Uganda and Kenya

Lisa Levine, MD, on Africa:

I'm a second year resident in Ob/Gyn at Albert Einstein in the Bronx. Since medical school I have been volunteering with an organization called PINCC. I chose to spend my two week vacation working with PINCC in Africa, helping to see and treat women in addition to teaching the healthcare workers.

Kisoro Hospital, Uganda, was the site of our first stop on the PINCC journey. Working with PINCC and 2 dedicated medical students, Chavi Kahn and Eleanor Chung, we trained the healthcare workers in Kisoro to provide a sustainable program for cervical cancer prevention. Most of these workers had never put in a speculum and did not know what cervical cancer is, how you got it, or how you treat it.

When we got to the clinic the first day, we could not even get to the clinic doors because there were so many women who had heard we were coming to the village. There must have been almost 600 women there in vibrant colored garb with babies either on their back or on their breast. Some of these women walked over 3 hours from their village, most without shoes, to see the muzungu (white) doctors.

We spent 5 very full days in Kisoro training doctors, nurses, midwives, and seeing patients. We were able to see over 550 women! We treated 55 women for pre-cancerous changes, but also diagnosed 3 advanced cancers. Unfortunately there is not much hope for women with advanced disease - the chemotherapy and radiation that is available in the States is nearly impossible to get there. But with the implementation of this program, there will be fewer women that have to die from this nearly 100% preventable disease; we will catch the early stages and treat them before it is too late.

The second week, we made our way to Nairobi, Kenya, where we stayed with Dan Ogola and his family, who arranged our visit to Kenya and the clinics we would work in. Dan is an amazing person. He lived in Kibera slums during his teenage years and would walk 3 hours to and from work for $1.50 a day. He took us walking through the Kibera slums. It is an area of 300 acres with 1 million inhabitants and it was one of the most disgusting experiences of my life. "Houses" are thrown up with clay, sticks and stones. There is no clean water or plumbing system; yet people have huge smiles and big hearts. I can’t count the number of times that we were offered help by some of the local people in forging the rivers of excrement. We worked in two clinics serving the women here, finding and treating many more potential cancers.

The trip was incredibly rewarding, but I had mixed feelings throughout the trip. There were some days that the extreme poverty and helplessness of the people just got to me. Was I merely attempting to bail out the ocean? In a continent that is full of political greed, incredible illness, destitution, and extreme need, was I making an ounce of difference?

Then I realized yes, we are doing something. We were helping to change healthcare there, even it is only one of hundreds of issues that need attention. And we are making people more aware - both in Africa and in the States. In Uganda, where the prevalence of HIV/AIDS was once 25% of the population, they have managed to bring it down to 6% in the past 10 years. It is an example of how education, knowledge, treatment, and determination can actually make a difference. And the doctors that we worked with in Uganda told us that if our program was successful, the governmental agencies would consider initiating this screening program on a national level. We can truly say we are working towards change, towards making a difference. You can't overcome huge obstacles without using stepping stones to get there.