Wednesday, July 13, 2011

PINCC - India in Mysore

Lighting the lamp to open the third VIA camp in Mysore

PINCC India in Mysore

July 14 2011

John Adams

We have seen a huge number of women here in Mysore – over 200 in the first three days – with pretty much the same percentages of positives and pap smears as usual in India.

The big news here is that last evening (Tuesday, July 12) we were taken to meet the Swamiji (god-man) of the JSS system. He is head of many health care and educational institutions all over the greater Mysore area, and is reputed to have a huge amount of power and ability to get things done. Our host hospital for this visit is JSS Hospital, by far the largest hospital in Mysore. The connection was made by Mr. V. Bhat, who is a leader in the local Rotary and a devotee of the Swamiji.

Our visit with the Swamiji seemed to be very successful, and he told us we should meet with the Karnataka State Minister of Medical Education. He also acknowledged how important our work is. We then went into a small dining room inside the ashram and were given dinner and tea. As we ate, Mr. Bhat called the Minister and set a meeting for Wednesday at 5:00.

During the night, Dr. Rashmi became quite ill and had to be taken to a nearby hospital emergency room. There are not easy ways to get transport at 2:00 am in India, so the young man on the hotel desk woke up another guest with a car and got the owner to take us. The young man also came along because he knew where to find the hospital. With Rhoda and Rashmi and her mother Mytree that made a really full car!

This hospital had an excellently stocked and fully staffed emergency room and no waiting patients, so Rashmi got seen immediately. Unfortunately, they could not find the cause of her pain and nausea, but gave her an injection to ease the cramps. In the morning, Rashmi and Mytree left us and returned to their family in Bangalore. Later in the day we found she was feeling better, but still unsure of the cause.

So Rhoda was on her own with the volunteer docs, and as luck would have it, we had 81 women to see, and carried out 2 LEEP, many cryos and biopsys, and worked over an extra hour to get everyone seen. It's hard to turn women away when they've been bussed in from a remote village for the screening. Dr. Shobha Krishnan, a Columbia Univ. professor with her own HPV NGO in Chennai and Gujurat, is visiting to explore collabortions, and she pitched in with background stuff in the medical area. I was inundated with registrations, clinical reports, and a spreadsheet that crashes every few minutes – but we got through it all!

Unfortunately the minister could not meet with us, so we are carrying on with whatever connections we can make and focusing on building a network of solid relationships for the future. Given all this, we were glad the Minister of Health Education was unable to see us!

One more day of camp and then we head for home – quite happy with the progress in both our sites, appreciative of the great organizational support both sites present, and confident that we will be able to scale up our operations in the Mysore

Friday, July 8, 2011

One of Infosys's buildings in India

July 7 2011

Reporter filming the press conference

July 8 2011

Dr. Vijaya introducing Rhoda at the press conference

July 8 2011

Dr. Vijaya is our lead trainee in Mysore

Dr. Rhoda Delivers a Wonderful Message in the Mysore Press Conference

July 8 2011

Mysore Report

John Adams
July 8 2011

We departed Puttaparthi at 7:00 am yesterday and were in the offices of the Infosys CEO Kris Gopalakrishnan in Bangalore by 11:00. Kris spent a full hour with us and was highly interested in what we are doing. We proposed that Infosys support our intention to scale up our PINCC efforts in India, through our collaboration with PHRII, to establish a Centre of Excellence for Cancer Prevention in Women. We are expecting that Infosys will send a manager of the Infosys Foundation to our clinic here in Mysore during 11-14 July.

Initially we would create a more established centre for our work in India, with Indian management and an Indian lead trainer (whom we would train). As growth occurs we would anticipate establishing VIA screening and training collaborations with other NGOs who are working at micro-scale around the country.

We are also working on a proposal for the Tata Family Trust to support our work here. Since PINCC has no legal basis in India, the proposal will come through PHRII.

With 25% of global cervical cancer cases and 27% of cervical cancer deaths world-wide, India is an overwhelmingly large and intense place for the present PINCC model to make a difference. Fully 10% of the global population lives in Indian villages! The government continues to ignore this disease and its prevention, so we will have to shame them into attention through Public Private Partnerships to get our work to scale. PHRII continues to be an extremely reliable, competent and committed partner in this venture. When polio re-appeared a few years ago, the Indian Government proved it could mount a nation-wide universal vaccination program overnight, so it is just a question of challenging the society's will to save 73,000 lives a year (one every 7 minutes) that are lost needlessly. Presently only 2.6% of Indian women ever have a single screening (2.3% in villages, 4.6% in cities). The opportunity is huge for harvesting this low-hanging fruit!!!

