Kisalaya, meaning a sprout, the extremity of a branch bearing new leaves. PHRII’s Kisalaya project is a groundbreaking community outreach project aiming to deliver high-quality care, testing, screenings, and education and counseling; for proper antenatal care and HIV/HPV control to women and children in rural areas. For many communities and village’s in southern India and Karnataka State, this outreach project has been the solution to  consistent generational health issues. Theses medical camps revolve every other week around different Taluks in Mysore. Here, women are able to receive cervical cancer screenings, education and awareness, health and counseling services; all free of cost. The preparation for such clinics takes extensive amount of attention and work and an extraordinary and talented team to execute the mission. On May 20th, 2018 we were fortunate enough to join in for the ride. PHRII’s staff members, this team of valiant women, have now attended the village of Sagarkatte one week prior to, and we are now ready to head back to deliver our duty to the women in this community.

 

Globally it is estimated that 528,000 or more women are diagnosed with cervical cancer and 275,000 die each year. Due to factors such as, early intercourse, pregnancy, contraceptives, and infectious postpartum or cervical lesions might contribute to the increase of Cervical cancer in India (Degarege, A., Krupp, K., Fennie, K., Li, T., Stephens, D.P., Srinivas, V., Arun, A., & Madhivanan, P., 2018). High prevalence of such diseases is related to the lack of care and preventive medicine in communities and in rural areas. In India, it is one of the leading causes of mortality among women; accounting for 23.3% of all cancer deaths (Sambath & Chandrasekaran, 2018). Although prevalence is higher in rural areas, it is still a heavy burden to be addressed in all India. Besides lack of proper and high quality care in both rural and urban areas, access to this care can be hard to obtain. With so many disparities, distribution of care and lack of resources necessary to test, are within the leading problems. In rural communities, such like Sagarkatte, the care available can range from 1 ASHA (Government care providers; one available per every 1,000 people), to a distant primary care center, to a city tertiary hospitals (upscale care hospital). In Sagarkatte, besides the community ASHA, the nearest form of care is a governmental tertiary care hospital which is about 1 hour away within the city of Mysore. This sort of situation can raise concerns and complications for many vulnerable populations like pregnant mothers. For many women in this community, waiting on private institutions like PHRII to deliver quality care to their doorstep is the best alternative they have.  

 

Cervical cancer is both preventable and curable, yet morbidity and mortality from the disease remain high especially in developing countries. Request for cervical cancer screening is exceedingly low among women due to lack of awareness of cervical cancer and the screening methods (Sambath & Chandrasekaran, 2018). There is very strong social and self stigma within India’s societal groups revolving health issues, especially on HIV/AIDS and preventive care. It is because lack of education and awareness that there is such high prevalence of infections across large populations. It is important to bring action and raise awareness to women and their children because for many, its not just about lack of knowledge to the issue but lack of awareness to types of help they qualify for. This is also one of the most crucial issues to address because women in India are not very open to seeking health care as their first priority. In a family, women are more concerned with their household and are expected to carry forward most of the responsibilities. Men’s role revolves around giving consent to the women for them to get care in certain health issues. Most of the time care is not sought out by the women due to family restrictions, financial strains, and fear and lack of trust in a system presented. PHRII understands many of these obstacles between the health issue and the solution, therefore, as the women come in to register for their free consultations and screenings, they are educated and counselled thoroughly. When a woman first arrives, she goes directly into a group counselling session where afterwards, she gets registered and placed with a one-on-one counselor before seeing the doctor for her screening. During our time there, as we proceeded through many of these sessions hour after hour, we saw positive and negative outcomes. In the same way that many women came and stayed, others left. However successfully, PHRII is able to screen about 25 women, dedicating one hour to each of them, ensuring successful and quality care one by one. To each of these women, reliable results are available to them after their samples are taken back into PHRII's laboratory. PHRII is then able to conduct thorough follow up with each of them to discuss treatment and further options.

 

Having an understanding of the culture and the condition of rural villages and larger communities, such as in Sagarkatte, allows for researchers to investigate other ways into the effectiveness of care provided. It allows insight to understand the impact of social stigmas and why minority populations don’t reach out for the help and treatment they need. In the hopes of also understanding all cultural barriers, we can use supportive evidence-based research to create an atmosphere of awareness and openness into these communities. This done in the hope of relieving a population of all tension, discrimination and social and self stigma. I can contribute my help into further research with institutions like PHRII, who are committed as a network to tackle these issues. By building awareness through groups in the community and addressing this health issue, the transition is made from stigma revolving HIV/ADIS, into a better healthier lifestyle condition for all minorities in rural areas.

 

References:

 

Sambath, S., Chandrasekaran, M. (2018). Knowledge, awareness and prevention of cervical cancer among women attending a rural based tertiary care center, Theni, South India nternational Journal of Reproduction, Contraception, Obstetrics and Gynecology. Vol 7 (2), p608, 4 p.

 

Degarege, A., Krupp, K., Fennie, K., Li, T., Stephens, D. P., Marlow, L. V., & ... Madhivanan, P. (2018). Urban-Rural   Inequities in the Parental Attitudes and Beliefs Towards Human Papillomavirus Infection, Cervical Cancer, and         Human Papillomavirus Vaccine in Mysore, India. Journal Of Pediatric And Adolescent Gynecology,               doi:10.1016/j.jpag.2018.03.008