Updates from our ED: January in the field
An update from the field written by our Executive Director, Kyle Engelman.
First thing upon landing in Ethiopia, I went to Cherish Cafe, owned by Sara, Dagmawi’s wife, for a delicious and much-needed coffee and breakfast. I still marvel at the serendipity of finding a Program Director with a career in public health, laboratory research and coffee!
From Addis I traveled to Hawassa, where I was greeted by our Ethiopia team and Heather, our Strategic Partnerships Manager. This was her first time visiting our programs in the field and she was excited to meet our clinical team.
The next day, we drove to Shebedino, splitting up between three sites where women were being screened. The team had trained health educators and administrators ahead of time to talk to village leaders and women to spread the word about screening dates. I went to Dila Aferafa Health Post with Ashenafi, where over 30 women were waiting by 9:30 am, gathering under a big tree with their neighbors and children to await screening.
Women gather under a tree with their neighbors and children to await screening.
I don’t speak the local language (Sidamiya), but I could tell right away there was some resistance to screening. Ashenafi explained that some women said, “But I feel healthy, I’m fine, I don’t need screening,” and I watched a familiar scene play out. First, health administrators and local leaders stepped in to explain the importance of prevention — how the virus doesn’t cause any symptoms, but if it’s present, it can develop into cancer, which is harder to treat. More significantly, a few, brave women went behind the curtain and got screened. Then, they came back outside and explained the ease and simplicity of the procedure to others. By 11 am, enough women were waiting that we had to add a third curtain to keep up with patient flow.
The first brave woman to be tested!
Meanwhile, Heather and Mesfin had an inspiring day at their site, Sadeka Health Post. Marta, a coffee farmer in this village had heard about the health screenings and knew it was an opportunity not to be missed (see below). She went door to door with her neighbors and proudly recruited 180 women to the health post for screening. This story reminds me again of how empowered women are when they have access to care.
Kyle, Marta (a coffee farmer), and Heather outside of the health post.
After 3 days of screening and spending time with the team in Ethiopia, it was on to Kenya. Like in Ethiopia, the team had arranged screening at several health centers and outposts. On arrival, the nurse I spoke with said “When we had to do an exam, there was a lot of fear. With this HPV testing, there is so much less fear and the women are so happy.”
Photo of the nurse who said “There is so much less fear” while educating patients on how to insert the test swab.
We visited with community health promoters who were so proud of their role and work. I was amazed at their initiative and advocacy. At Kiganjo Health Center, the health promoters had gone to the police academy down the road to recruit female officers. At Karatina Subcounty Hospital, the promoters walked to the local market to recruit and screen women in a small building amidst fruits, vegetables and grains.
Health promotors recruiting women in the market for screening.
Two health promoters from Kiganjo.
In both countries, I visited the labs where our staff tests patient samples for analysis. This aspect of our programs is new since we adopted HPV testing. It adds a larger component of quality assurance and logistics to our program, but it also presents an opportunity: to strengthen the local health systems and improve the quality of testing in Ethiopia and Kenya.
Here is Mary, the lab director at Karatina, posing with the HPV test kits we brought. She was as thrilled as we were to add 1,000 more to the freezer to analyze women’s samples!
It was a whirlwind week and we screened 1,195 women, spent quality time together as a team, and even fit in time for delicious coffee (in Ethiopia) and chai (in Kenya) and a few wildlife sightings.
Our team enjoyed delicious pineapples from the market after a day of screening.
In the two weeks since I’ve returned to the US, the lab teams have already run all the samples, and health workers have communicated the results to the women. They started bringing women with positive results to the health posts for treatment, which is hard and important work. Screening is only the first part of the equation – we can’t prevent cervical cancer unless we treat the women who screen positive. And, since these women have to be found and brought back to the health center for treatment, there’s always a chance for loss-to-follow-up.
Over the past three years, our teams have achieved an 89% treatment and referral rate with HPV testing, but we take nothing for granted. Every woman we see is a woman with a family, a community, and a full life ahead of her, and our mission is to make sure she goes through the entire process of care- from screening to treatment.
Thank you for following along!
About Post Author
