About the Pap Smear Test in Cuba
Irina Echarry
HAVANA TIMES — Kenya said she would never undergo a Pap smear* – and that was it. Despite my curiosity as a teenager, I couldn’t imagine how to get into her mental labyrinthine to understand the reasoning behind her refusal to do something that other women in the apartment building did without the slightest protest.
Later, two of her daughters also refused. I could see them evading the nurses, each wondering when those health care workers would just leave them alone.
I remember that one time I was talking to one of them in a doctor’s office, and when I started to say that it was a little bothersome…with that everything was over: “That’s the very reason I don’t get them done,” was her reply. The girl ran off and just left the conversation hanging.
From the first time I had the test, I had to wonder why some women don’t want to have them done.
Entering the doctor’s office, clinic or a hospital ward is always emotionally chilling, and if it’s about something so personal as having one’s genitals examined, the mixture of fear and worry only increases.
If we add to these the coldness and hardness of the specula, as well as the fact that the exam rooms often don’t provide the necessary privacy, it’s logical that some women feel aversion to the whole thing.
But to walk away from having the peace of mind of knowing that you’re healthy — or, if not, to decline timely intervention in addressing any problems in the cells of the cervix or an infection — is really difficult to understand.
Still, many women stop getting Pap tests or Pap smears out of fear of the pain, discomfort or the diagnosis itself.
Sometimes this is the result of misinformation, while other times it’s because the call from a nurse or the designated family doctor is disagreeable (based on some unpleasant experiences in prior consultations). Yet many women refuse the service simply because they don’t evidence any symptoms of illness, therefore they don’t find the exams necessary.
For all of them I have some news – which isn’t new, but they probably haven’t experienced it (and if they’ve been going to any medical facility like those in the Alamar neighborhood, they’re not familiar with this because these haven’t been used in many such places for a long time).
It’s that cytological examinations are being done with disposable instruments. For taking samples, heath care professionals are using sealed kits that include the following: a disposable speculum, an endocervical brush, a wooden spatula, a cotton swab, a plate glass sample holder, a box napkin holder and a disposable blade.
Gone are those dreaded moments and the aversion to the speculum.
Plus, there’s something more. As the last test I had done proved inconclusive, the nurse came to visit me and performed the cytology at my home. You can’t ask for any more privacy than that.
—–
(*) – Pap smears are performed every three years on women between the ages of 25 and 60 as a screening test used to detect potentially pre-cancerous and cancerous processes in the endocervical canal (transformation zone) of the female reproductive system.
Hello from NYC, NY, in the USA! This is a really interesting introduction to health care in Cuba. I am guessing that, from time to time, you hear things about what a typical clinical procedure is like in the USA — or you hear second-hand descriptions of what it’s like to go to an emergency room at a hospital in the USA. Your description sounds more sane than what I hear spoken on radio or on television here in the USA. My best wishes to you!
“the nurse came to visit me and perform [the procedure] at my home.” The last time I remember home visits from either doctors or nurses up here was in the 1950’s! Nowadays, unless you’re part of the 1%, rather than the 99%, you have to go to your doctor’s office (or in most likely, the H.M.O. center), after, of course, making an appointment weeks, if not months, in advance, then get the bum’s rush in-and-out of one of the many exam rooms into which the doctor or nurse briefly flutters, fulfilling his or her 50+ consultations each day.
Incidentally, due to unpleasant experiences during her adolescence, my wife has a similar aversion to even visiting a doctor or nurse. Until a recent E.R. visit due to a sprained ankle, she had not visited a doctor or nurse since shortly after the birth of our youngest daughter, 16 years ago! I’ll have her look at your entry–but I doubt it will do any good in persuading her.