Prevention International: No Cervical Cancer (PINCC) was established in 2005 by Dr. Kay Taylor, a gynecologist who during a medical mission to Honduras saw more cases of women dying of cervical cancer in that one trip then her entire career. The first PINCC trip, in late 2005, was to the Mosquito Coast of Honduras. With only 3 eager volunteers, Dr. Taylor and her team visited three health clinic sites and began training healthcare workers in cervical cancer screening and treatment.
Today, PINCC takes teams of five to twenty volunteers, including OB/Gyn Medical Directors, on six trips to Africa, Latin America, and India. PINCC has trained over 400 medical professionals. Our volunteers have directly screened and treated over 15,000 women during training, and certified 27 centers in 9 countries who continue to provide services to thousands of women every year! From such humble beginnings, PINCC is continuing Dr. Taylor’s vision of creating sustainable programs that prevent cervical cancer and save women’s lives. We are currently training 14 more clinics and hospitals. Read about our campaigns
THE STORY OF PINCC’S BEGINNINGS
by Kay Taylor, MD, Director and Founder
PINCC was established in 2005 by Dr. Kay Taylor, a gynecologist who took early retirement to begin fighting the scourge of cervical cancer among poor women living in under-resourced areas. She volunteered on a 2003 medical mission to Honduras, where she found 3 cases of invasive cervical cancer - as many as she had seen in 15 years' practice as an OB/GYN doctor at Kaiser. Research unveiled the huge extent of the disease worldwide. The tragedy is, this is the most preventable cancer in the world! The USA and most of the western world has reduced the rate of cervical cancer down to 2.2 deaths per 100,000 women whereas the rates in Africa and Latin America are fifteen to twenty times higher. Kay began researching the international problem, and found publications on a new method designed for under-resourced countries: the see-and-treat, single-visit technique piloted by the Alliance for Cervical Cancer Prevention. She decided to take the technique where it was most needed, training medical personnel and donating the necessary equipment to run self-sustaining cervical cancer prevention programs.
The Beginning: Central America
The first PINCC trip, in late 2005, was to the Mosquito coast of Honduras, with only 3 volunteers where we visited 3 sites. In 2006, PINCC increased both the team and the sites served in Honduras, working at 7 sites. The coast of Honduras now has a good screening and referral system, thanks to Cuban-trained doctors who are continuing the work. In 2006, we also added the small mountain town of Achuapa, Nicaragua, and the Acahual Clinic in Managua. This women-operated clinic serves the poor barrio next to the town dump, and provides services and retraining for prostitutes as well as poor and abused women. By 2007, PINCC had donated equipment and certified medicos at 3 sites in Nicaragua, and was working in both Guatemala and El Salvador.
We continue to work in Nicaragua, having trained at 8 sites and certifying 45 medical providers. In 2010, we will begin training at the University of Leon, with the OB/GYN Residency program, qualifying both professors and residents in the see-and-treat method of cervical cancer prevention.
Our greatest success has been in El Salvador. PINCC was first invited to El Salvador in 2006 by a grassroots non-profit organization, ProVida, which works in villages and barrios to bring health care and clean drinking water to neglected communities. Their doctors and Director, Graciela Colunga, wanted to develop the skills to provide screening and treatment for cervical pre-cancer in their clinics serving poor and rural communities. The government programs were too expensive and overloaded for women to access care, especially in rural areas. The average amount earned per day is $3 or less. Also, the OB/GYN Society in El Salvador had ruled that only gynecologists could do the treatments, preventing women from accessing care at local clinics. Women are waiting 6-12 months to get an appointment. Women told us stories of “free” care for which they were charged several days’ wages, and then sent home because it was too busy that day. One mother said, “They told me I had a bad disease on my exam, and I should go to the hospital in San Salvador. But who would take care of my children for 2 days, and where would I get the $25 it would cost? I am a widow, and only make $3 a day”. PINCC performed a loop excision while training the clinic doctor, curing the woman the same day she was seen. She was crying with joy and gratitude. Her doctor is following her to be sure there is no recurrence, under the protocols we taught. And all her sisters, cousins and other relatives went in to get their exams as well!
