DispatChes
In one week,
the team was
able to screen 671
women.
local counterpart Víctor
Yat Tiul speaks with
women waiting to be
seen in alta Verapaz.
VIA/Cryo method in Guatemala. Working through
a local network of indigenous community groups,
the team was able to conduct analysis and treatment in the very rudimentary facilities available in
the villages.
PfS earned the trust of
indigenous communities
in no small measure because of the involvement
of 14 Mayan gerentes (
community managers) within
the diverse cultural and
linguistic regions of the
highlands. The gerentes,
all of whom are respected
and trusted community
leaders, joined the teams
as they traveled to their
communities and became
the vital link bet ween rural
patients and quality medical care.
Any efforts at improving women’s health, including this project, inevitably become linked to the
controversies surrounding
reproductive choice for
women. Mayan women are
proud, hardworking members of their communities.
Although most Mayan
women over 40 have little
formal education and stick
to traditional gender roles,
they provide the backbone
to the rural household.
Their health is therefore
critical to the health of the
community and to the future of their families. The
number-one reason cited
by PfS patients for their
desire for good health is to
continue to work and support their families so that
their children can stay in
school and get an education. They know that their
good health extends to
economic empowerment
for their children, families and communities and
helps to end the cycle of
poverty in Guatemala. PfS
is uniquely positioned to
reach the target group for
cancer screening.
If the Guatemalan government has any hope of
reaching its stated goals
it will need to invest in
the education of Mayan
health care providers who
will stay in their local communities, and provide support to the infrastructure
needed for these individuals to do their work. Organizations interested in
helping the most needy
Guatemalans will need to
ask themselves how best to
provide services to those
who are most in need. The
tendency is for volunteer
groups to stay near the
larger cities where accommodations are more comfortable, yet this limits access for the very people
most in need of services.
With this in mind, PfS is
in the process of building
and equipping a facility in
the interior of Alta Verapaz
in hopes of finding volunteer groups willing to
travel the extra distance
to bring needed services
to the Mayan population.
In one week, the PfS program launch team was
able to screen 671 women.
Of those screened, fewer
than half had ever had a
pap smear before—and of
those that did, less than
half knew the result. But
just learning of an abnormal pap smear result is
meaningless if no treatment is available.
Treatment of actual cancers is very expensive. Even
in developed and prosperous economies it involves
burdensome costs. In poor
countries, for practical purposes, such treatment is unavailable. Addressing this
important issue in Guatemala means finding new alternative models of health
promotion and disease prevention that will not add to
the financial burdens.
By being able to test
and treat patients on the
spot, the VIA/Cryo method,
provides the means to address this gap. The challenge now is to take the
lessons learned in these
pilot projects and apply
them on a widespread basis. For its part, the Ministry of Health now plans to
revamp the program using
VIA/Cryo in collaboration
with PfS.
And for their part, the local health care volunteers
we worked with are ready
to shoulder the burden of
a more ambitious and extensive VIA/Cryo effort.
Esteban and Liliana, two
members of the mission,
worked in over 100-degree
heat to accompany us on
our trip and now hope to
become certified to perform the procedure independently. Having a team
on the ground will go a
long way toward expanding the reach of cervical
cancer treatment to rural
women in Guatemala, and
saving lives.
Dr. Rick Renwick is an
obstetrician-gynecologist
with special interest in
cancer treatment and
prevention. He is currently
affiliated with Gundersen
Lutheran Medical Center
in La Crosse WI and the
University of Wisconsin.
