Continuous Medical Education at Migosi Sub-County Hospital in Kisumu, Kenya

Continuous Medical Education at Migosi Sub-County Hospital in Kisumu, Kenya

Migosi Sub-County Hospital is a government level 4 hospital situated in Migosi sub-location of Kisumu County. The hospital is staffed with a Medical Officer Superintendent, Nursing Officer, Lab Technologists, Clinical Officers, Pharmacy Technologist, Support Staff, HTS Service Providers, Peer Counselors, and a Nutritionist. The facility has a catchment population of over 20,000 and is expected to provide services to over 5,000 women of reproductive age per year. Some of the services offered include Antenatal, MCH services, Anti-Retroviral Therapy, Family Planning, Home-based Care, Basic Emergency Obstetric Care, and Inpatient care. The Hospital has strengthened its cervical cancer department and has been in the forefront of beating cervical cancer. The department embraces a “see and treat” slogan and uses the Visual Inspection with Acetic (VIA) method and treatment by means of cryotherapy. The Hospital has intensively engaged Community Health Volunteers (CHVs) who take advantage of any chance to urge women to come for cervical cancer screening. On 14/02/2019 Dr. Phil Gorrindo visited the facility to...
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The Inaccessibility of Sexual Health Care for Disabled Women in Canada

The Inaccessibility of Sexual Health Care for Disabled Women in Canada

In Canada, standard health protocol recommends that women receive a Pap test every few years in order to detect cervical cancer as early as possible. However, health practitioners at ACCESS, a clinic in Vancouver which provides sexual health services exclusively for disabled women, have identified a significant deficit in the accessibility of such services for the demographic they serve. This inaccessibility is derived in part from a widespread lack of appropriate equipment. Many offices do not possess an accessible exam bed with a lift, preventing gynecological screening for disabled women. Additionally, many doctors, in providing care to these women, draw upon the misguided assumption that individuals with disabilities are not sexually active and thus neglect to ask their patients for a comprehensive history of their sexual health. Because this discourse does not occur, or is  not prioritized due to more immediate health issues directly relating to the disability, cervical cancer is rarely screened for amongst disabled women, and thus persists largely...
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Tumaini La Maisha Health Services Organization

Tumaini La Maisha Health Services Organization

This is a non-profit organization that works jointly with Kisumu Hospice Center established at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) on cancer projects. Breast, cervical, prostate and esophageal cancers are its focus. The Kisumu Hospice serves the local community and supports a satellite hospice center at the Siaya District Hospital. On average, the hospice aids 50 patients each month. The organization promotes cancer awareness and helps navigation through patient referall by community screening and linkage. The foundation has established an accommodation unit in Nairobi that hosts a total of six patients at a time who have been referred for radiotherapy. It has also established a school in Nyakach (Kisumu County) for vulnerable children and offers support to the school. The organization works with partners like Aga Khan Health Services, JOOTRH and Oncology Department to offer services to cancer patients. The organization takes the lead in participating in national events, organizing medical camps and community outreach programs with an aim to...
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World Cancer Day

World Cancer Day

Yesterday, on February 4th, the world celebrated World Cancer Day. Initiated in February 2000 at the World Summit Against Cancer for the New Millennium in Paris, the event is an initiative of the Union for International Cancer Control. The Paris Charter aims to promote research, prevent cancer and raise awareness. 2019 marks the beginning of the organization's "I Am and I Will" campaign, which will last till 2021 and emphasize each individual's personal commitment to reducing cancer's impact. In concurrence with World Cancer Day, the UN World Health Organization released a statement explaining that incidences of cervical cancer will likely increase by almost 50 percent in 2040. It noted that the number of new cases could be reduced if all girls between the ages of 9 and 14 are vaccinated for HPV. The organization stressed the importance of collaboration between governments, UN agencies and healthcare professionals to preventing increased rates of cervical cancer....
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Minimally invasive surgery for cervical cancer is a higher risk than the abdominal surgery

Minimally invasive surgery for cervical cancer is a higher risk than the abdominal surgery

Story by Suzanna Larkin, T'19 Cervical cancer screening has greatly reduced its incidence in the United States, resulting in about 13,000 cases a year and 4,000 deaths. It remains the fourth most common cause of cancer death in women worldwide, however, causing over 300,000 deaths per year. Cervical cancer develops after persistent infection by the human papillomavirus (HPV), an extremely common STD.  While later stages are treated with radiation, early stage cervical cancer is commonly treated through surgery.  An increasingly popular method is a minimally invasive surgery performed through small cuts in the abdomen, using either laparoscopy or a robot. This surgery technique is regarded as a medical advancement that lets patients recover faster. Unlike drugs, which are heavily regulated by the Food and Drug Administration, surgery is more adaptive. As long as the hospital allows it, surgeons are able to try new approaches with unconventional tools.  Two recent studies published in the New England Journal of Medicine found that in comparison...
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Eradicating Human Diseases: Opportunities and Risks

