Cancer Awareness, Screening And Vaccination for Urban & Rural Women of India A Mobile Bus Approach A Concept Note From
Recently two of the Senior Lady Gynecologists at a well known Govt. Hospital in Bangalore were diagnosed with advanced stage Breast Cancer. Being practicing Gynecologists and well aware about Breast Cancer, they never thought of testing themselves for Breast Cancer. Due to late diagnosis of the Cancer, both were forced to undergo Surgery and follow up painful Chemotherapy, which would have been avoided if they had undergone early screening. If this is case with Gynecologists, it is high time to think about the prevailing situation among the AAM JANATA.
i. We Care Society s integrated approach on Breast and Cervical cancer involves 1. Provide Education and Create Awareness Early Screening and detection Vaccination (Cervical Cancer) programs for girls above the age of 13yrs ii. 2. Mobile van equipped with Mammography and VIA/PAP facility will be put into action for the program
The Problem
Developed World 21 % (25 Lakhs) of all mortality Developing World 9.5 % (38 Lakhs) of all mortality 70-80% Cancer cases are detected at late stage when treatment is difficult Early detection of cancer helps in complete cure of some cancer Prevention by taking some precautionary measures is the best way to prevent cancer
thousands Deaths in 140 120 100 80 60 40 20 0 Cervical Breast Lung Stomach Developing countries Developed countries IARC, 2005 (based on: Yang B et al. Int J Cancer. 2004; 109: 418-424.)
Women in India are reluctant to discuss problems openly with their family due to the fear of cultural and social stigma attached to Cancer
Breast Cancer In India Breast cancer is on the rise in India - research predicts a 3% increase every year (Source: CMAJ) 76% of cases currently diagnosed are in the advanced stages - which can rarely be treated successfully (Source: Cancer Institute of Chennai) In India, one in every 22 adult women are affected by breast cancer. If breast cancer is detected early, can be easily cured or stalled. But the problem is it still remains the most undetected type of cancer. The fact is, women die of this disease because doctors are often unable to identify the tumor even after a mammogram or because the lump is not detected on time to get it removed.
80% of the women who should have an annual mammography exam do not because They are unable to find a facility conveniently located for easy use It takes too much time to arrange and travel to appointments Difficult to request time off work (approx. 2 hours) Little to no awareness and education available to women about breast cancer
It is a cancer of the female reproductive tract It is the most common cause of cancer death in the world where Pap tests are not available The central cause of cervical cancer is human papilloma virus or HPV: HPV is transmitted through sexual contact The HPV detected today could have been acquired years ago There are many different types of HPV that can infect the cervix, vagina and vulva Low-risk types may cause genital warts High-risk types may cause pre-cancer and cancer of the cervix Most women who are infected with HPV will never have any symptoms It is the easiest gynecologic cancer to prevent through screening and early vaccination
Fear Ignorance Embarrassment Painless Symptoms 30-40% OF TOTAL INDIAN POPULATION AT RISK FOR CERVICAL CANCER
No visible program that promoted Breast & Cervix health Breast cancer is the 2nd biggest killer of women in India, the 1st being cervical cancer Insufficient, immediate access to Breast & Cervix health services Poor Infrastructure Shortage of qualified technicians Limited breast & cervical cancer care in hospitals Backlogs in breast & cervical screenings Limited Governmental Support Lack of national cancer plan Lack of coordination between governmental agencies There is an urgent need for Intervention to overcome this situation in India. Hence our initiation is targeted to address these issues which the nation is facing currently.
Our Solution To The Problem
To increase awareness about Breast & Cervical cancer, through early screening in Urban & Rural India, so that none of the Women should reach advanced stages in Breast and Cervical Cancer Awareness Transformation Impact
To demystify Breast & Cervical cancer Address the myths and personal stigmas around Breast & Cervical cancer Make public the impact of Breast & Cervical cancer on the society To offer an easy, direct, comfortable platform to address the needs to women Provide free screening for BPL families
To help create interactive conversation between health practitioners & women, mostly in their vernacular, around breast & cervix health Coach women on how to examine on their own Offer clinical exams done by skilled professionals Offer free Mammograms & Visual Inspection with Acetic Acid (VIA) / PAP smear tests for early detection Assist patient in the navigation towards definitive point of care and provide rehab facilities Vaccinate (Cervical Cancer) the girls above the age of 13years All these are offered through a Mobile Bus equipped with Mammography and VIA test facility
Our Solution: Organize Awareness Camps, Breast & Cervical Cancer Screening Camps at various villages & taluk levels Undertake vaccination program for Cervical cancer A Mobile unit equipped with traditional film mammography equipment and VIA / PAP Smear services will be pressed into service for each of these screening camps along with trained Oncologists Based upon the initial examination, the patient will be either cleared off the cancer or referred for further expert opinion Assistance will be provided to patients in terms of referrals to the good hospitals, hospital admissions, patient care, post hospital discharge, follow ups etc,. Benefit to society: Increased reach and affordability Early detection of Breast & Cervical cancer resulting in definite curing or stalling of the disease Vaccination prevents the onset of Cervical cancer later in the life of the young and adolescent females Quality screening which will bring high quality services directly to all women in the neighborhoods where they live and work Proficiency: The screenings will be performed by an all female trained technicians and results will be read and interpreted by trained professionals.
