Our Programs

GIAHC acts as a coordinating platform between communities at grassroots level, and academic/training institutions, to help raise awareness about HPV related diseases and cervical cancer in a culturally sensitive manner. Our model works on the principle of task shifting: to shift less sophisticated procedures such as cervical cancer screening and early treatment from highly trained professionals (such as physicians) to nurses and community health workers (CHWs) with appropriate training, particularly in regions of the world where there are acute shortages in human resources.

We are currently using the visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI) to detect early precancerous changes. We also strive to initiate treatment on site (with cryotherapy for early changes and precancerous stages) and refer those with advanced disease to appropriate physicians/hospitals, wherever possible. Our goal is to promote self-sustaining models that focus on education, prevention, screening and treatment.

In the near future, we hope to adapt to objective, more accurate cost effective technologies such as HPV DNA testing and biomarkers that identify host cell integration as a precursor to cervical precancer and cancer. GIAHC has collaborated with the Adyar Cancer Institute in Chennai, that conducts 12-day, hands-on training programs in cervical cancer screening for physicians, nurses and community health workers. The cancer institute will be partnering with us to identify/establish more training centers across India in the near future.

GIAHC is also working to collaborate with other physicians/ nurses/ CHWs to organize travel teams to monitor the sites that are trained by us for quality assurance and continuation of the program.

Our organization has also spurred interest among university student groups who have helped build this program. Students from Yale and Harvard have spent time at our sites, and currently students from Columbia University have launched a program to help raise awareness about HPV related diseases on campus, and, work at our international sites as well. In addition, we have a research focus to answer questions in order to improve the lives of millions of women.

KMVS/BHOJAY PROJECT

Kutch Mahila Vikas Sangathan (KMVS) is a grassroots collective of rural women in the Kutch district of Gujarat, India.

Since its inception in 1988, KMVS has grown from a three-person venture into a dynamic organization of more than 70 staff members and 13,500 rural women who have been organized into collectives. As a local federation of rural women, KMVS has heralded a movement of social change by addressing critical issues that touch the everyday lives and livelihoods of rural women and their larger communities. The primary goal of KMVS is empowerment of women through interventions which address the issues concerning their lives.

KMVS has worked on public health issues for the last nineteen years, but the focus on the Reproductive and Child Health Program (RCH) began in 1998 when KMVS first coordinated with Bhojay Sarvoday Trust, an organization committed to provide basic medical facilities to rural Kutch.

The KMVS Human Resource Institution Development Cell (HRIDay) focuses on urban development, capacity building and health programs to support rural women in Kutch, Gujarat. Capacity building is the top priority for KMVS in its promotion of substantive and sustainable development; thus education and awareness training forms the foundation of all KMVS activities, and through the entire process there is a focus on working closely with the community.

In the spring of 2009, HRIDay began work on a Cervical Cancer Screening and Awareness project in partnership with Bhojay Sarvoday Trust, Nearly half a million women are newly affected by cervical cancer each year. The majority of these women live in developing countries, including more than 100,000 in India alone. In developed countries, the incidence and mortality rates of cervical cancer have gradually decreased, thanks largely to screening programs. In developing countries, however, most women do not have access to effective early detection and treatment programs that can halt or slow the progression of the disease. Although 80% of cervical cancer deaths currently occur in developing countries, a screening and vaccination program can change this trend.

The idea for the Cervical Screening program started when Dr. Shobha Krishnan, a primary care physician and gynecologist working in New York, visited KMVS and the Bhojay Sarvoday Hospital to discuss simple and cost effective methods to diagnose cervical cancer in rural and low resource settings without use of a laboratory. Motivated by the high prevalence of cervical cancer in India, Dr. Krishnan's advice, and the success of their past collaboration, KMVS and Bhojay Sarvoday Trust are again working together. Their goal is to raise awareness about HPV and cervical cancer and to lower rates of cervical cancer by getting women tested and treated. KMVS will use its skills and experience working with women in the area to organize education and training and raise awareness about this issue on the grassroots level. KMVS staff will assist the health workers from Bhojay to conduct the mass cervical screening. Women identified at these camps as potentially having cancer are referred to Bhojay Sarvoday Trust Hospital for treatment.

About Bhojay Trust Hospital

Bhojay hospital is a trust hospital mainly funded by Jain communities originally from Bhojay that are invested in development work in the region. Most of the work at Bhojay involves gynecology camps and ophthalmology camps. Camps are conducted every two to three months.

Between 30 and 50 gynecological surgeries are performed over a two day period. Patients are all gathered at the hospital on a particular day, and surgeons travel from Mumbai and offer their services free of charge. There is no cost to the patients for the surgeries. All activities of the hospital are run by Mr. Liladhar Gada, a former businessman from Mumbai who now dedicates all his time and energy towards development projects in Bhojay.

With regards to cervical cancer screening, so far, several community health workers have been trained at the Tata Cancer Memorial Institute in Mumbai and the Adyar Cancer Institute in Chennai to educate and conduct mass screenings. An average of two villages are being screened per week and positive cases referred for further management. In this fashion, Health Teams will spread into new districts, and several villages will be covered.

Future strategies for program design to overcome challenges and improve lives and learning include: initiating clinical research programs and assessing cost, accessibility and education aspects of the project. In addition, documentaries, puppet shows, and male health educators will be involved to help increase knowledge about HPV and HPV prevention in the rural populace.

Research has shown that educating men and seeking their support will improve the rates of women getting screened and treated for cervical cancer. In addition, men can also develop HPV related diseases and in turn transmit the virus to their female partners, causing diseases in them. Therefore, it is GIAHC's vision to include men as full partners in the education, advocacy and developmental strategies for prevention and effective control of the spread of HPV. "The elusive male factor has to be addressed and emphasis should be placed on men as sexual partners, husbands and fathers if we are to reduce the viral load in this society," says Dr. Krishnan.

About ICTPH

Members from the Tanjore site of ICTPH have been trained at our flagship-training center at The Adyar Cancer Institute and will be commencing their cervical cancer education, screening and treatment program shortly.