Juanita’s Story 21
Some illnesses are hard to tell apart
After listening carefully to Juanita describe her pain and
discharge, Don Pedro explained that signs often tell us the
general kind of health problem someone has. But sometimes
several different illnesses can cause the same signs. For
example, a change in the amount, color, or smell of a
woman’s vaginal discharge could be caused by:
• a sexually transmitted infection (STI).
• an infection of the vagina that is not an STI.
• pelvic inflammatory disease (PID), which is an infection
of the womb and tubes, often caused by an STI.
• cancer of the cervix.
To get a better idea about which of these problems was
causing Juanita’s signs, Don Pedro needed to know whether
Juanita and her husband used condoms, and whether either
of them had had other sex partners. Juanita admitted that
she suspects her husband has sex with other women, since
he is gone for months at a time to work. But they had never
discussed it, so she did not know for sure. The last time her
husband came home, however, he had complained of some
pain when passing urine. He blamed it on the foods he ate
at the coast.
With this added information, Don Pedro said he
suspected Juanita had an STI, probably gonorrhea or
chlamydia. Because it is difficult to tell these infections
apart, it is better to treat both of them.
Step 3:Think about all
the different illnesses
that could be causing
Step 4: Look for clues that
can tell you which answer
is most likely.
Step 5: Decide which
answer is probably
the right one.
What is causing the problem?
Infectious diseases are those that are spread from one person to another. They
can be spread through touching infected people or objects, or through the air or
water. The germs Don Pedro thinks are causing Juanita’s illness are spread through
sexual contact. But not all diseases spread from person to person.
Non-infectious diseases (not spread between people), may be caused by:
• something that goes wrong in the body, such as weak bones from aging.
• something that harms the body from the outside, such as lung problems from
breathing a lot of dust or smoke.
• something the body lacks, such as enough good food.
But illnesses rarely have just one cause. (To learn more about identifying other
causes, see page 26.) Different things contribute to whether a person is healthy
or sick, including a person’s beliefs and cultural traditions, conditions in the home
and surrounding environment, and the ways in which land, wealth and power are
Where Women Have No Doctor 2012