As reported by ICO's Center for Cancer Research December 15, 2016 publication, cervical cancer ranks as the 2nd most frequent cancer among women in Afghanistan. To address this concern La Jolla Golden Triangle Rotarians, Brown and Moini, researched screening options and became aware of a colposcope developed by Mobile ODT (ODT). This scope when connected with a smartphone facilitates cervical cancer screening. Brown and Moini met with Dr. Bruce Kahn, a San Diego based OB/GYN using this scope in his private practice. He encouraged Brown and Moini to consider training medical professionals at Nangarhar Public Hospital and Nangarhar University Teaching Hospital on use of this scope and offered his ongoing professional assistance. Thereafter, Moini traveled to ODT's headquarters in Tel Aviv, Israel and received training on use of the scope. (Moini holds a Bachelor's Degree in nursing from the University of Tehran in Iran.) Moini thereafter traveled to Adana, Turkey and participated in training of four female Afghan OB/GYNs on the use of the scope as well as other training activities.
Following the training sessions Brown and Moini again met with Dr. Kahn in San Diego then to explore treatment options for once cervical cancer symptoms are detected. ODT representatives and Dr. Kahn suggested considering a device that is simple to use in a developing country known as a cold coagulator manufactured by WiSAP based in Germany. Two of these devices have now been purchased and put in use at the two Jalalabad hospitals where the trained OB/GYNs work. Dr. Khan holds ongoing Skype training calls with the Afghan OB\GYNs doctors on use of the scopes and treatment devices. This includes his evaluating the doctors' diagnoses of images posted securely on the web and also training regarding treatment when called for. To date, 179 women have been screened using the scopes. 37 have been treated with the cold coagulator and several patients have had hysterectomies or were referred to Pakistan for further evaluation. Through the Foundation's early efforts in this program, there is a clear need for a public awareness campaign regarding screening for not only cervical cancer but also self- examination for breast cancer. Dr. Kahn, has offered his services for ongoing training if we expand the screening and treatment program to include additional doctors from public hospitals in additional cities and one of his professional colleagues has agreed to assist in this training as well. Accordingly the Foundation proposes expanding the program.
Expanding the Program through a TRF Global Grant
The La Jolla Golden Triangle Rotarians and Jalalabad Rotarians, working with their current contacts at the Afghan Ministry of Public Health, will identify six additional public hospitals outside of Jalalabad for training and implementation of cervical cancer screening and treatment building from the successful model presently in place in Jalalabad. This will involve purchasing one scope and six treatment devices and providing training of two OB/GYNs from each of the six. (The La Jolla Golden Triangle Rotary Club has five scopes and related accessories in inventory for use at these additional hospitals.) The training will take place in Jalalabad under the supervision of two of the Jalalabad doctors previously trained on the scope and treatment device-- one of whom is a Jalalabad Rotarian. An Afghan technician who is a Jalalabad Rotarian was previously trained on the scopes and will participate in the training a well. The La Jolla Golden Triangle Rotarians will coordinate Dr. Kahn's participation in the training session via Skype and Dr. Kahn's and his colleague Dr. Susan Cu-Uvin's, participation in ongoing training sessions to the newly trained doctors upon their return to their local hospitals. The La Jolla Golden Triangle Rotarians will coordinate participation by ODT's representatives in the initial training as well and in some of the ongoing training thereafter.
The Host and International Clubs recognize that the need for cervical cancer screening and breast cancer screening is not well understood among the population in Afghanistan. Accordingly as part of this program, these clubs working together will create a substantial "awareness campaign" regarding these two topics. This can be carried out through presentations in all of the female public high schools in Jalalabad. The Jalalabad Rotarians have a close relationship with each of the female principals of these schools and with the Nangarhar Director of Education. Further the Jalalabad Rotarians have a close relationship with the IT trainers working in the computer labs of all of these schools. These network contacts can be used as platform for public education regarding the need for screening and self-examination. The Jalalabad Rotarians also have contacts with female students at Nangarhar University Faculty of Education as well as female students in midwifery programs in Jalalabad. These contacts can be used for the public awareness campaign as well. Further as part of the training of the OB/GYNs from the additional cities, a public awareness component can be built in for these doctors to assist with the implementation in their respective cities. The Jalalabad networking model can be provided as an example for replicating.
Project funds will be used to purchase screening and treatment equipment and costs associated with the training itself—transportation, lodging and stipend all as specified in the budget.
Equipment will be procured and delivered to Jalalabad within three months of receipt of funds and training will take place within three months thereafter.
Cervical Cancer screening and treatment training budget--see document downloaded
This grant has been approved by TRF and fully funded Nov. 6, 2017