Teammate Spotlight: Sandra Oketch

Sandra Yvonne Oketch has been working with Dr. Megan Huchko and the FACES team the Nyanza Region of western Kenya for the past ten years. She has 10 years’ work experience in both health research and program set up in maternal reproductive health and HIV/ AIDS care and prevention. She started as a Clinical and Community Health Advisor at FACES, where she became interested in the cervical cancer screening and prevention program. After going back to school to complete her degree, she is now the study coordinator of a cluster randomized trial testing two implementation strategies for HPV testing. Her roles include managing the study team, partnering with the reproductive health team to implement study activities and evaluating some of the study data. The work of enrolling and following up almost ten thousand women is not without challenges. In addition to the inherent challenges of coordinating a study that size, Oketch has had to deal with flooding, flyaway tents, political...
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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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Community Health Campaign: Thoughts Station by Station

Community Health Campaign: Thoughts Station by Station

Not much changes yet everything seems different whenever I return to my home country of Kenya. I was reminded of my first time in Kisumu last year with Dr. Megan Huchko & Katelyn Bryant-Comstock and how anxious I was, even though I was in Kenya, I was completely unfamiliar with this region, the local language, and the culture. Last year, I was a rising junior filled with high hopes, yet naïve of the intricacies of proposing a project and carrying it out. This year, I have returned with much more practical expectations as well as a greater capacity to carry out my project: using GIS spatial mapping to enumerate the risk of loss-to-follow up for treatment of HPV. My project is taking place in Migori, Kenya as a part of the ongoing Cervical Cancer Screening & Prevention Study. The use of geographic information systems will help us create correlations between women’s sociodemographic variables as risk-factors and treatment loss-to-follow up rates....
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Kenyan court case challenges government stance on abortion

Kenyan court case challenges government stance on abortion

After a three-day hearing, Kenya's high court adjourned a case on safe abortion until September 18, with a verdict expected by the end of the year. The case will decide if the government is responsible for the death of a teenager from complications of a botched backstreet abortion, and could increase access to safe abortion for women throughout the nation. The Kenyan ministry of health withdrew guidelines on safe abortion in 2010, and has since banned health workers from receiving training on abortion. FIDA Kenya and the Center for Reproductive Rights are challenging the ministry's decision, saying that it is a violation of women's rights. The government's removal of guidelines and training on safe abortion, they argue, has led to an increase in illegal and often unqualified practitioners taking advantage of desperate women, who face serious risk of complication or even death. The girl at the center of the case, known by her initials JMM, died last month after a botched backstreet...
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Let’s Talk About Sex: Peer-Led Comprehensive Sexuality Education in Rural Kenya

Let’s Talk About Sex: Peer-Led Comprehensive Sexuality Education in Rural Kenya

What is the function of the clitoris? Before I began teaching comprehensive sexuality education (CSE) at WISER Girls’, a secondary school located in Muhuru Bay, Kenya, I never imagined that this would be the most frequently asked question. Especially among a class of female third-year high school students. When I was first asked, I gave a cursory – and yes, somewhat bashful – reply, explaining the clitoris as the “anatomical source of sexual pleasure in females.” But this answer did not satisfy the students, and they probed for more information. As we engaged in a discussion, I learned that many weren’t familiar with an external representation of the female genitalia – especially one with a “non-reproductive” function. As my answers became more justificatory about the significance of the clitoris, I realized that my attitudes about legitimized female sexuality had begun to leak into my responses. While I tried to remove any bias from my answers, I struggled with leaving my...
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