches as we made our introductions while her very excited dog and cat ran afoot. It was not until Ruth stared to talk about her heath that the urgency of her situation became clearer.
Ruth sat in a straight-backed chair against her living room wall as we concluded the transitional chitchat into our intended conversation: a discussion about Ruth’s recently discovered ailment. As the conversation began she grew visibly solemner in her demeanor, a reflection of her worry for herself and her family. We listened intently as she started to open up and tell her story.
Forty-four year-old Ruth first came in contact with MEDLIFE in March of 2014 at a mobile clinic held near her neighborhood. At the clinic she received one of the routine mammograms MEDLIFE provides for clinic visitors; this was Ruth’s very first mammogram, and her first medical check-up in a very long time.
The mammogram revealed a growth in Ruth’s right breast, one that the doctors considered suspicious. The growth was not diagnosable from the single exam; it could be something benign, or it could be cancerous—the doctors were unsure. Her case required follow-up mammograms, ultrasounds and potentially a biopsy; all medical treatment that far exceeds Ruth’s financial affordances and health care access.
Ruth’s husband supports the family of four with the money earned from very inconsistent construction work. He was at a construction job when we met with Ruth, but she said the work comes and goes. The spacious house in which they live is unfortunately not one of the family’s assets; it is rented from Ruth’s uncle. On top off their financial obstacles, a strike at the local hospital has further complicated Ruth’s medical situation. Doctors have not worked for months, and unless it’s an emergency visit, no one is able to access medical help.
The recent strike is not these communities’ most significant obstacle related to health care. Unfortunately, Ruth and many women living in impoverished communities in Lima lack basic knowledge about common women’s health complications like cervical cancer and breast cancer. At mobile clinics, MEDLIFE provides women’s health exams like pap smears and mammograms to detect medical issues early. Women in the communities where MEDLIFE works do not normally undergo self-breast examinations, routine pap smears, and other preventative medical care due to their lack of resources and health education.
The inability to access medical care has proved to be a significant problem in Nueva Esperanza. This is especially true for Ruth and her husband, who both have chronic conditions that require frequent medical attention. Ruth suffers from a chronic cystitis, or a reoccurring urinary infection, which she explains puts her in severe discomfort every day. Her husband also has numerous chronic conditions, but cannot be seen by a doctor until they return from strike. Despite these preexisting health issues, Ruth rattled them off in passing conversation compared to our discussion about her more recent situation, for which she is most concerned. “I am very scared for my health—and for my family,” Ruth admitted.
Due to Ruth’s financial limitations and the potential severity of her situation, MEDLIFE has continuously supported her through the follow-up mammogram tests, ultrasounds, and other medical appointments to determine and diagnose her problem. Unfortunately, her secondary exams were as inconclusive as the first; the growth in her breast is rare and difficult to detect. The uncertainty makes Ruth feel even more unsettled than the knowledge of her medical issue.
We eventually drifted away from talking about her health to lighten the mood and to learn a little more about Ruth’s daily life. She explained that she is partial to cooking arroz con pollo (chicken and rice) and bonding with her family over good conversation. She added, however, that normally happy moments have recently been tainted by her worry that she is unhealthy; it’s difficult to rid her thoughts of the looming diagnosis.
As Ruth’s condition stands now, doctors are still uncertain about the growth in her breasts, but they’re working on identifying the root of the problem and the proper medical treatment to eradicate it. Despite Ruth’s frustration with the limbo her medical situation hangs in, she expressed her gratitude for MEDLIFE’s support. One of MEDLIFE’s nurses, Janet, has accompanied Ruth to her appointments, and we will continue to support her in various ways through the process.
Upon departing Ruth’s house, we could see immediate relief in her eyes, which contrasted her visible hesitation and timid demeanor we observed at the beginning of our visit. Her relief was not for anything we had accomplished, but simply for our presence at her house. We represented a sign of support and that a resolution of her trials is within reach.
