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Lata Bai’s Visit to the Dispensary

How a simple, user-friendly, five-minute test can save the lives of 274 women in India each single day…

Lata Bai is a 46-year agriculture farmer working in Nanded.  She owns a small land growing seasonal crops and makes just about enough to make two ends meet, which includes paying for her children’s school, books, and monthly expenses.  After her husband died three years ago, she had a hard time learning to live on her own and take care of her children.  Seeing how difficult her life was, her helpful in-laws moved out of her house and went to live with their first son’s family so that Lata won’t find it difficult to support them as well.

Lata did not mind the back-breaking work as long as she did not go and seek money, help or support from others. Being a strong woman she tried to inculcate the same habits into her two children aged 14 and 16. She was indeed proud of the two as they worked hard to be good at their studies while helping their mother out, whether with housework, in the farm during holidays, or running errands for her.

It was about three months back that Lata began feeling slightly uneasy with her health.  She did not want to make it obvious to her children so as not to worry them.  Only last week, she decided that she would go to the hospital in the district and meet the doctor.  Very focused on getting to the hospital, she completed her work early and reached the hospital.  It was quite a while since she had been to one and realized how busy the place was. She settled down on a wooden table and almost instantly fell asleep.

When her turn came, the line had considerably thinned, so the doctor spoke to her patiently, getting her to speak up.  She asked a lot of questions, checked up Lata thoroughly and then prescribed some medicines.  As Lata got up to leave, the doctor asked her: “Lata, wait. You are 44, aren’t you? I suggest that we should check the health of the mouth of your uterus once. Infections in that area can lead to serious pain, discharge, bleeding, and even cancer over a period of time. Not that you have any problem like that but ideally women between 30 and 65 years should maintain the health of the uterus through annual checkups so that any infections can be treated before they turn into a bad situation.” Lata was scared and wary of the doctor’s words. She said, “But doctor madam, I am a widow of 3 years. I don’t think I will have any infection now.” The doctor explained to her patiently that infections on the mouth of the uterus – or the cervix, as it is called – persist for a long time and often go unnoticed even as the cells infected by a virus called the HPV develop into a cancer over 10-15 years. She further assured her that the test would take just 5 minutes and would not hurt at all.

Lata thought for a minute and realized that would be worth her time, as she may not be coming back in a hurry if the meds worked and her uneasiness stopped.

“Yes doctor.  Please do.  So long as I don’t have to come several times as I lose an entire day if I have to come to the hospital.  Also, how will it help me?” She asked.

The doctor showed her a picture of the cervix on the wall and said, “Can you see this? Infections such as this can cause symptoms at a late stage and by that time, the treatment needed can be quite expensive and extensive. It is better to test every year so that simple, affordable medication can cure the problem quickly.”

Lata lay down on the bed while the nurse performed the procedure; the test was over in five minutes, just as the doctor promised.  As Lata tidied up her clothes, the doctor showed a screen of a big phone – she called it a tablet – and she pointed at pictures on it, moving the pictures around with her fingers.  “See these two photos? Can you spot anything different?”  Lata peered at the screen and said, “Why, this area has a small whitish patch which was not there in the earlier photo.”

The doctor was deeply impressed.  She said, “You are very right, Lata.  This means that by and large your system is fine but there’s a minor infection. I will give you meds for that, you need to take those regularly and finish the course; then we will test next year to see how much it has improved.”  The doctor uploaded Lata’s file and went back to attend to her next patient after explaining to her how the medicine should be taken.

Lata headed home clutching her meds and medical card carefully.  Little did she realize that she was one of the lucky ones who could be screened as part of a routine visit for cervical cancer.  Little did she realize a small patchy infection could be picked out just using a small, handheld instrument connected to a mobile tablet. She was really thankful that the doctor could sort out her problem without any more visits to the hospital.

If Lata had refused the test or had come to the hospital after another 2 or 3 years, her condition would have advanced and she would have been too ill to take care of herself.  Lata was one of the lucky women to be tested using the Smart Scope®, a low-cost, point-of-care screening test that would identify issues of the cervix and show up on screen with a traffic light coloured “Red-Amber-Green” auto-generated score that will not need an expert on site for primary screening.

Care of the cervix, especially for women after 30 years, becomes a major priority; unfortunately, very few women know that they should get themselves tested every year or two.  Every year, cervical cancer kills more than 300,000 women worldwide.  Most deaths occur in low resource countries due to lack of access to regular screening, onsite experts, and specialized equipment.

India accounts for nearly 26% or 100,000+ of these deaths making cervical cancer the 2nd largest killer among women. Caused by the Human Papillomavirus – HPV, this cancer puts almost 80% of sexually active women at risk. Early age of marriage, high parity can be major contributors to heightened risk.

Today, thanks to the developments in technology such as Artificial Intelligence and mobile based solutions, a 5-minute test to detect cervical cancer and pre-cancer is now available in the remotest regions in the country.  This is a preventive test that will help detect cervical cancer / pre-cancers early and enable timely treatment thereby avoiding painful, invasive and expensive treatments. This test is recommended for all women over 30 years of age.

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