PINCC in Africa

On September 15, 2006, PINCC embarked on its first mission to Africa, starting in Kenya. We began our work in the Siaya district, on the shores of Lake Victoria, among the Luo people. Our team was Dr. Kay Taylor, Pat Sax, our coordinator, and Dr. Terry Dunn, a great urogynecologist from Denver. Our partners in this journey were a large team of doctors and nurses from Matibabu. These American doctors from Kaiser established a clinic and HIV center in this area. We were their first gynecology team. The clinic, in the village of Ukwala, is small but well appointed, with electricity, water and a pharmacy. We worked there several days, then traveled to outlying village clinics, an hour or so out on dirt tracks. Here, there were central pumps to collect water, very basic sanitary facilities, and little electricity. They are staffed intermittently by Clinical Officers, similar to our Physician Assistants. The word had spread, and hundreds of people came from miles around to see the doctors.

PINCC set up our gynecology clinic in a new place every day, and saw everything from children who had been raped to grandmothers with advanced cancers. There is a desperate need for medical care in Kenya; there is one government gynecologist for the Siaya District of 2.5 million people. None of the women have ever had a gynecology exam or Pap smear, including our volunteer staff. We did lots of educating, and got most of the staff members to have their first exams; they were then very effective at convincing the village women to be examined!
Cervical cancer is indeed a scourge here. In the 160 women we saw, there were 3 invasive, advanced cervical cancers. This is around 2%, an astonishingly high number. There were many precancerous dysplasias as well. Unfortunately, there was little we could do for the women with advanced cancer. There is presently no radiation therapy available in Kenya, and very little chemotherapy, which is used for hopeful cases. All we could do was counsel them and their families, and supply pain medication. Catching this disease early and treating it is so important in Africa!

We also saw many women with HIV/AIDS; the rate in this area of Kenya is about 40%. With Matibabu's developing HIV/AIDS center, there is great hope for these women to live long enough to raise their children. It is crucial that they are screened and treated for cervical dysplasia, though, because of the rapid progress to invasive cancer that occurs in HIV+ women. Giving antiretroviral drugs doesn't stop this process, so they need examination every 6 months.

Probably the most important thing we did was to begin teaching and training health workers to do exams and treatment of women. We gave lectures to the Siaya Medical Teaching College's classes for Clinical Officers and Nurses, as well as graduate Clinical Officers working in the hospital and clinics. We will begin hands-on training upon our return in February.

Dr. Terry Dunn, in addition to working in clinics, performed 8 surgeries for women with urogenital fistulas (a disabling complication of childbirth in Africa), as well as several other operations. She worked with the government gynecologist, teaching him her techniques.

After two very full weeks in Siaya, we returned to Nairobi, the capital city. In the village of Ngong, an hour outside Nairobi, we worked with HIV+ women who have been sexually abused or prostituted, at the wonderful Shelter Women of Kenya program, which also runs an orphanage for children whose parents died of AIDS. Mary Kuria, its director, is a great inspiration!

We also met with the Kenya Women's Medical Association. Dr. Veronica Manduku, a radiologist, is working to set up a radiation therapy program in Kenya. Josephine Mwenga is a lawyer who works with programs to combat violence against women. Dr. Elizabeth Okoth is Medical Officer of Health for Siaya District. All 3 have agreed to serve on the Board of Directors for PINCC Kenya/ East Africa. We will collaborate with them in a new Well Women Clinic in Nairobi as well. These dynamic women are dedicated to improving the lives of women in Kenya; I'm proud to be working with them.

Finally, we flew on to Lusaka, Zambia. Here, we met with Dr. Christine McDonald, a Scottish gynecologist who has settled here. She is very active in bringing modern medicine to the University Teaching Hospital, and plans a new gynecology service for poor women. She has also taken in 25 of the street children of Lusaka. She is tutoring them, sending the brightest to secondary school when ready, and teaching the others a trade. We plan to work with her to establish her clinic on our return. We also met Dr. Parham, a gynecologic oncologist from University of Alabama, working with CIDRZ (Center for Infectious Disease Research in Zambia). They have established a great program for women with HIV in 6 public health clinics in Lusaka, using the one-visit see and treat cervical cancer prevention technique we do. They have trained nurse-midwives to do the screening and cryotherapy. They plan to expand to another 18 clinics in Lusaka, and in others in rural areas. They will need more doctors to teach, train and establish these programs, so we will work with them. Zambia, like Kenya, needs many more doctors and health workers to reach their widespread, inaccessible population.

Africa is an enormous challenge! Yet there are many special people dedicating their lives to make a difference. With the help of our volunteers, and of supporters like you, we can partner with them to save women's lives and improve health care for the women of Africa. Please be as generous as you can as you consider your end-of-the-year donations. Thank you for helping us reach out to them!