In the hectic scene of down pouring rain clattering on the tin rooftop and women huddling body-to-body underneath the passageway to abstain from becoming drenched, this woman calmly rocked her baby and in her arms she laid, peacefully asleep until she handed her over to me so she could be screened. The baby’s eyes slowly opened to adjust to the dim hospital light but she quickly realized this strange being was not her mother and searched anxiously for a more familiar face. I tried the peak-a-boos and tummy tickles to distract her, but I had no luck and she quickly let out a cry to signal for her mother. When I brought her into the makeshift examination room, she immediately ceased her cries just like any other child would by the comforting touch of their mother.
Dr. Stuart Fischbein (OB/GYN) had already suspected that she had vulvar cancer and had confirmed the diagnosis with CCC’s medical director and GYN oncologist Dr. Jennifer Lang. They immediately called for a biopsy and asked that she get referred to the nearest hospital that could attend to her medical care right away. With very limited resources, it was the best they could do. My heart dropped in that instant. I knew almost nothing about vulvar cancer. All I knew at that point was that this baby was going to lose her mother and as radical as it sounds, it could happen any day now.
Vulvar cancer in a young woman is extemely rare. After speaking with Drs. Lang and Fischbein to learn more about the pathology of this patient’s condition, I couldn’t help but think what a tragedy it was that this woman could have prevented her now advanced stage cancer. As a single mother and only 34 years old, she was now going to have to leave behind her baby because she likely had limited to no means of obtaining the health care she needed. In a woman as young as her, it was possible that HPV was a factor in the progression of this cancer. This virus also happens to be the leading cause of cervical cancer.
In a long and exhausting day’s work, we are proud of what we accomplish but I feel that harsh moments of reality like this reminds me of the importance of CCC’s work and mission to PREVENT situations like these from reoccurring.
It’s already midway through our time here in Kisii and it just so happens that we reached the week’s record high of screening 305 patients in one day. Despite the early morning downpour that continued into the afternoon, the women stood calmly as they awaited their turn to be seen. At this point in the week, we typically witness a sense of independence and efficiency in our trainees as they are each seeing, at the very least, their 30th patient. The CureCervicalCancer team unanimously felt that all 20 new trainees were performing the procedure with complete competence, identifying pre invasive cervical cancer lesions without hesitation. By the end of the evening, 48 patients were treated with cryotherapy, setting the day’s positivity rate at nearly 16%.