Preserving Cervical Health Across Borders: LIG Global’s Mission to Empower Peruvian Healthcare Workers

Through training and empowerment, Cajamarcan Midwives are changing the lives of women of all ages.

January is Cervical Health Awareness Month. This year, LIG Global highlights the cervical cancer treatments and preventative screenings they help implement in the Cajamarca region of Peru. Through training and empowerment, Cajamarcan Midwives are changing the lives of women of all ages.

January is Cervical Health Awareness Month in the United States. In the month of January, health care workers unite to provide more information on what exactly cervical healthcare is and how to promote access to proper cervical healthcare treatments and prevention. With cervical cancer previously being the leading cause of cancer death in women in the United States that was effectively addressed by preventative screenings via Pap and HPV tests, as stated by the CDC, it is evident that preventative measures in this sector of health have a significant impact. Despite these efforts, more than 13,000 women are diagnosed with invasive cervical cancer each year. While this daunting number may strike fear in people’s hearts, even invasive cervical cancer is preventable through the use of vaccines and proper screening [NCCC]. With that in mind, Cervical Health Awareness Month helps promote these preventative measures in hopes of eradicating the effects of cervical cancers and other cervical health problems.

Like many health issues, health disparities, such as access to care, stratify the impact that cervical health problems impact different demographics. In particular, the NIH has stated that cervical cancer is “overwhelmingly a disease of poor women with low educational attainment who are not receiving Pap tests.” These health disparities are not limited to the United States; they are evident on a global scale.

In Peru, cervical cancer remains the leading cause of cancer deaths among women, due to the fact that Pap tests and proper screenings are not widely available. Peruvian women aged 35-50 years old, who are typically at risk for cervical cancer, have not had access to screening due to systemic issues such as limited laboratory infrastructure and healthcare workers trained to provide and process screenings. In order to address this issue, the Peru Ministry of Health devised the TATI Project, that hoped to increase cervical cancer prevention with three key goals: increase community education and information distribution; increase screenings; and increase diagnostic and treatments. Nevertheless, many women still suffer from a lack of proper cervical healthcare across the nation of Peru [PAHO].

Seeing this devastating health disparity in Peru, LIG Global dedicates its resources and efforts to improving the cervical health of women in Cajamarca, Peru. A particularly isolated region in the western chain of the Andes, Cajamarca faces the cervical health issues aforementioned. LIG Global works at Hospital Regional Docente de Cajamarca with the healthcare providers employed there to provide them with the information to properly screen for cervical health issues.

In particular, LIG Global teams up with midwives from the Cajamarca region to teach them how to carry out Visual Inspection with Acetic Acid (VIA) screening for a plethora of cervical health problems. VIA is a valuable preventative screening measure, as it is relatively simple to carry out, provides rapid results, and requires inexpensive and accessible materials. With VIA, abnormal areas of the cervix suspicious for cervical cancer can be seen and biopsied, precancerous lesions can be treated immediately, and proper care can be provided to prevent the manifestation of cervical health diseases. Most importantly, the midwives can take the skills they develop under the training of LIG Global to various locations throughout the Cajamarca region and provide this necessary care to women in need.

The training process provided by LIG Global consists of a two-part course: classroom education and hands-on clinical experience. For the first two days, Cajamarca midwives partake in a thorough class focusing on cervical cancer as a whole and the procedure they will be learning to carry out. LIG Global Ob/Gyn volunteers start by providing a solid foundation of knowledge regarding cervical cancer and then proceed to teach the midwives how to carry out the VIA as stated below:

• Dilute 3-5% acetic acid is applied to the cervix and changes are observed over the following minute.
• The application of acetic acid to the cervix will lead to the interaction of the acid with proteins that can lead to the formation of a dense white patch that is visible to the eye. The extent of formation of the white patch will vary depending on the health of the cervix.
• With naked eye inspection, individuals can determine if the cervix is healthy (little to no white patch), precancerous (formation of white patch that is denser with more progessive stages of cervical cancer), or cancerous (growth that may or may not be white).
• Findings are documented in an orderly manner that specifies what formations occurred and in what quadrant of the cervix.
• During these screenings other cervical issues can be detected, such as cervico-vaginal infections, genital warts, polyps, and leukoplakia [WHO].

Following the rigorous classroom training, midwives are placed in groups with the LIG Global Ob/Gyn volunteers and sent into the clinic to begin to carry out VIA under the guidance of the volunteer Ob/Gyn. During this 2-day clinical experience, LIG Global volunteers and the newly trained local midwives provide cervical cancer screening to over 100 women, free of charge. These screenings lead to early prevention as well as proper diagnoses and treatment that save the lives of many women.

The impact of LIG Global does not end at the end of the medical program; midwives feel confident and empowered to provide this screening to women on their own and continue to prevent and treat cervical diseases for years to come, ultimately saving the lives of thousands of Peruvian women in the Cajamarca region. Additionally, these midwives are now well-versed in VIA to the point where they can continue to educate fellow midwives and spread their knowledge to help even more women throughout Peru receive access to sufficient cervical healthcare. Moving forward, LIG Global knows that the foundation of knowledge they provided will be impactful for many years, but funds to provide these midwives with proper resources and supplies will be instrumental in empowering self-sufficient healthcare providers in Cajamarca to screen and treat their patients. LIG Global has already began to transform the quality of cervical healthcare for patients in the Cajamarca region, and with its continued efforts to empower healthcare providers in the region, the organization can have profound impacts on the state of cervical health in Peru, converting it from a region facing disproportionate levels of cervical cancer to a region confidently and accurately preventing and treating cervical diseases.

References:

CDC. Cervical Cancer Statistics. https://www.cdc.gov/cancer/cervical/statistics/index.htm. Published June 8, 2020. Accessed January 2, 2021. 

National Cervical Cancer Coalition. Cervical Health Awareness Month. NCCC. https://www.nccc-online.org/hpvcervical-cancer/cervical-health-awareness-month/. Accessed January 2, 2021. 

U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Excess Cervical Cancer Mortality A Marker for Low Access to Health Care in Poor Communities. National Cancer Institute. "https://www.cancer.gov/about-nci/organization/crchd/about-health-disparities/resources/excess-cervical-cancer-mortality.pdf". Accessed January 2, 2021. 

Cervical Cancer Prevention in Peru: Lessons Learned from the TATI Demonstration Project. PAHO/WHO | Pan American Health Organization. "https://www.paho.org/hq/index.php?option=com_content". Accessed January 2, 2021. 

WHO. Training of health staff in VIA, HPV detection, and cryotherapy: Trainees' Handbook. Cervical cancer screening and management of cervical pre-cancers. "https://www.who.int/docs/default-source/searo/tobacco/trainees-handbook.pdf?sfvrsn=6778145d_2". Published 2017. Accessed January 2, 2021.