Photo: Dr. Lourdes Camacho

Dr. Lourdes Camacho Paneque, a specialist in gynecology and obstetrics, began to feel a vocation for the profession as a child, when her grandmother took her to visit the hospital where she worked in the municipality of Banes, Holguín province.

She is proud of her accumulated experience and contribution to helping the peoples of Bolivia (2006-2008), during an international mission, and now on a second mission in the La Tinta neighborhood, Alta Verapaz department, Guatemala, since 2017.

“Since I was five years old, I have lived in Havana and I undertook all my studies in the capital. At the end of my degree, I volunteered to go to the Cuban mountain range to provide rural services in the Manuel Piti Fajardo contingent.

“I was assigned to the community of Caney de las Mercedes, in Bartolomé Masó municipality, Granma province. I undertook the sixth year of my degree, plus another two, at the Mariano Pérez Barí Hospital. It was precisely at that stage that I learned about various gynecology procedures, so I decided to opt for the specialty.

“I like the obstetrics side. I have two children, and I always asked to see my labor through to the end because I wanted to know what a person experiences when she is in that process.”

How was the experience in Bolivia?

I worked in a place located at a high altitude above sea level. To get there, we were advised not to eat for a day before to avoid vomiting. The journey meant passing around a mountain on a road known by the population as Death Road. When it rained, the roadway got very slippery and cars overturned. It took about eight hours to reach the town. On that mountain there was snow and frost almost all year round.

Incredibly, upon arriving at the site, the medical college and the professionals who practiced private medicine there were opposed to us providing care to the population. They were part of the political opposition to President Evo Morales.

I remember that right on my arrival, a woman in labor in a very bad condition came into emergencies. Luckily I resolved the situation, and then sent her, with no risk to her life, to another institution in the capital for specialized treatments.

It turns out that the members of the medical college wanted to sue me, claiming that I did not clean the uterus properly. As I received the patient in a critical condition, I entered surgery accompanied by several doctors, including the director of the hospital. Everyone testified to how her life was saved and the lawsuit did not proceed. The best thing that happened to me was that one day I met that same patient, and she thanked me for being alive. The population there was very poor and it hurt to see how they took advantage of them.

In Bolivia, I faced extreme situations to save women who were almost at death’s door. I had the good fortune to be in Pando when President Evo Morales opened a hospital in that department, with first class medical services provided free of charge to the population.

Another case was that of an eight-month-old girl with a burn on her face. That had nothing to do with my specialty, but when we study in Cuba, we do medical rotations in each of the specialties, and one knows how to look for the information to face the circumstances in any environment.

Do Cuban doctors select the place where they will work?

Never, that decision corresponds to the leadership of the medical brigade, responding to the number of inhabitants in each municipality, and the needs of the country. We go with the willingness to work in the places where we are needed.

What have been the most difficult cases in Guatemala?

It is very common to attend difficult births, with premature and low birth weight babies, a product of medical negligence during pregnancy. There is no organized health system with a well-conceived maternal and child program. I have had cases of patients living in very remote villages who begin labor at 28 weeks. One must apply a lot of knowledge to that newborn so that it doesn’t die.

Generally, in remote areas, births are performed by midwives or birth attendants, who resolve situations, but when there is a complication such as with a child who is in a breech position, the woman comes to us in a very deteriorated state, because she has been in labor for many hours, and the infant has suffered in the birth canal.

In both countries, there are laws against abortion?

That subject is very distressing. In both places, abortion is prohibited and I have had to assist many adolescents and women who were raped and become pregnant.

In Guatemala, I receive a large number of women raped by relatives or people close to the family. There I practiced a cesarean section on a 12-year-old girl who was raped by five men. It was never reported and the men were not investigated. Others identify their rapist, report them, and the authorities do nothing. They even make me fill out a very extensive file describing the injuries caused and in the end, criminal proceedings never begin. Psychiatrists certify that raped women never recover from this trauma, even if they receive medical treatment and follow-up.

In these countries, they prevent access to abortion in a safe institution, which is why women go to other places, without the necessary hygienic-sanitary conditions, or they buy abortifacient drugs or insert implements through the vagina to interrupt their pregnancy. Then we receive them in the hospital in an advanced septic process, almost on the verge of death. The prohibition of abortion leads to two problems: one, unwanted pregnancies, and another, the possible maternal death of women who turn to unsafe contraceptive methods.

I can give you another example: I received a teenager with a full-term pregnancy who was diagnosed with eclampsia. She told her father, days before her admission, that her sister’s husband had raped her. We arrived convulsing and on investigating her family history, they told us that her entire pregnancy she had been very quiet and sad. She didn’t want to explain her suffering. A cesarean section was performed and she was hospitalized to apply medication. Then we noted a regression. It turned out that the rapist was visiting her in the hospital. After treating her with the psychologist, we got her to cooperate with the treatment.

Why go back to perform another mission?

Missions outside the country are a learning experience, and they remind me of that moment in which I worked in the mountains. Outside of Cuba, you face situations and conflicts with few available resources. Blood for transfusions is usually scarce, and obstacles are created by local medical personnel who see medicine as a business.

On missions, a professional learns about other cultures and much more. In Cuba, we have the support of our colleagues. On an emergency shift, there are residents, students, specialists and teachers. Outside the island, there is only the doctor and sometimes a nurse to solve a case.

In Guatemala, we now do 24 hour shifts. On a duty day, I usually do more than nine caesarean sections, and the work is very intense. We get patients who need blood transfusions, which we do not have, and we use all available resources to save them.

How do you view yourself?

As a fulfilled woman.