We first met Maria Borja Nono, age 55, about a year ago when she attended a MEDLIFE Mobile Clinic in the community of Shobol Pamba, Parroquia San Juan, del CantÃ³n Riobamba in Ecuador. She was examined by our gynecologist and found to have a cystocele, a medical condition that occurs when the wall between a woman’s bladder and her vagina is torn. This rupture most likely occured during the delivery of one of Maria’s 13 children.
Although Ecuadorian laws call for free and universal access to healthcare, the country continues to experience high levels of maternal death and complications from childbirth. Many women from indigenous communities give birth in their houses, due either to the lack of transportation to surrounding hospitals or to the notion that hospitals provide culturally insensitive care.
According to CARE USA, indigenous women are accustomed to being surround by friends and family during childbirth and to giving birth in a vertical position — customs that are not always allowed in country hospitals. As a result, women do not always know how to identify signs of maternal risk, nor how to seek out help for complications that occur from childbirth.â€œIn all seriousness, I’ve been in need of having an operation for this problem for over 20 years now,â€ Maria tells us during our interview with her at her home in Riobamba. â€œI just could never afford it, especially having so many children to take care of.â€A typical day for Maria consists of walking a distance of about three miles to and from work where she is a day laborer in a lime mine, coming home to take care of household chores and care for her elderly mother, staying up late to cook the family’s meals for the following day, and getting a maximum of four to five hours of sleep per night.
Her husband also works in the mines and has a similarly stressful daily schedule.Once diagnosed at the Mobile Clinic, it was clear that Maria was going to need surgery, and financial assistance to cover the medical costs. Always punctual and cooperative, Maria had eight medical clinic appointments consisting of check-ups and further examinations. She was accompanied to each appointment by MEDLIFE follow-up coordinator, Maria Chavez.
â€œI met up with Miss Chavez and she helped me through the good and the bad,â€ Maria told us through tears during our interview. â€œShe helped me. I give thanks to God for her help. Even when my own children couldn’t be around because they were working far away, she was there up until the final days. Thank God that even today she is helping me, economically and emotionally.â€Prior to her surgery, Maria’s tests revealed several complications including vaginitis and possible bladder fistula (an abnormal connection between the bladder and the vagina) for which a cystography was performed. Currently, our patient is relieved of most of the pain and discomfort she had been experiencing and is regularly returning for medical examinations for further alteration of bladder muscles.