Dr. Art Levit (on right in photo with gynecologists in Nicaragua)is well-known to anyone involved with the OB/GYN Department of Kaiser Oakland over the past 20 years. He recently retired, receiving a special tribute from the residents for heading their training program. Art went on a Central America Campaign with PINCC last year, and stepped in to be Medical Director for our Africa Campaign in Kapenguria, Kenya. He posted this review on Great Non-Profits:
PINCC is an organization that gives meaning to the phrase "more bang for the buck." Although it runs on a shoestring - using a virtually 100% volunteer workforce (medical and non-medical) - it leverages the power of it's endeavor by creating and supporting self-sustaining operations at target sites. I have participated with PINCC in Central America and in Africa as a physician-trainer, offering local healthcare workers an effective and inexpensive approach to 1) early diagnosis of cervical PRE-cancer and 2) accompanying treatment to prevent progression to cancer. Training efforts are directed at healthcare facilities that provide low cost or free women's services.
These procedures are office-based, inexpensive, and highly effective. PINCC re-visits each site several times to validate the quality of work being done and to certify individual healthcare workers (physicians, nurses, physician assistants, nurse-midwives, medical officers, etc.) in the diagnostic and therapeutic procedures they have been taught. PINCC also donates equipment and supplies where necessary, enabling recipients to maintain a very low cost clinical operation over time. The focus may seem narrow, but cervical cancer is the number one cancer killer of women in the developing world. The significant impact of the efforts of this organization, now in operation for 6 years, is expanding over time.
Hayley Miller is a dedicated volunteer for Prevention International: No Cervical Cancer. She graduated from University of California Berkeley in May 2010 and is working towards her entrance into medical school in 2012. Hayley met PINCC while working in Mysore, India and admired the work that PINCC had demonstrated. She arrived back in the Bay Area to meet the rest of the PINCC staff and to immediately start volunteering. Hayley has helped spread our mission. Her focus primarily is on social media, including refreshing and renewing Facebook, Twitter, and Flickr. Hayley wants to spread PINCC’s passion to other young women in the Bay Area; Hayley organized a presentation given by the founder Dr. Kay to a group of over five hundred women in the Panhellenic sororities of UC Berkeley. She wants to continue giving presentations to local young women regarding HPV, how it leads to cervical cancer, and the effects of this disease internationally. Hayley also helps PINCC with fundraising events such as, Fiesta Latina, which raises money for resources for PINCC trips to Latin America. She helps advertize, set up, and brings resources to help successfully raise money for women in Latin America. In the past she has participated in PINCC trips in Mysore, India and this year she will be venturing to El Salvador and Nicaragua.
The first day is always chaotic. That is what Carol, the Prevention International No Cervical Cancer (PINCC) program director told us. I felt myself relax and remembered why I love working abroad. We come with goals and ideas of how we want to help and make a difference, but the local environment will ultimately dictate the work done. And the environment is difficult to predict. PINCC has a successful track of working in many different countries in a variety of settings, so this “chaos” is something written into their agenda. I had come on the trip with Dr. Gupta, one of my own OB/GYN attendings who is fluent in Spanish and well versed to international work. So I knew whatever the day and trip would bring, there would be plenty of support.
… my global health experience with PINCC was everything I hoped it would be. Most work trips I have done in the past have left me wondering if I really made any difference at all. This trip was different. I understood I was part of a process, a meaningful process that would help to transfer a specific life-saving skill to the hands of the local doctors that could and would help to save many women’s lives from a preventable cancer. And I left with optimism, hope, and satisfaction that PINCC was truly doing something positive in every community they touched and I was honored to be a part of it. My self growth was also very apparent throughout this trip and was very fortunate to accompany and learn from Dr. Gupta, who is an inspiring obstetrician/gynecologist devoted to global health, on this trip. I look forward to being a future PINCC supporter and volunteer in the future.
(For information about volunteering with PINCC click here)
I was a little apprehensive arriving in Lima, Peru as this was my first PINCC trip. Thankfully, Carol Cruickshank, our trip administrator, and Dr. Melissa Miskell, our medical director, greeted me with warm smiles and instantly eased my nerves. I joined the PINCC team for their third week in South America. While the rest of the team took a much needed break and explored the city, Carol and Melissa briefed me on what to expect as the only other physician over the next week. During this meeting, I learned about the PINCC procedures and my responsibilities but more importantly, I learned about the people I would be working alongside. Carol has exceptional organizational skills and an ability to understand the needs and strengths of each member of the team. She transforms a foreign country and a group of strangers into a home and a family working together. Similarly, Melissa's confidence, dedication and laid back yet adventurous attitude create an ideal work environment. Her passion for serving women is inspiring and keeps the team going when fatigued.
