As part of my effort to get out of the way of our local staff and start handing over leadership for the program, I recently stopped teaching workshops. I still attend them all, and jump in to help answer questions when our volunteer facilitators are need a hand. But I sit in the back, taking pictures and silently willing our volunteers to speak up, laugh a little more, and get more comfortable in front of the group. Sometimes I slip out to take phone calls or prepare the snack, and once in awhile I’ll leave to visit women who are sick with reproductive health problems in that particular village.
That’s how I ended up alone in her house last week. I wasn’t really alone – her husband and sister-in-law were there – but I was visiting on my own. I wasn’t sure what anyone expected of me. They had told me before that she had cervical cancer, but that the surgery she needed would cost $5000. The hospital had sent her back, unable to help if the family could not find the money for the surgery.
Before I went to visit, I wondered if asking me to visit there was the community’s way of suggesting I fundraise for her surgery. Once I arrived, it was clear that no treatment could be helpful anymore. She was lying flat on her back, rigid, crying out in pain every few seconds. Her sister-in-law spooned her rice porridge while her husband told me that she had been like this for a month already. I showed him some simple exercises he could help her do to help ease the stiffness in her legs and arms, and explained how to prevent and care for bedsores.
I told him I would check with our doctor and bring her some painkillers. “It won’t make her better, but maybe she will be more comfortable.”
That was last Thursday morning.
Our health center staff were treating patients at the jail Thursday afternoon, so on Friday morning I stopped by. The doctor was in a village , the manager was busy, and I was tired. Saturday I went to play, and the health center was closed on Sunday. A few times on Monday it occurred to me to go look for the doctor again, but I figured the staff would call me when he was free. By Tuesday morning, I was annoyed with myself for delaying so many days already. When I arrived at the health center, the staff was incredibly busy. “Either the doctor or the manager will go with you to meet her this afternoon.” To be honest, I was a little bit happy when no one was available to go at two oçlock- I had been talking to a great friend in Seattle on Gchat while I finished up an evaluation report. An extra hour to return to those two activities was a welcome surprise.
At 6 o’clock on Tuesday evening, someone from the health center stopped by my office with a package of painkillers, with instructions that the sick woman should take one in the morning and one in the evening. “But there are only eight pills here, These are only going to last her four days.”
“Try these ones, we’ll give her more if she needs them,” she told me, and I shrugged and agreed, too tired to argue.
On Wednesday morning, I got on the moto with our two interns, and we went to finally deliver the medicine. When we turned off the main road, we could hear the chanting already.
“Fuck. Oh no. What the fuck.” The interns giggled; they thought I was talking about sex. I was too upset to switch to Khmer and explain. “That’s her house, that’s her house, fuck fuck fuck.” We pulled up in front of the house, where old people wearing white lace were gathered around the group of monks chanting into a microphone, a funeral.
“Go ask them who died,” I finally got out in Khmer, and the girls’ faces flashed recognition as they realized this was the house we were going to visit.
Yes, it was her, they confirmed, hurrying back to me, a little frightened by my anger and tears. My shoulders shook, and I walked away from them to sit on a daybed in front of a house across the street. “Fuck. Fuck. Fuck. Fuck. I could have fucking brought her the medicine last week and now she’s fucking dead.”
They suggested that I could go join the funeral. I was wearing a printed skirt that hit above my knee and a bright t-shirt though, so I waved the idea off, got back on the moto and went home.
I wish that there was something I’ve learned from this, or even an important question it raised for me. Or I wish that I felt satisfied pointing out the structural issues here, with a reminder of the importance of changing the system. Because yes, it is structural: Cambodia has one of the highest rates of cervical cancer in the world. And by now we all know that HPV, a sexually transmitted infection, is responsible for around 70% of cases of cervical cancer. In a country where most married men regularly visit prostitutes and often cannot afford or choose not to use contraception, it’s not surprising that rates of cervical cancer are so high here.
But it’s personal too, because I could have eased her suffering in her last few days, I could have made her a priority, and I didn’t. I’m not here to save or to fix anything, and I’m not a doctor or a nurse – my job isn’t to provide people with any kind of healthcare. My job is to accompany women though, and this week, I fell short.