training six midwives and Pathfinder Medical Director Dr. Enrique
Guevara, and seeing more than 50 patients, we're back today at the big
national institute for our last day of work. (Pathfinder is the NGO
PINCC is working with in Peru.)
The Instituto is a big, hectic, medically sophisticated place, where
there are scores of patients waiting in long halls with rows of seats
facing the same way, three across.
Originally built in 1826, it's been updated and expanded repeatedly
over the years.
Our job here is to train several OB/GYNs in visual inspection with
vinegar (acetic acid) and in cryotherapy so they can, in turn, train
their OB/GYN residents and midwives to work in outlying clinics where
neighborhoods are poorer and often without resources for either
examinations or treatment.
The VIA technique (or IVAA, as it's called in Latin America) and
cryotherapy treatment for patients with exams showing smaller pre-
cancerous lesions caused by HPV, are techniques that haven't been used
here. In the former case, VIA will add a new, inexpensive and
effective examination tool. In the case of cryo, the doctors' arsenal
will be expanded to include a less extreme treatment method for minor
In six months, when PINCC returns, we hope to continue training
medicos and expand to a total of 3 outlying clinics.
-- Larry Shushan