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This Winter clinic season MEDLIFE performed around 300 pap smears in Lima and 270 in Ecuador to screen for cervical cancer.
In Ecuador our nurses deliver the results to community leaders, who hand out the results. In Lima, we used to rely on community leaders to hand out the results of the tests, but we realized the results were not always getting to our patients.
Our nurses decided that the only way to make sure their patients got the results was to deliver them themselves. They go community by community and call each patient to get them their results. They then explain the results to each patient and leave them their phone number so they can get in touch if they have questions.
Pap smears are an important screening for cervical cancer and can catch the disease while it is still treatable. They also test for various kinds of infections. Many of the women in our communities have never gotten a test nor are they aware of why they should get them. When we have a patient with an infection of some kind, we give them a prescription for the medicine they need. If they test positive for cancer, we get them an appointment with an oncologist and accompany them. Luckily, no one has tested positive for cancer yet this season.
Getting the tests in our Mobile Clinics gets them that first test, but it also serves the purpose of teaching patients about cervical cancer and why it is important to get yearly tests.
MEDprograms was initially concerned when they noticed the number of pap smears going down in the communities the more we visited. But after speaking with the women in the community, we learned that they had taken up the habit of getting a yearly test on their own. Medlife’s educational approach is working!
As more women get tested regularly in our Mobile Clinics, we expect to see fewer cases of untreatable cervical cancer and more women getting tested regularly in the future!
On Friday 9th September, we held our first PAP smear educational workshop. MEDLIFE has been carrying out PAP smears to test for cervical cancer since some of our earliest clinics. However, recently our nurses have noticed that many women have not been benefiting from these results as they have never been educated on how to read them correctly. Women who were being given normal results were worrying that they had cancer as they didn't know what a positive or a negative smear looked like on paper.
Therefore, the MEDLIFE nurses have been collaborating with obstetrician Zaida Lara to design a workshop that goes hand in hand with giving out the results of the tests. The first of these workshops took place in the community of Kawashi, Villa María del Triunfo where Zaida, along with MEDLIFE nurses Ruth and Carmen, talked the women present through reading their results. Zaida explained to the group what a positive result would look like compared to a negative result and what the different types of abnormality could be. For example, she explained how a result that showed up as being ‘abnormal' could be anything from a yeast infection to an early onset cancer.
The woman who attended the workshop were clearly pleased to hear this news; “as soon as I opened my result I began panicking, having someone to talk through it with me and explain every step made it that much easier,” one woman told us. The workshop also meant that the women were able to talk to the nurses about their individual results and what the next steps would be. For the first time, they were able to act immediately if there was something wrong with their results and know the exact course of action to take. Furthermore, it allowed us to quickly and efficiently get the patients who need more help into our follow up program.
So far, MEDLIFE has treated hundreds of patients who have been diagnosed with abnormal PAP results and helped with 20 cancer diagnosis'. Hopefully, with this new way of delivering information, we will be able to help even more patients to get the treatment they need.
In Febuary 2016 MEDLIFE gave an educational workshop in Talleres Artisenales, a new community for MEDLIFE, located in Pamplona Alta. Year-long interns and local medical staff worked together to give the workshop. Topics included family planning, the importance of regular exams for breast and cervical cancer, what support exists for people in abusive relationships, as well as nutrition and diabetetes prevention. Many women there had never had a breast exam or pap smear, and were encouraged to come to the mobile clinic MEDLIFE will be holding in that community and see a doctor. Local medical staff explained realistic food substitutions people good make to have a healthier diet and reduce diabetes risk, for example, swapping soda for fruit juice without artificial sugars. Educational workshops are a great way to build awareness, organization, and trust within a community before moving onto bigger projects like staircases and mobile clinics!
A child brings a gift for the MEDLIFErs at the meeting.
The hills around Lima where MEDLIFE works are arid and desert like. Access to healthy food like fresh produce is scarce for most residents. When a community in Via El Salvador expressed interest in working with MEDLIFE to creating a community garden, MED programs intern Jessica Danker jumped at the opportunity and decided to work on this as her intern project.
