Saturday, February 8, 2014

Bungoma PINCC visit February 1 - 8, 2014

PINCC volunteers arrived in Bungoma and immediately fell in love with this beautiful city.  On our first day we were welcomed at the District Hospital with smiles and genuine Kenyan hospitality.  Everyone was very enthusiastic and eager to learn, or in some cases improve upon, the skills necessary to provide the community with cervical cancer screening, a great need in this community.

It was immediately apparent that Bungoma and the surrounding area is in desperate need of these services, as we found that the overwhelming majority of women screened during our visit had never been screened before. We were struck by how many middle aged and older women came to get screened for the very first time with us this week.  On the contrary, the large number of young women who wanted to be screened impressed us.  The program outreach and awareness the community had regarding the importance of cervical cancer prevention was encouraging. Many women from the vulnerable population clinic (CCC), including many HIV+ patients, were screened this week as well, which was a great opportunity to educate women about HPV and risk factors for cervical cancer. We also received referrals from surrounding towns for positive or questionable cervical exams. In addition to all of these patients, we were happy to screen all of our trainees as well as the community health workers who provided health education to patients as they waited to be screened. It truly was remarkable to see the volume and wide range of women who wanted to be screened with us this week.
In general, we were able to screen between 35-55 patients per day, perform approximately 5-7 cryotherapies per day and between 1-3 LEEPs per day.

By the end of our week of training, which included morning and afternoon didactics as well as in-clinic precepting, PINCC was able to certify 8 trainees in VIA and 2  trainees in cryotherapy. We were also very proud to certify Dr. Kubuasu, the only OB/GYN in Bungoma, in performing VIA, Cryo and LEEP.  As this was PINCC’s third and final visit to Bungoma, the focus was to encourage sustainability and assignment of roles within the healthcare team. We supported efficiency in the regulation of patient flow, promoted the utilization of their own equipment and resources, encouraged troubleshooting and overall management of the screening program independently.   PINCC volunteers were excited to take a step back and watch this site grow into self-sufficiency day by day.

We were also able to donate a LEEP machine to this site, as well as other essential equipment.  Bungoma District Hospital (BDH)  will now be able to provide cervical cancer screening along with treatment on-site and on the same visit if a lesion is identified. This will also enable BDH to accept referrals from outside hospitals and clinics that do not have the resources to provide cervical cancer screening or treatment options for their community. The nursing staff were very excited about their current plan to have the hospital serve as a main training hub in order to continue expanding these vital services to other outlying clinics and dispensaries.

            With new certifications and skilled staff, Bungoma District Hospital will now be able to provide these services every day of the week at their family planning clinic. We were pleased to educate all the women who came for screening about the new availability of this service. Cervical cancer screening services were in such high demand this week, that as we were finishing up our last exams the clinic was already accumulating a long waiting list for women who wanted screening. Therefore, the women we did not have time to see will be screened in the coming weeks by our newly certified and competent participants.

In the past week the trainees blew us all away with their dedication, effort and enthusiasm for learning about cervical cancer screening and treatment. It was so rewarding to watch as their confidence and skills improved each day.  From trainees who were learning VIA for the first time to the veteran nurses who have been practicing VIA for some time, everyone showed amazing progress in their abilities and made our whole team very proud. 

Outside of our time in the hospital, we volunteers had a blast taking walks around town, getting caught in the occasional rainstorm or power outage, chasing aggressive chickens away from our dinner table almost nightly, and treating ourselves to excessive amounts of pizza and chocolate to reward our hard work. 

We are very grateful to the PINCC volunteers who came before us and fostered such strong relationships with the trainees in Bungoma. All of our work combined has led us to complete what was started a year ago and we couldn’t have done it were it not for the strong foundation the groups before us had built. We have every confidence that the people of Bungoma will be well served by the dedicated and skilled staff we have trained over the past year. We also thank our amazing driver Mike and our lovely lodging host Dennis for their assistance throughout the week.  Every member of our team plays a vital role in PINCC’s mission to prevent cervical cancer.

Although this was the final visit, Bungoma will always hold a special place in our hearts.  As we leave for home or for our next PINCC training site, we leave with an overwhelming appreciation for all the trainees, patients, hospital staff and the wonderful people in Bungoma for what they have accomplished within their community.  Undoubtedly we learned as much from everyone as they learned from us. It was an irreplaceable trip for all of those involved and we couldn’t be more proud of the result.

Dr. Monica Hahn and Lauren Ayres, RN

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