This is an open letter to the new Minister of Health, Jerry Narace. My friend (who I will call Anna to keep her privacy) is always ready to laugh. She can talk endlessly without being boring or self-centred.

She is a tough cookie with a warm heart. She is in her early thirties, with a husband who adores her and three small children, the type of citizen we need in our savage islands.

She moved to Washington temporarily. I was thrilled when she called and settled down for a long chat. The usual lilt in her voice wasn’t there. Then she dropped the bomb:

“Didn’t you hear?”

“Hear what?”

“I have cancer. Second-stage cervical cancer.”

“Did you have any symptoms?”

“None,” she replied.

In my panic, I laced into her, which was wrong of me. “Why stage two? Lots of women have pre-cancerous cells, but they get picked up in Pap smears. Why didn’t you get one done in Trinidad before you left?”

She replied “I did.”

Silence. I thought of myself, of thousands of women who have Pap smears. I thought those tests pick up these things. She was speaking:

“I had my Pap smear done last year, and the year before. The results were sent to labs recommended by the doctors who did the smears, In North, in South Trinidad.

“I would always get a slip of paper saying ‘normal.’ No medical indicators, no numbers, nothing. Just a slip of paper. I believed that slip of paper.”

Mask terror

She said the hospital in Washington where she was being treated was among the best in the world for cancer. She knew she was lucky that she was there and not here, now. Then she stopped sounding brave. She said:

“I went for a routine check-up in Washington. When the doctor first told me I had cancer I was stunned. He was shocked that my Pap smear last year didn’t pick it up, because the cancer has advanced. I thought these things only happen to other people.

“I cried for two weeks almost non-stop. I want to tell all the women of Trinidad to be careful which labs your doctor sends your Pap smear to. They don’t get it right there; they don’t get it right. If they did, I would have no cancer.”

We talked some more, and I said the usual things, about how cancer is now like a treatable chronic disease (which it is), and that people live a lifetime with it.

We both went through the motions, but the bravery in our voices didn’t mask the terror beneath, the knowledge of the long battle ahead.

Why does our health care fraternity operate without any checks and balances? I have written to every successive health minister for years now, and have called on the Medical Board to declare a code of ethics for the medical fraternity and a bill of rights for patients.

I actually did a draft of each in this space culled from best practice codes and bills used worldwide.

If there was a complaints body set up by the Medical Board or Medical Association, perhaps a young woman like Anna with small children would never be contemplating death today.

Checks and balances would protect both doctors’ reputations and patients’ lives.

It is said a civilised society is measured primarily by the manner in which we treat our most vulnerable citizens.

What kind of people does this every-day sacrifice make us?