Sunday, July 11, 2010

How PINCC Got to India

John Adams



Dr. Rhoda Nussbaum and I have made one or two trips to India each year since early 2003, to the ashram of Sri Sathya Sai Baba in Puttaparthi (Andhra Pradesh state) to support our spiritual growth.


Sai Baba is a service, or "Seva," oriented holy man who has created an extensive educational system (K-Ph.D. – all free), an extensive health care system (two general hospitals, two super-specialty tertiary care hospitals, and a Mobile Hospital – all free), and extensive projects to provide reliable and safe drinking water to over a thousand cities and villages in southern India. Whenever we visited the ashram, Dr. Rhoda would do "Seva" in the local general hospital, and I would teach in the local MBA program.


During each visit, while volunteering in the gynecology section of the hospital, Dr. Rhoda found that she was seeing several cases of advanced cervical cancer on each visit, which was rather unsettling, since she had only observed one such case during an almost 30-year practice in San Francisco. Of course in developed countries, Pap smears have become ubiquitous, and as a result, cervical cancer rarely occurs. However, in less developed countries like India, there are no Pap smears in the village areas, and so there is a great deal of cervical cancer.




After one such visit, in early 2008, Rhoda began searching for a way to respond to the frequency of this completely preventable disease. During this search, she learned that Dr. Kay Taylor, with whom she had served as a resident many years earlier, had already laid the groundwork and established PINCC, which at that time was providing screening in Africa and Central America. Kay invited Rhoda to come along as a volunteer physician (and me as a volunteer "go-fer") on the next trip to Kenya and Tanzania. We did join this trip, to learn the process and logistics, in order to propose bringing the PINCC program to southern India.



When we returned to the USA, in late August 2008, Dr. Rhoda was very excited about bringing the PINCC process to India and set about to make it happen. After much persistence, it became clear that the place to start was the Sri Sathya Sai Mobile Hospital (SSSMH).  After many exchanges of contracts and logistics between us, PINCC and the SSSMH director, Dr. Narasimhan, we set off for Bangalore in late July, 2009 with Dr. Kay Taylor and Pat Sax, to bring the PINCC process to India for the first time.


The SSSMH operates with a Director, a small support staff, and a large pool of volunteer doctors, all of whom speak the language of Andhra Pradesh – Telegu. Three teams of 20 or so doctors of varying specialties join the mobile hospital for four days each, from the 1st to the 12th of each month. The mobile hospital visits the same village on the same date each month, and each of the 12 villages visited serves as a "magnet" for surrounding smaller villages – so about 180 villages receive free medical care each month!



Our PINCC team, Dr. Kay Taylor, Dr. Rhoda Nussbaum, Pat Sax, and me, travelled with the mobile hospital August 1-12, 2009. During this period we initiated training with 12 gynecologists, in three teams of four, and in the process, we screened about 350 women and conducted 27 Cryo and LEEP procedures. We were highly impressed with the organization and level of competence of the entire SSSMH operation. Dr. Narasimhan, as the Director, and his key staff members, are the embodiment of love and service! We all felt that this first foray into India was a huge success, and we all appreciated the quality of care and service being provided by the SSSMH. At the end of this tour, Dr. Kay named Rhoda PINCC Medical Director for India, and me Program Administrator for India.




Following the August visit, several of the doctors were comfortable enough, after only one cycle of training, to begin VIA screenings and to carry out Cryo procedures.


Dr. Rhoda and I returned to the SSSMH December 1-12, 2009, for a second round of screening and training, along with Dr. Zena Levine. During this second round, we screened an additional 250 women, performed 28 Cryo and LEEP procedures, and certified four of the more experienced physicians.



As I write this we are deep in the preparations for our third screening / training sessions with the SSSMH, and also to opening a new PINCC program for the Prerana Reproductive Health Clinic in Mysore!

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