Rosadia lives alone with her green pet parakeet whose cage sits near the door, surrounded by cluttered bits of clothing, garbage bags, buckets. Even her mattress is covered. The house smells of damp dust and dirt since it is almost always misting outside at this time of year. Her house dimly lit by a single light bulb. There is no kitchen, no sink, not even a stove to be found; just a small television set with two massive antennas sticking out. Rosadia smiles as we come inside and greet her.
The piles of clutter spread around the room look like vague lumps; individual objects are hard to distinguish. Just like it is hard to distinguish home from home, community from community in the hills during the perpetual greyness of a Limenean winter. She smiles as we come inside, the state and disorder of her home seem just fine with her. She is over 70 years old.
She moves slowly with a stooped posture. She wears a red baseball cap whenever she goes out. As she grabs the brim to remove it the mood in her eyes changes- like when someone is unexpectedly delivered bad news and you can see their positive energy keeping their spirit afloat get sucked out of their face, shrink, shrivel and fall away like a deflating balloon.
The reason for the abrupt change in Rosadia´s mood is bulging out of the left side of her head, her skin is taught, a lump the size of a tennis ball that looks like it would not just bleed but burst if cut into. She has a massive tumor. She has had it for 3 years.
Andres, a MEDLIFE medical intern, and Ruth gather around her and inspect the tumor on the dirt path the leads to the shack. The dirt is wet and slick underfoot. The mixed scent of smoke, mud and dog feces is a constant prescence, adding a kind of texture to the air. Behind us the hills stretch into the distance and eventually melt away into a grey daze. A visually indistinguishable cloud of homes and people like Rosadia.
Her motor function is impaired in the walk test. She complains that she cannot sleep well because of the pain, and because it is hard for her to properly rest her head with such a large tumor. The pain is obvious in her eyes and Andres inspects the tumor.
Her neighbor Nilda, a 23 year old mother, tells us she feels as if Rosadia is her own mother, and she cares for her as if she is.
Thank god, because Rosadia’s own kids do not care for her. They don’t visit her either. “They don’t have time,” said Nilda.
Nilda’s own children shrieked with delight as they played on a wooden beam that supports Nilda’s house across the way as Andres gave Rosadia the exams and Ruth talked with Nilda.
Rosadia isn’t the only one who is sick here- Nilda has a massive tumor on her chest.
Nilda’s children took turns swinging back and forth on the wooden beam, hanging off of each other, lighting up the hillside with the sound of their laughter. It is no wonder people love children so much. They looked like little islands of joy, an oasis, perhaps blissfully ignorant or perhaps immersed in their play just momentarily rising above the grave problems facing their mother and neighbor Rosadia rarely leaves her home. Neither does Nilda, for fear that something would happen to Rosadia, that she might need something. She is totally devoted to caring for Rosadia and her children.
Ruth and Andres conclude they need to get Rosadia an MRI to see what can be done about the tumor. We take Nilda’s information – she is our only way of contacting Rosadia. She will need to help Rosadia get to the appointment. It would be hard for her to make it there on her own in her phsyical condition, and she only speaks Quechua. Who knows how long it would take her to find medical personel that could communicate with her.
Several weeks later Nilda waited all day with Rosadia at the hospital. They couldn’t get anything. Going through the public health system is simply too slow so we meet them on a corner on a chaotic street in the valley below the hills where they live. Rosadia is wearing the same red baseball cap, blue plaid skirt, and sweater she was wearing when we visited her home several weeks ago.
Cars are constantly honking. The median in the street is full of garbage. The air is thick with car exhaust and when the wind blows you can smell both. We are on a street full of businesses offering private medical testing. We couldn’t make an appointment in advance though. We push through the sea of honking cars, rushing pedestrians and shouting street vendors from one lab to the next, asking for the exam. We are turned away time after time. The doctor isn’t here right now. We only do them at night. We are full, they tell us.
Janet finally finds a desk inside of a café. Inside people are sitting drinking coffee, eating pastries. Salsa music is blaring in the distance. The desk organizes and makes appointments for medical testing in nearby labs from inside the bakery. They can finally help us here.
Rosadia feels bad that Nilda has had to leave her children all day and apologizes. Nilda tells her not to worry. They will be ok she says. They are young. The lab can’t do the MRI right now. Nilda will have to return with Rosadia at night. At least her husband will be there to look after the kids then.
This is why we send out the nurses into the field to not only pay for exams and appointments, but to accompany our patients to them and help them navigate the complicated and chaotic medical system. Everything is slow. They explain to the patietns what the doctors tell them. They make sure they find the appointment, get one, and don’t just end up waiting around all day, getting nothing and never returning.
MEDLIFE is currently waiting to get the results of the MRI that Rosadia has been waiting three years for. We worked with Nilda and her public insurance to get her testing. Her tumor is not cancerous and we are following the process of treatment. Our fingers are crossed for both of them.