This community had tried to start a garden project in the past, but were unable to complete it because they lacked the resources to purchase proper soil and to modify existing infrastructure to create a good space for the garden.
Over half a billion people worldwide suffer from chronic food insecurity, and many more lack access to healthy foods. The communities MEDLIFE works in are no exception. Community gardens can be an effective way of addressing this problem.
Along with the obvious benefit of creating access to affordable fresh produce, and the health benefits that follow, community gardening has a host of other benefits that are supported by research in a variety of settings. The positive effect that urban green spaces, something that is very scarce in the communities where work in Lima, have on mental health and overall well being is heavily documented. Participation in community gardens increases civic engagement, and has even been shown to be related to reduced crime and juvenile delinquency in some studies.
The local elementary school was chosen as the site of the Via El Salvador, garden so that the community could get the children involved and use it as a learning tool for them. They can learn where their food comes from and about nutrition with hands on experience. The parents, teachers, and children involved with the school are responsible for the upkeep of the garden. The harvest will be distributed to the families with children in the school. MEDLIFE will check in with the school periodically.
The garden is an eco garden, meaning it is grown naturally without the use of pesticides and other chemicals. It has six garden beds planted with lettuce, carrots, cilantro, aguaymento, celery, Swiss chard, beets, and more. Jessica gave an educational workshop about nutrition in November of 2015 after the garden was planted. She talked about the impact of dietary choices like Inca Cola vs. fruit juice, white rice vs. brown rice, how to combat anemia with improved diet and how to use foods from the garden to combat common nutrient deficiencies in children.
As of December the project is going well and Jessica is hoping to do another garden project during her work with MEDLIFE.
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Ober Allen, J., Alaimo, K., Elam, D., & Perry, E. (2008). Growing vegetables and values: Benefits of neighborhood-based community gardens for youth development and nutrition. Journal of Hunger and Environmental Nutrition, 3(4), 418-439. doi: 10.1080/19320240802529169
Teig, E., Amulya, J., Bardwell, L., Buchenau, M., Marshall, J., & Litt, J. (2009). Collective efficacy in Denver, Colorado: Strengthening neighborhoods and health through community gardens. Health & Place, 15(4), 1115-1122. Retrieved from http://www.sciencedirect.com/science/article/pii/S1353829209000598
Our latest educational workshop was located in a small community in the Nueva Esperanza area of Via Maria del Triunfo. MEDLIFE will bring a Mobile Clinic to this same community in March of 2013.
During the workshop, MEDLIFE staff members presented on a number of health topics, including the importance of psychological health and sleep, preventative tests for breast and cervical cancers, and nutrition. Along with our usual preventative health topics, we also touched on – for the first time – the important issue of property rights.
As many of our supporters know, MEDLIFE Peru works primarily with low-income, informal settlements established just outside of the city of Lima. Poverty, terrorism, and a lack of opportunities in rural Peru have prompted thousands of residents to migrate to these urban slums. As these communities become bigger, more established, and better organized, residents begin to move toward legal formalization of their homes and communal spaces.
Yet, the country has struggled in developing a comprehensive plan for urban development. With changes in government administration, treatment of informal settlements has varied widely. The involvement of several different agencies, sometimes with conflicting policies, also makes the process of legalization a murky one to navigate.
Santos Abad, a government lawyer, explained the basics of acquiring land title, highlighting the primary agencies involved in the process: COFOPRI (government agency that deals with property formalization), the municipal government, and – in some cases – the court system.
Abad outlined an important law called the prescripción adquisitiva de dominio. This law states that an individual may gain legal land title simply by possessing the land, peacefully and consistently, for a minimum of 10 years. The government's 10-year rule is a seemingly adequate amount of time for legal owners to reclaim their land or, if they wish, take squatters to court.
Community members listened attentively and immediately began to ask questions. In addition to general information about legalizing their property titles, many wanted to know more about the intricacies of sharing property. What happens when you share a home but are not married? How can parents ensure that their homes get passed on to their children?
Residents have voiced a need for more education, in order to better understand their legal rights. MEDLIFE hopes to begin including this type of training, focusing first on property rights, in our upcoming educational workshops.
Stay tuned for more information on important issues regarding land rights in Peru, coming soon!