Just during PINCC’s training visits to ProVida in our first year, 2007, we screened 322 women and treated 79; and in the past 3 years they have screened and treated thousands of women. In 2008, a Peace Corps volunteer in the northeast mountain communities around the Honduran border heard about PINCC from a friend at ProVida. She decided to make this cancer prevention program her project during her final year. She talked to the doctors in the 4 mountain villages she served, and the to the head of a clinic program in La Palma, the largest central town in this border area, where HIV is much higher because of the amount of trucking that passes through. PINCC has now trained this facility’s nurses and doctors, and donated treatment equipment, so the women of these remote villages can get screened and treated. There are also many women who come across the border from Honduras to be seen in these clinics.
PINCC always makes sure that the staff treating HIV positive women are trained, and that they educate women to get their screening examinations every year. Because of their reduced immune system, HIV positive women progress to cervical cancer much faster, and anti-HIV drugs don’t inhibit this growth. The simple process of screening and treating early dysplasia will give these women a longer life, allowing their anti-viral drugs to keep them healthy.
Word of PINCC’s trainings continued to spread, and we were invited into many other clinics and facilities to train when the 2009 National election took place, and the Mayor in San Salvador changed. The conservative new mayor decided to go back to the old way of having women go to gynecologists, and fired the gynecologist head doctor we had trained! However, in the same election, the liberal party won the Presidency, so the leaders who work with PINCC were promoted to the National Health Department (MINSA), and many of the doctors we trained are now employed there as well.
PINCC has now been asked to collaborate with MINSA to train and equip many clinics and hospitals in El Salvador. This is a wonderful opportunity to assist El Salvador in building capacity country-wide.
Our first trip to Africa was in 2007, to Kenya. Matibabu, an American-supported site in western Kenya, invited PINCC to train at their site. This facility is now operating independently, in cooperation with the Siaya Hospital nearby. Another site at Kitale, Kenya is also serving its women with screening and treatment. Training at Pokot and Kisii continues in 2010.
In Kisoro, a small town in Uganda, PINCC trained 9 health practitioners including doctors, mid-level medical officers and nurses in cervical screening and treatment, from 2007-8. Their program is so effective, and the demand so great, that they have begun their own outreach program. Every month, they take their team in a LandRover, with the portable equipment we left them, and go to villages within an hour’s drive. They have committed to screening 3,000 women a year in this rural, subsistence-agricultural community. PINCC will complete training in Kayunga, Uganda this summer, certifying their staff and leaving the final equipment. We have been training at Bukumbi and Shirati in Tanzania, near Lake Victoria and will complete their training in 2010.
PINCC is currently working at 2 sites in India: Puttaparthi in Andhra Pradesh State in Southern India, and Mysore in the state of Karnataka, India. Dr. Rhoda Nussbaum, volunteer PINCC Medical Director for India and John Adams, volunteer PINCC Trip Administrator for India, began the PINCC program in August 2009 with the PINCC founders Kay Taylor and Pat Sax at the Sri Sathya Sai Mobile Hospital in Puttaparthi. There they trained 14 gynecologists and screened approximately 350 village women. The Mobile Hospital services 12 center villages/ month, providing overall medical care to thousands of villagers from surrounding hamlets each year. Now with this training, the one-visit “see and treat” protocol for cervical cancer screening and treatment is included. The training continued in December 2009 with another 250 women screened. At that time a LEEP machine was donated to the Mobile Hospital. PINCC India will continue training of volunteer gynecologists at this site in August, 2010.
PINCC India was contacted by a clinic in Mysore that serves women from the surrounding villages and also tribal women from the hill country in Karnataka. This site, at the St. Joseph’s Hospital in Mysore, is being sponsored by the Public Health Research Institute of India (PHRI) and the Prerana Reproductive Health Clinic of Mysore. The first training is scheduled for August 4-7, 2010.
PINCC’s newest project is in Lima, Peru, where we began working with Pathfinders International in June 2010 to train their 4 clinics, as well as doing some training in the giant women’s hospital in this city of 8 million people. We are now expanding to other areas with Pathfinders, and have trained their staff of gynecologists and midwives to do training themselves. We plan to expand this collaboration to other South American countries.