Aydalina Aviles

Aydalina Aviles has spent more than 100 days in the hospital for treatment of her advanced-stage cervical cancer. Photo: Miguel Alvarez.

In a Nicaraguan hospital far away from her home and her children, Aydalina Aviles endures a battle against a deadly disease

Aydalina Aviles, 44, is a single mother from a small city in rural eastern Nicaragua, close to the Atlantic Coast. For four months, she has lived inside a crowded hospital room in Managua, hours from her home. Eight beds covered in pink-striped sheets line the sterile blue walls. Two ceiling fans creak as they move a gentle breeze through the warm room. A piece of paper taped to the foot of Aydalina’s bed states her name and diagnosis: cervical cancer.

Aydalina has not seen her three children, ages 15 through 26, since she arrived at the hospital in August for treatment. “My children say, ‘When are you coming home?’” she says. She has asked them not to spend the money it will cost for the long journey to visit her, even though she wishes she could see them. “It makes me feel so bad because I fear that there may be a day when I’m not here.”

“It makes me feel so bad because I fear that there may be a day when I'm not here.”

Before she became sick, Aydalina raised her family in Ciudad Rama and supported them through various jobs—handling loans at a bank, taking care of animals on her father’s farm. Her husband left her 15 years ago, when her youngest child was just a baby. Aydalina’s brother and sister are now supporting her children as she gets treatment in the hospital.

Aydalina first knew something was wrong in mid-2008, when she began bleeding irregularly. Her doctor conducted a Pap smear, and the bleeding became worse. After experiencing a severe hemorrhage, Aydalina had a biopsy. It’s cervical cancer, her doctor told her two weeks later, an advanced stage.

A test for protection

Patients standing in hallway of hospital oncology ward

PATH is introducing a test to detect the early warning signs of cervical cancer, before the disease advances.

Cervical cancer is by far the most common type of cancer among women in Nicaragua, most often diagnosed in its late stages. It is the number one killer of women in the country. While women in wealthy countries are screened regularly for early warning signs of cervical cancer and treated before the cancer develops, women in Nicaragua and other developing countries rarely receive screening for the disease. Poor countries lack the resources and equipment to provide effective testing, and women may have difficulty reaching health services.

PATH is working with the Nicaraguan government and our partners to protect more women from cervical cancer. We are introducing a new screening test that allows health staff to detect human papillomavirus—the most common cause of cervical cancer—and treat it during a single clinical visit. Designed for low-resource settings, the test can be run on portable equipment using rechargeable batteries and can be conducted by less-skilled health workers. It gives more women a chance at protection from cervical cancer, long before they become sick.

A matter of economics

In the hospital in Managua, Aydalina has undergone radiation and chemotherapy to treat her cancer, treatment that has made her sick to her stomach and taken away her appetite. She speaks a lot with other women who are also fighting cervical cancer. “This experience has been hard, but I’ve learned that I’m not the only one who suffers,” Aydalina says.

After more than 100 days in the oncology ward, Aydalina recognizes the urgent need for more services to help women like her. She also realizes that her circumstances are influenced, in part, by the imbalance of resources that PATH is trying to change.

“There’s a cost to life,” Aydalina, dressed in a blue floral hospital gown, explains from a chair near her bed. “Life really depends on having the economic means to survive.”