Dr. Rhoda just completed a press conference here at PHRII headquarters, attended by about 20 local reporters. We will be looking for great coverage in the local English language and Kannada language papers tomorrow! Also tomorrow, Dr. Rhoda will be presenting a CME lecture at JSS Medical College, which is also our venue for next week's VIA clinic. JSSMC will be sending some new trainees and so far appear to be eager to become a central partner in the Mysore PINCC work going forward. Rhoda and I are scheduled to meet the spiritual leader of the organization that sponsors JSS to pray for his support next Thursday at the end of our fourth day of screening / training.

More to come!

Tuesday, July 5, 2011

Kay may remember this woman from two years ago when she gave padnamaskar following her LEEP procedure

PINCC India completes fifth clinic at SSSMH

A typical SSSMH clinic scene: Arithmetic, English, Telugu, the Goddess Lakshmi, and the Gynecology section!

July 5 2010
John Adams

We were overjoyed at how excellently the SSSMH team of gynecologists have developed and made this program their own. Duirng the six months since our last visit in December, they racked up the following numbers:

VIA -- 1276
Pap -- 16
Biopsy -- 260
Cryo -- 40
LEEP -- 8

They also referred 12 women with cervical cancer to various cancer treatment centers.

We had two wonderful visits from earlier patients. A woman who was referred with cancer two years ago stopped by to thank PINCC and to get rescreened -- she is completely healthy! Another woman who had a LEEP done two years ago also stopped by for rescreening and expressed her gratitude as well. 

During the just completed five day camp, we saw 225 women, performed 4 LEEPS and 6 cryos.

We will not need to bring PINCC-India back to this site. When we come to be at the ashram, we may go along for a day or two, but only to check in and exchange greetings. 

Sunday, July 3, 2011

Amidst the rewards, some sadness, too

LEON, Nicaragua -- Working with PINCC in Central America has always been richly rewarding and fulfilling, especially since the screen-and-treat protocol being taught serves mostly poor women who otherwise would have no care at all.

But sadness and frustration come with the experience as well.

For me, having just returned from my third trip, two things have affected me profoundly.

The first is the realization that I get to drive away from Jalapa, Nicaragua -- a profoundly poor place -- and escape the misery I see around me. Not an option for the people we serve there.

The second is the unexpected and completely shocking experience we just had in Leon: while her mother was being examined, we played with a little girl of about 7 years old, who seemed entirely happy and normal. But I'll always feel helpless when I think of her. We learned that she has been treated repeatedly for a common sexually transmitted disease, apparently from abuse by her mother's husband or boyfriend.

In the United States, we would have called the authorities. She would have been protected somehow.

No such thing in Leon. We had to watch her leave with the adults in her life, and there was nothing we could do to intervene.

-- Larry Shushan, PINCC volunteer in Central America

Friday, July 1, 2011

PINCC-India at Sri Sathya Sai Mobile Hospital

SSSMH Patient Record Format

PINCC-India at Sri Sathya Sai Mobile Hospital

Dr. Rhoda preparing to begin the day's screening

PINCC-India at Sri Sathya Sai Mobile Hospital

From John Adams
July 1, 2010

We opened our fifth camp at the Sri Sathya Sai Mobile Hospital, based in Puttaparthi, Andhra Pradesh, today. What we found when we got to today's venue, Rachuvarapalli Village, was most heartening. The gynecology section administrator presented us with summary statistics for their VIA work during the six months since we were last here.

During their regular 12 day camps each month January through June, they have conducted 1276 VIA screenings and carried out 40 cryotherapy and 4 LEEP procedures. Three LEEPs were brought back to be done while Dr. Rhoda is here.

Their record keeping is very good and the lead VIA doctors are performing with confidence and competence. We introduced our QA materials today, and these were heartily welcomed, along with the idea of making one improvement every day. Our primary focus now at this location, in addition to reviewing quality items and procedures is to work towards increased "bench strength" of doctors who can capably carry out LEEP.