Saturday, Jan 22
Nora Burns, OMSIV – Ohio University College of Osteopathic Medicine
Today is the first screening day. Wow, am I nervous. I’m not doing the exam, I’m not teaching it and I’m certainly not getting an exam! Yet, I’m still nervous. We agreed the first depistage would be at 9am so we trooped over to the hospital after our usual breakfast of bread, jam and instant café au lait.
Nine-thirty came and went with no women. I was getting more nervous – what if no one came? Could four days of training, a radio spot and 32 decontaminated speculums all be for nothing? Ce n’est pas possible! The trainees assured us that the women would come; they were most likely busy with chores at home.
Of course, they were right, by 10:15 we started counting the women who looked older, unsure who was there for screening or a consultation. The trainees divvyed up in two exam rooms and so began the first cervical cancer screens in Saraya.
Andrew, Tracy, Mel and Paulette supervised and offered advice to the trainees, with some translation by Leah and me. Fatou Traore, a well-known midwife and one of the trainees, did an amazing job of explaining the cancer, the natural history and the screening process to the patients. Fatou is unique among the medical staff because she speaks Malinke, the local language. Most of the staff is Wolof so they often use translators to interview patients. You can imagine that this extra lingual challenge could make a pelvic exam uncomfortable!
I spent most of the day in the waiting area, greeting the women. One woman delivered while her relatives waited just outside. I loved watching the familiar signs of a family greeting their newest member. Grandma told me quite proudly that it was a “den ke!” (please excuse my bambaraized Malinke), “It’s a boy!”
I had a long talk with one woman who’d trained in the Beugona goh program, which is Wolof for <big sister>. The big sisters encouraged the women in their village to visit the health post for prenatal visits and the hospital for deliveries. She asked more questions about cervical cancer and I was happy to spend time discussing it with her. She will certainly be explaining the screening to more women!
We worked right up to a lunch of rice and fish and a well-earned lunch break. I wandered around town a bit with the PCVs, enjoyed a cold yogurt and then headed back for more screenings. We ultimately turned away a few 50yo+ ladies and, of course, the three men who asked to be screened. Plenty of women screened – Success!
After changing into our “athletic clothes” (scrubs for me), we hit the basketball court right next to the hospital. As I write that, I realize I’m implying there is another court in Saraya; alas this is the only one. We practiced our moves with some enthusiastic kids while the first two teams played a very competitive game. Fatou Kane, a lab assistant in the training program, enthusiastically shot some baskets. Don’t ever play HORSE with her, I lost badly!
Lucky for us, Captain Prepared (Tracy Irwin, in case you couldn’t guess) also proved to be Captain-if-I-didn’t-go-to-medical-school-I-would-have-been-a-basketball-coach! She’d analyzed the team and come up with a defense strategy to knock them out of the water! Who needs a clipboard drawing of the key with dry erase markers? Not Coach Toubab! She demonstrated our strategy with rocks for positions and a twig to mark the basket. Chris later commented on how different it was to play with a strategy. I think he may try it again sometime J
Have I kept you in suspense long enough? Did we win the game? A random bunch of Americans v. an organized Senegalese youth team? It was a very exciting game – up and down the court enough to wind even the spectators. Chris had some excellent free-throws (how did he keep getting fouled?), Andrew turns out be a great ball handler, garnering more baskets for our side. My favorite had to have been Tracy boxing out a player who clearly had no idea what to do with that maneuver!
I hadn’t played since I fouled out a game in eighth grade so it was wonderful to get back on the court. I might have snuck in an illegal hold (though no ref saw it!) With one minute left, Andrew passed me the ball and I went for it. Nothing but net, thank you! Unfortunately, it was not the winning point. J Our enthusiasm, both on the court and off (thanks, Karen!), came to no avail. We lost, even after Fatou told us we must win the game! Well, there’s always next Saturday!
What an incredible day! The Senegalese healthcare workers finished their training program and implemented the first cervical cancer screenings in the department of Saraya; this is the first step to bring screening to all the women in the region of Kedougou!
As I think about this amazing accomplishment, I remember first learning of Peace Care. I immediately knew that I wanted to get involved. As an RPCV, I have a different idea of an “international rotation” than most students so I was happy to find someone like Andrew to serve as my preceptor!
As most of you know, the decision to work on cervical cancer was made in the last month or two. This issue is very close to my heart. A few years ago, my aunt, Patty McGuire, died of cervical cancer. As the training is expanded to include more healthcare workers and more women are screened, this will spare many husbands and children the loss my uncle and cousins suffered. Yea Peace Care!! Yea Saraya Hospital!