Next month, a Little Rock doctor will complete a yearlong project to help women in Belize get necessary medical care. Dr. Gary Wheeler with the University of Arkansas for Medical Sciences has been working with the Belize Family Life Association and its network of clinics on an educational video that encourages Belizean women to get annual checkups to prevent cervical cancer.
Early morning heat and humidity fog up the glass windows of a small café inside the Coningsby Inn, a bed and breakfast in Belize City. Kitchen doors swing open and the smell of scrambled eggs and sizzling bacon waft into the dining room.
“I’m making fried bread. We call it “fried jack” in Creole,” says the chef, as she lays the bread in a pan and smoke begins to rise from the hot stove. “First we give [patrons] a cup of juice and fruits.”
Gale Robateau is cooking breakfast for Dr. Wheeler and other guests. She says health care concerns are always on her mind, because National Health Insurance doesn’t cover everything.
“Yes, it can be so expensive and not all the time I can afford it,” said Robateau. “Right now, with schooling and things like that it’s very hard to pay. But when it comes to tests and services under $100, NHI is very good.”
Robateau lives in a village, called Western Paradise, a few miles outside of Belize City. She wakes up at four o’clock every morning and catches a bus to make it to work on time. Robateau’s main job is cooking and cleaning at the inn, which doesn’t provide enough money to take care of her medical needs and the health needs of her son who has a weak heart.
“The other day, I took my son to check about his heart and the test he has to take is like $345. It’s so expensive,” says Robateau, as she serves breakfast to guests.
Like Gale Robateau, many middle class and poor women in the country rely on the Belize Family Life Association, or BFLA, for crucial clinical care, especially reproductive health and family planning services.
Dr. Wheeler says Belizean women are often busy taking care of work and family and sometimes forget to take better care of their bodies by getting an annual exam.
“What we’re trying to do is create a video just to explain what the facts are, how a Pap smear is done, what will actually happen to a woman when she gets the procedure done, and do it in a way that’s sensitive to the sensibilities of the different populations that we’re making the videos for,” said Wheeler.
The multilingual videos are in English, Spanish, and Kekchi a native Mayan language. Dr. Wheeler says the videos will be shown throughout Belize in urban areas, rural villages and coastal communities in an effort to better educate the public.
Across town, an old colonial-looking building with faded yellow paint and pale green columns is home to the BFLA’s main office in Belize City.
Joan Burke, the organizations executive director, has just given a young woman a pamphlet with additional information on the clinics Pap smear services. Burke says about 80,000 Belizean women within the reproductive age group should be getting a Pap smear every year.
“Unfortunately, between the Belize Family Life Association and the Ministry of Health, as well as the private sector, we are not even reaching 10 percent of that population, which is of great concern,” said Burke.
She says women in Belize are becoming sexually active at a younger age increasing their chances for contracting cervical cancer. Finances are another factor.
“You have women who live in very remote communities where transportation is not reliable. They have to leave their communities to come into urban areas where the [health] services are available… that’s an additional cost,” said Burke.
Burke says health care providers can’t assume that women know the benefits of a Pap smear. She hopes the videos will shatter myths, help women take control of their personal health, and change risky behaviors.
“Just from our outreach and discussions with women, we find that many of them have all kinds of misconceptions,” said Burke as she walks down the clinic’s hallway to her office. “I remember one woman asking if the [Pap smear] procedure is when you take the womb out, clean the womb, and put it back in. Then you have some women who say they were told that you take a spoon and you scrape the womb… so there are many misconceptions that we need to dispel out there.”
Raphael Amoa is the cytotechnologist for the BFLA. He studies cells for evidence of diseases, like cancer. Amoa says a number of women are seeking screening services when it’s too late.
“They need to come and do a Pap smear test every year, because we are looking for cells that are malignant or precursors to cervical cancer,” said Amoa, after viewing slides under a microscope. “Like I was telling Dr. Wheeler about the carcinogenesis of cervical cancer, it takes a long time before cancer develops. If an abnormality is caught, your life is saved.”
Back at the Coningsby Inn, Gale Robateau says she’s thankful for the BFLA.
“It helps a lot of people… a lot of us, especially when it comes to some of the tests,” said Robateau. “The other day, I took some tests and it was free.”
Dr. Gary Wheeler has been to Belize several times over the last decade and says he wants to do his part to bolster public health initiatives in the country.
“Whether you’re talking about development in southeast Arkansas or Belize, the most important thing is to provide mentoring and leadership opportunities for the people who are in these areas that want to move forward,” said Wheeler, as he looks up from his morning cup of coffee at the Coningsby Inn. “In the area of cervical cancer, there’s been some desire by some of the people here in Belize to come to the United States for training and we’re going to try to facilitate that.”
On his last medical mission trip to Belize, Dr. Wheeler, with the help of a crumpled map and an SUV, navigated his way around the entire country. During the journey, he met with BFLA doctors and nurses in Belize City, San Ignacio, Dangriga, and Punta Gorda to get their input for the educational videos that will finally be distributed in February.