Clear The Case Conduct Awareness Camps A Bus equipped with Mammography & VIA /PAP smear units at the camp Initial Consultancy by the trained profesionals Conduct Mammography & VIA /PAP smear Test Result Send it for Expert 2 nd opinion Follow up post Hospital discharge & provide counseling & Rahab Services Reference to Hospital
Women in Urban And Rural areas of India Women between the ages of 35-70 years Women of every income level
Our Goals Is to raise awareness of breast & cervical cancer through education and awareness camps To provide free Breast & Cervical cancer screening to women from Urban And Rural areas through our mobile unit to ensure mammograms & VIA/ PAP tests are more accessible To promote early diagnosis and empower women by early detection and education to conquer breast & cervical cancer To facilitate expert opinion and also refer the patients to nearest Cancer hospitals for further treatment To provide rehab services to patients post discharge from the hospital (in the later phases of the project)
Our Advantage Community Outreach Network of Grass Root level NGO s, Anganwadi Workers, Asha Worker & Women Self Help Groups Strong Association with like minded organisations Renowned Advisory Board Screenings by trained female technicians Caring, volunteer staff to deliver results of tests Information about Local Oncologists, Experts and Hospitals, if necessary
1 2 3 Identify Vulnerable Regions Organize Screening Camps Shortlist NGOs / Anganwadi / Asha workers/ SHGs/ Volunteers In The Regions within WCS network Depute SHG teams to Mobilize Target Women Groups Monitor the progress Train the ground level teams on Basics of Human Physiology Conduct Awareness Camps Conduct Evaluation Study Train the ground level teams on Basics of Breast & Cervical Cancer Submit The Report 23
1 PHC Sub Center Villages 2 Conduct Census of Eligible Women (30-70 yrs) in village Conduct Awareness Camps Mobilize Women Conduct Screening Camps Convey Results Pick the Doubtful Cases 3 Biopsy Further Analysis at Bangalore Conduct Confirmation tests on +ve cases Advice Treatment Provide Assistance in Hospital Admission Provide Assistance to the +ve cases & Monitor the Progress
In the current circumstances, a push towards HPV vaccination for Cervical Cancer for all children girls age >13 years may be the best preventive strategy from a Public Health standpoint. We Care Society is working towards implementing this program shortly in its project areas 25
Impact of Our Intervention
The Impact Early diagnosis remains an important early detection strategy, particularly in low- and middle-income groups where the disease is diagnosed in late stages and resources are very limited. This strategy can produce "down staging" (increasing in proportion of breast & cervical cancers detected at an early stage) of the disease resulting in the cases that are more amenable to curative treatment and less financial burden on the society and the patient s families compared to the late stage diagnosis.
Help in conducting the Awareness Camps within your Offices, Housing Complexes, Communities, Colleges, Ladies Clubs, Villages etc,. Mobilizing the audience for the Awareness and Screening camps By donating cash for conducting the Awareness and Screening camps both at Urban and Rural areas Sponsoring various components of the Mobile Bus, Mammography Machine, Its accessories and Project Recurring costs
Initial roll out in Bangalore in the 1 st Phase Roll out at select District Head Quarters in the 2 nd Phase Adoption of all districts in later phases for the Adoption of all districts in later phases for the same with multiple mobile units
S.N. Details Counts 1 Villages covered (Cervical, Breast, Oral Cancer) 50 2 Awareness programs 50 3 Attendees 3521 4 Registered for screening 2921 5 Attended screening Cervical 1919 Breast 1919 Oral 1736 6 Suspected cases Cervical 372 Breast 29 Oral 39 7 Second level screening done Cervical 130 Breast 11 Oral 12 8 Infection Cases treated 13 9 Pap done at the recommendation of pathology dept 8 10 Pre cancer cases treated 6 11 Reports pending for diagnosis @ pathology dept of SDM 26 12 Normal cases diagnosed after Colposcopy and biopsy 26 13 Tobacco users identified 1607 14 Cessation advice given 1010 15 Psycho-oncology volunteers trained 51
Operational Team Mr. Nandakishore : Healthcare Consultant - President WCS Mr. Hombal : Head Operations Dr. Sardesai : Gynecologist Mrs. Archana: Psychiatrician Mrs. Shobha : Lions Club (President, Hanumanthanagar, Blore) Mrs. Shanta : Lions Club (Malleswaram, Blore)
Operational Team Contd.. Dr. Ramadesai Dr. Radhika Naik Dr. Vijayalakshmi Kamat Dr. Madhuri Revankar Mrs. Veena Hanchinal Ms. Ranjitha Pooja Mrs. Shantha Hospet Mr. Umesh Naik Mr. Ajay
Advisory Team Dr. Vimala Patil : Gynecologist Dr. Nadig : Consulting Physician Dr. Gopinath : Consulting Onco Surgeon Mrs. Poornima : Rural Health Care Expert (Vice President)
Our aim is to provide a blueprint design and model for mobile health services To become an integral part of visible and accessible health services To Enhance Partnerships with Academic and Corporate Groups To Enhance Partnerships with Government (national and local) National roll-out To Developing a self-supporting program that screens and saves the lives of women across India To Provide more comprehensive Mother & Child services through Mobile Units To Involve schools and youth to help spread the message
It is unforgivable to allow women to die from preventable ailments. Breast Cancer and Cervical Cancers can be treated once detected early. Women of today arise. Let us fight stigma and save many lives. For a nation without women is as good as no nation. Women hold keys to the existence of the world. -Quote By An African Leader
Contact : Mr. Nandakishora.K, President We Care Society Mobile: 9902256304 Email: nandakishore.sk@gmail.com,