I have been asked to rejoin a team which is in an ongoing mission to reduce the burden of Cervical Cancer morbidity and mortality in Rwanda. This is considered part of the global effort put forth by the World Health Organization, calling for the elimination of cervical cancer through vaccination, screening for pre-cancerous conditions, and treatment of pre-cancer and cancer when found (90-70-90 initiative). Rwanda has been a leader in African nations in vaccinating girls against HPV, the cause of most cervical cancers, but screening and early treatment has lagged behind, due to inadequate volume and training of health care workers to effect these changes.
I will be part of team of physicians and nurses which I been part of for several years, IOWD (International Organization for Women and Development). I will be using lectures, case presentations, hands on training for LEEP and thermal ablation and supervising trainees perform screenings through visual inspection of the cervix with acetic acids. These are methods endored by WHO. The team is planning to work in clinics in Kigali, Rwanda's capital where we already have contacts, with the medical school and gynecology residents, as well as several remote health centers.
The primary population served are the women of Rwanda and their families. With only 11% of the population of the country ever screened, many of the cancers are detected in advanced stages with an unacceptably high mortality. Encouraging and modeling a culture of screening, and promoting accessibility of this will reduce mortality and morbidity from this devastating, prevalent and preventable disease. Women in African countries are the backbone of the families as well as the economies, and promoting their health has a large impact on the health of the country.
Further, training and empowering physicians and health center nurses to diagnose and treat pre-cancerous and cancerous lesions continues to set the groundwork for this project.
As above, empowering and training health care workers in screening through visual assessment and treatment through LEEP and thermal ablation will promote a culture of early detection. Normalizing screening and detection helps eliminate some of the health care myths and hesitancies that continue to be prevalent in the culture. Our continued contacts and outreach has been widely accepted and we are already seeing changes in the clinic staffs for promoting screening programs. Further, we have monthly Zoom meetings through the ECHO project, which helps their OB-Gyne staff work through and discuss cases, and continues to support the work of the Rwandan medical community. I have been part of these ECHO calls since their inception, and remain active to help promote and support skills and knowledge.
In keeping with the World Health Organization's call to eliminate cervical cancer, I was privileged to participate in an ongoing mission that is in keeping with this goal, using vaccination, screening and treatment of pre-cancerous lesion in Rwanda this past May. Our team travelled with other health professionals under the auspices of IOWD (International Organization for Women in Development) in participation with the University of Rwanda's OB-Gyne department.
We had two basic arms to this project: The first was a two day lecture and practicum for the ob-gyne residents and medical students. This involved lectures on the basics of HPV changes on the cervix and how to evaluate and treat women with pre-cancerous lesions of the cervix. This was followed by a practicum to teach colposcopy skills, biopsies and treatment with thermal ablation and LEEP. We had good participation with both students and residents.
The second arm to this mission is supporting the district hospitals and clinics who see the overwhelming numbers of women in the country. These are staffed by nurses and health care workers and many are participating in the country's efforts to test women for the HPV viruses responsible for cervix cancer and then follow up with evaluations and treatments as needed. Our role is to support their knowledge in the evaluation of the participating women, assisting them in broadening their campaigns and improving their skills.
Over the years that we have been working in Rwanda on this project, the nurses in the clinics in Kigali as well as in outlying districts have formed wonderful working relationships with us, and express gratitude at the efforts that are made in their behalf. They work very hard for their populations and are deeply committed to the global efforts to eliminate cervical cancer. We are hopeful to be able to continue this work, further solidify and expand relationships in this country rich in beauty and in generosity and warmth of their citizens.