The first work day was overwhelming to say the least. We arrived at the clinic site and the team instantly flew into action, unpacking and organizing each exam room in a matter of minutes. After the rooms were ready, women were checked in and interviewed. During the initial interviews, I led a 30 minute basic class on Visual Inspection with Acetic Acid for midwives and physicians from the surrounding areas, focusing on how to identify the squamocolumnar junction and acetowhite changes. During this and other classes, I had the privilege of meeting midwives and physicians who had traveled great distances to learn from us. In fact, one woman had spent 16 hours on a bus ride the night before yet eagerly listened during our early morning classes. I'm honored to teach people who are excited to learn and can directly translate their knowledge into helping others. One of the trainees explained that in her clinic, a cryotherapy machine had been donated over a year ago yet no one in the area knows how to use it. She would see countless women with cervical lesions and few options for treatment while the cryogun sat collecting dust. Fortunately, many people and organizations recognize the health needs of the women of Peru and give financially. However, without the knowledge and skills to use the valuable tools that have been donated the benefit is lost. The mission and importance of the work that PINCC does became clear in that moment.
After the brief teaching session, we divided the trainees into exam rooms and began seeing patients. Despite facing poverty and sometimes physical and sexual abuse, the women we treated exuded strength and compassion. It became clear that the trainees were dedicated to improving their lives through cervical cancer prevention but also support and counseling. I was able to watch the skills of the trainees improve throughout the day and their confidence grow. At the end of the day, we would regroup and have another teaching session. This session would focus on specific questions that the trainees had, going over the pre-test questions and identifying low grade vs high grade lesions with the aid of flashcards.
For the more advanced trainees, we also taught cryotherapy and Loop Electrosurgical Excision Procedure (LEEP). The trainees would practice LEEP on a piece of raw meat at the end of a small paper cup. This exercise gave the trainees a chance to practice excising different size lesions. One of the trainees is actually a physician who teaches residents at the training hospital. Like the others, he was excited to learn new skills since unfortunately, LEEP and cryotherapy are not part of their regular curriculum. I was excited to have the opportunity to impart skills to someone with the passion and capability to teach countless others.
As a physician, we are indoctrinated in the see one, do one, teach one motto. Having only been on one other medical mission trip, I don't have that much experience. During the other trip, I acted as a provider, seeing as many patients as I could in a day knowing that after I left there wouldn't be access to care for these women. During the PINCC trip, I had the ability to not only provide my skills but teach local providers these techniques. Leaving Peru, my heart felt full with the knowledge that women will continue to receive the preventative care they need long after PINCC has left thanks to the dedication of the local providers.
Dr. Karen Spizer is an internal medicine doctor at Kaiser Walnut Creek. She is interested in women's health, and trained with PINCC to perform VIA and cryotherapy so she could volunteer with our teams. She has gone to Central America in 2009, and will accompany us to Kenya and Uganda in August 2010.
Dr. Erin Cox — A. Einstein School of Medicine, Bronx, NY
Dr. Erin Cox was working in Nicaragua on a project with a midwife in Esteli, during her last year of Medical School, when she met Dr. Kay Taylor and a PINCC team, which had come to teach and give care in Mulukuku and Achuapa. She became enthused about our work, and returned during her residency to help in training clinics in Honduras and Nicaragua. Here she is instructing Dr. Barinia at Mulukuku, who went on to do training and supervision of VIA programs in Matagalpa. Erin was instrumental in bringing other Einstein students and residents to work with PINCC in both Latin America and Uganda. Erin has now completed her residency, and is in practice in Texas.
Mariam Nabaale is the Matron in Charge at Kayunga Hospital, Uganda. She squeezes out time to train in cervical screening and treatment during PINCC’s visits, and marshals her nurse-midwives’ schedules to include training as well. “There are so many women who come here too late, with invasive cancer. We must learn the way to stop this terrible disease”, she told us. In Uganda’s main hospital in Kampala, 70% of women’s deaths are from cervical cancer. Mariam hopes her daughter’s generation will not have to watch their mothers and grandmothers die of this preventable disease.
Amelia Coplan was the first volunteer to accompany the PINCC founders on a mission. She had just graduated college in November 2005, when the 3 intrepid adventurers headed for the Mosqito Coast of Honduras, working in La Ceiba, Limon and Ciriboya. Her inventiveness and unflappable spirit made her a favorite of the other medical teams we traveled with. After the campaign, she became PINCC's ambassador to Nicaragua, helping to start our program there. Amelia is now enrolled in nursing school.