Eradicating Human Diseases: Opportunities and Risks

The Director of the Center for Global Reproductive Health, Dr. Megan Huchko, participated in a panel on November 28th entitled "Eradicating Human Diseases: Opportunities and Risks." Dr. Gavin Yamey (Director for the Center for Policy Impact in Global Health) moderated the event, which featured Dr. Christopher Plowe (Director of the Duke Global Health Institute), Dr. Lavanya Vasudevan (Assistant Professor in Community and Family Medicine) and Dr. Osondu Ogbuoji (Deputy Director of the Center for Policy Impact in Global Health) as additional panelists. While the panelists disagreed on the definition of eradication, they all commented upon 'donor fatigue' and the economic and political difficulty of completing eradication as cases dwindle. The panel discussed the difficulty global health programs face in second-world countries, which don't benefit from the same economic resources as first-world countries or as many donations as third-world countries. The panelists stressed the importance of continued screenings, especially in the case of cervical cancer, and emphasized the necessity of childhood vaccinations....
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One Man, His Wife’s Legacy, and the “Monarch of Dreams”: Cervical Cancer Prevention in Zambia

One Man, His Wife’s Legacy, and the “Monarch of Dreams”: Cervical Cancer Prevention in Zambia

The women of Zambia have the world’s fourth highest rate of cervical cancer; yet, Zambia’s government provides free cervical cancer screening services. This begs the question: why does such a high incidence of cervical cancer persist? The answer is due, in part, to a lack of awareness amongst the female population regarding this disease, particularly in rural areas. Robert Zulu, in upholding the legacy of his late wife whom he lost to cervical cancer, aims to inform and empower Zambia’s women by encouraging regular cervical cancer screenings. These preventative measures are especially important for HIV, which disproportionately affects Zambia’s women, as this disease increases the likelihood of cervical cancer diagnosis by three times. Zulu’s non-profit, Rakellz Dream Initiative, takes an incredibly unique approach to this end of raising awareness, producing plays and movies about cervical cancer. Zulu’s latest film, “Monarch of Dreams,” which is based on his wife’s battle with cancer, premiered on October 31st in Lusaka, Zambia’s capital. The...
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Embracing My Role as a Researcher – Sharing My Small Slice of the HPV Research Pie

Embracing My Role as a Researcher – Sharing My Small Slice of the HPV Research Pie

Guest Blog: Carissa Novak Throughout my recently completed Masters in Global Health Science, Duke’s Global Health Institute faculty regularly stressed the importance and potential impact of disseminating research findings. Therefore, I felt presenting the research findings from my thesis at the 32nd International Papillomavirus Conference inSydney, Australia, this fall was not only appropriate but necessary. Due to ongoing conversations regarding HPV vaccination coverage and HPV screening for cervical cancer communities are witnessing a tremendous increase in screening rates, especially in low-resource settings, where cervical cancer is most common. However, most programs still face significant challenges in addressing HPV positive women’s low rates of follow-up and treatment. My attendance at the conference was an opportunity to share the findings of my thesis work, in which we found that in western Kenya, a setting where resources were limited for all HPV positive women, stigma and isolation were the main differentiating features between women who accessed follow-up and those who did not. Interestingly, I presented...
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US Preventive Services Task Force recommends primary cervical HPV testing as an effective cervical cancer screening method

US Preventive Services Task Force recommends primary cervical HPV testing as an effective cervical cancer screening method

Cervical cancer is the fourth most common cancer in women worldwide. In the US, deaths from cervical cancer have decreased by more than 50 percent over the past 60 years, since the introduction of regular screening tests that detect high-grade precancerous cervical lesions and cervical cancer. However, over 13,000 women are diagnosed with cervical cancer annually and about 4,200 women die from it, even with screening and treatment. Recommendations continue to evolve, reflecting the latest screening technology and evidence. The new USPSTF recommendations for screening have been recently published in the latest issue of JAMA. Women over 30 now have three options for screening, including HPV testing alone; the other two options are pap smear and a combination of pap smear and HPV testing. HPV testing has been shown to be more effective than a pap test as it is able to detect precancerous cells earlier and more accurately than cytology. These screening guidelines update the previous guidelines; now, for...
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Health Systems Barriers to Cervical Cancer Prevention in Kenya

Health Systems Barriers to Cervical Cancer Prevention in Kenya

Blog by Charlotte Page, Ob/Gyn Resident: This is a follow-up post to “Patient Barriers to Cervical Cancer Prevention in Kenya”. I’ve realized while in Kenya that there are a lot of things I take for granted in bathrooms in the US: running water, a toilet that flushes, toilet paper, soap, and electricity. If you’re missing one of these things, the restroom is that much more uncomfortable – or perhaps even unfunctional. Similarly, small systems issues here in Kenya can inhibit women from receiving the healthcare they need. For the HPV-positive women in the study I’m working on, such problems can significantly increase the amount of time and effort required to get treated with cryotherapy, to the point that some women don’t obtain treatment at all. To paint a picture: yesterday I was at Migori County Referral Hospital (MCRH), one of the sites where cryotherapy is provided in our study. This procedure uses compressed gas to freeze precancerous cells on the cervix, thereby preventing them...
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