Trip Report: Nicaragua – September 2011

Amanda, Kayla, and August with San Juan de Rio Coco coop collaborators

From Sep 21- Sep 30, 2011, Grounds for Health trained a new cohort of 11 doctors and nurses on cervical cancer screening using Visual Inspection with Acetic Acid (VIA) and Pap, and treatment of pre-cancer with cryotherapy. Of the 11 providers, nine received certification in VIA and five of those also received certification in Cryo. Two received certificates of participation only. Grounds for Health will support the trained providers as they put their new skills to use over the next several months, ensuring that they have the material and personnel resources needed to continue offering screening and treatment at their respective clinics,

During the course of the campaign, a total of 306 women were screened, 93% of whom were within the target age group of 30-55 years of age. The high percentage of women seen in the target group is one indicator of success for the promoter training conducted previously.  Of the total women screened, 24% had either a positive pap, positive VIA test or both and 14% received same day treatment with cryotherapy. All (100 %) of high-grade paps were confirmed with VIA.

Smiling faces after a talk on cervical cancer while waiting to be screened

This marks the first training / campaign at our new program site, San Juan del Rio Coco in the department of Madriz, Nicaragua, where we expect to continue working for three years. The event was carried out in close collaboration with our four co-ops partners at this site, UCA San Juan, UCPCO, PRODECOOP and CORCASAN. This collaboration with local, community groups, will ensure that thousands more women receive the information and access to life-saving health services long after Grounds for Health leaves.

Highlights:

• Launched new screen and treat training program and campaign in San Juan del Rio Coco, Madriz.
• Established the first treatment center in the region
• Co-op coordinators demonstrated impressive management and coordination skills
• Co-ops and SILAIS commitment mobilize local resources to help  women requiring further diagnosis and treatment

Next Steps:

• Follow up on biopsy results and next steps for patients who require additional treatment
• Donate cryo equipment at Hospital Primario Luis Felipe Mocado and one additional site staffed by provider trained to competency in cryotherapy
• Donate biopsy punches to SILAIS Somoto
• Establish schedule of supportive supervision for new provider cohort and conduct monitoring and supervision visits
• Complete pilot project with SOPPEXCCA/SILAIS Jinotega and document results
• Develop proposal for Master Training Program in Esteli and present proposal to PRODECOOP management during the pre-Assembly (later in 2011)
• Conduct follow-up meeting with co-op coordinators to develop work plan for next phase focused on community outreach and education, including mentoring for community health promoters
• Expand on the current Co-op Coordinator’s guide; develop a comprehensive resource for co-op coordinators focused on community mobilization
• Work with curriculum development experts to modify the Trainer’s guide and package it for use in the Master Training Program

Making good use of readily available materials to practice Pap and VIA

Amanda & Dra. Barinia

Volunteer team

GFH preceptors and trainees