Tuesday January 18th
Peace Care Blog by Tracy Irwin, MD, MPH
The community of Saraya has welcomed us warmly. Our Peace Corps comrades (Leah, Meera and Chris) and Nora’s knowledge of Malinke and Bambara has allowed us to stop at almost every shop and compound to say hello. This included the tailor where Nora got a skirt (pange) made, then to the village chief that was sitting outside the post office. There is a lot of value/respect in ones name and by now he has named all of us. I am Miriama Dumba. Damba is the female name of his last name Damb Fakha. He named us all after him. We all giggle like grade school children every time someone says Damb Fakha. For example, Nathan our team photographer is Ibrahim Damb Fakha.
Today is the day we started our training. Some think we are here to train about cervical cancer screening but locally it is known as “disease of the pants”. We all are in a varying state of restfulness, some slept soundly, others awoken by guinea fowl, a snoring man in the property next door or the frisky donkeys. Who knew it was donkey mating season? Everyone is in good spirits and excited for the training to get started.
We get up around 730am for breakfast of bread and jam or nutella. We boil water for tea/coffee on a butane tank. Rounds at the clinic began at 830AM. The language challenge is largest for Paulette, Karen and I, though there is a lot of shared medical terminology between English and French. There were four patients. A woman with lower leg infection (erysipelas) a gentleman with pneumonia and a toddler that had 2nd degree burns from hot water over 50% of her body. The residents were able assist in the bandage change which took over 30 minutes. The bandages cost the family $10 per day to change, which is a lot of money here. We also checked on the postpartum patient after her breech delivery. She and her baby are doing well. I spent the morning reviewing the training curriculum for the day.
Once the training began, the morning was full of discussion about experiences and expectations. As we start training “the trainers” (people who will continue to train other health care workers when we leave) it was interesting to get their baseline exposure. Some have never seen cervical cancer or performed a pelvic exam while another has a family member with a lesion suspicious for cancer. The woman was able to have a biopsy and is waiting for the results to come back from France….They have been waiting 3 months. All 5 trainees’ enthusiasm and dedication to bring this service to Saraya is contagious to the team. It appears there is a national cervical cancer screening program being developed by the President’s wife but nobody knows what it involves, what systems will be put in place, or how long it will take to get to the rural communities. The closest VIA program we have heard of in Tamba, 4 hours from here.
This project is a true partnership, something rare that I have seen in my work in developing countries. We have spent a lot of time discussing ways to get the word out to the community, how to get the community to support women diagnosed with cervical cancer, what is the best way to follow up screen positive patients and how to create a system of referral for treatment when necessary. We come with ideas and information but not solutions. The solutions need to be created together.