Download 2015 Introduction to PINCC

About PINCC 2015
PREVENTING CERVICAL CANCER (PINCC)
Developing Sustainable, Affordable, Quality Cervical Cancer Prevention Centers
In Africa, Latin America and Asia
Who We Are:
Prevention International: No Cervical Cancer (PINCC), dba Preventing Cervical Cancer, is a
non-profit medical training and community education organization that establishes selfsufficient cervical cancer prevention and treatment centers for women in underserved
countries in Africa, Latin America and Asia.
How We Began:
Dr. Kay Taylor, a gynecologist, and Dr. Pat Sax, a clinical social worker, founded PINCC in 2005
following a one-week medical mission to Honduras, where Dr. Taylor saw more cases of deadly
cervical cancer than she had during her entire career in Northern California. Dr. Taylor and Dr.
Sax, with a single volunteer, returned to the Mosquito Coast later that year to begin training
healthcare workers in cervical cancer screening and treatment. Since that first trip, PINCC has
trained approximately 700 medical personnel and certified 35 clinics in 10 countries in Africa,
Latin America and Asia. PINCC continues to expand its training to new clinics in more countries.
Our Mission:
Prevent cervical cancer among women in under-resourced countries worldwide.
Our Goals:
1. To expand the availability of cervical cancer prevention programs to under-resourced
countries around the world where screening for and treating cervical cancer precursors is
uncommon. 2. To improve women’s health and enhance healthcare delivery in underresourced countries.
3. To optimize benefits for women by teaching doctors in host countries how to train other
healthcare workers in cervical cancer screening and treatment.
About PINCC 2015
4. To promote awareness of cervical cancer, influence public health policy, and aid
government and educational institutions to implement and support practical, medically
sound, and economically viable methods of cervical cancer prevention.
5. To raise organizational visibility, build support, and generate the resources necessary to
continue and expand this program in under-resourced countries around the world.
Where We Work:
Since 2005, PINCC has partnered with health ministries, local health organizations and clinics,
and other non-profits to build sustainable cervical cancer prevention programs in El Salvador,
Honduras, Nicaragua, Guatemala, Peru, Cameroon, Kenya, Uganda, Tanzania and India. PINCC
is currently exploring invitations to collaborate with partners in Bangladesh, Ethiopia, and
Burma (Myanmar).
What We Do:
1. We focus on women in underserved parts of Africa, Latin America, and Asia to prevent
suffering and death due to cervical cancer. Because cervical cancer takes up to 15 years to
develop, it can be prevented through periodic screening and treatment of cancer precursors.
2. We collaborate with medical professionals, government agencies and civil society
organizations in the host countries to build sustainable screening and treatment programs.
3. We partner with clinics and hospitals to train health care providers to become proficient in
screening for and treating cervical cancer precursors, donating the equipment and community
outreach and education materials necessary to support sustainable programs.
4. We utilize evidence-based techniques approved by the World Health Organization (WHO)
that are affordable and accessible for local health care providers.
5. We offer screening and treatment training at no cost to the facility or the community.
6. We equip clinics with essential medical equipment for ongoing screening and treatment
services for community women.
7. We refer women with invasive cervical cancer to hospitals able to provide advanced medical
or hospice services.
8. We educate communities in the developing countries about cervical cancer and its
prevention.
9. We provide services on an invitation basis, and in accordance with bilateral contracts.
About PINCC 2015
10. We engage with government departments, institutions, and women’s organizations in the
host countries to influence public health policy and establish sustainable programs to reduce
cervical cancer.
How We Do What We Do:
1. We bring teams of volunteer doctors, nurses, health educators and support personnel to
provide training of community health workers, medical providers, and other clinic/hospital
staff, at no cost to the host facility.
2. Our cervical cancer screening training utilizes Visual Inspection with Acetic Acid (VIA) and VILI
(Lugol's Iodine), and the treatments are Cryotherapy (ablation by freezing) and LEEP (Loop
Electrical Excision Procedure). We enhance medical care services by also providing training in
breast and gynecologic examination, and diagnosis and treatment of common problems such
as infections.
3.The health care providers who commit to this training program are required to conduct many
cervical examinations and treatments over a year, with proctoring by experienced personnel.
4. PINCC commits to three or four training visits per site, returning approximately every 6
months. Between visits, the local staff trainees agree to perform 10 to 20 examinations per
month. Trainees maintain a log book with patient details and medical results for each woman
examined.
5. Women with positive or questionable results are re-examined during PINCC’s follow-up visits
by proctored medical staff and treated as needed.
6. PINCC provides both didactic and clinical instruction, with manuals, visual aids, and direct
experience. Trainees are assessed with written and visual testing, and must master a list of
skills for certification. Facilities are certified only after they have established regularly occurring
screening and treatment clinics, community health education, record-keeping, follow-up
systems, and the means of procuring necessary materials to carry out the program.
7. PINCC also trains and equips community health workers at each site, with educational
flipbooks in English and one or more local languages, designed to be understandable by a semiliterate audience, and posters for the centers.
8. PINCC works with in-country trained personnel to provide interim proctoring and support
between training visits. A two-day clinical proctoring visit to a training site reinforces goals and
accelerates training..
Why We Do What We Do:
Cervical cancer is the most common cancer in women in many developing nations and is the
fourth most common cancer among women worldwide. In 2012, WHO reported an estimated
About PINCC 2015
528,000 new cases of cervical cancer with 85% of the global burden in the less developed
regions. High-risk regions include Eastern Africa, Melanesia, Southern and Middle Africa.
There were an estimated 266,000 deaths from cervical cancer worldwide in 2012.
Yet death due to cervical cancer is 100% preventable with early detection and treatment, which
is the case in the United States and other developed countries PINCC is committed to bringing
the benefits of developed world screening and treatment to women worldwide.
The Biggest Challenges:
1. Global Challenges
a. In developing countries, cervical cancer kills more women than any other cancer. Over
80% of women newly diagnosed with cervical cancer live in these areas. Most have
never been screened; many are diagnosed too late to have any realistic hope of
recovery.
b. Cervical cancer is one of the easiest cancers to detect, treat, and prevent when caught
early. If every woman were screened just once in her lifetime, global cervical cancer
rates would drop by 30%; screened twice, rates drop to 60%.
c. Women in developing nations are more susceptible to the disease than their sisters in
the first world. Yet they do not have access to screening and treatment.
d. Women with HIV/AIDS have a six-fold higher risk of cervical cancer, and lower response
rates to treatment. Yet most HIV/AIDS programs do not include cervical cancer
education, screening or treatment.
2. Local Challenges
a. While VIA/cryotherapy is low cost, many women cannot pay for biopsies or Pap lab
services, which are sometimes needed when the lesion is deep or severe. PINCC is
working with partners to develop a fund to cover the cost of pathology for the women
that require biopsy/Pap lab services.
b. For those found to have invasive cervical cancer, it is challenging to navigate the
distances, scarcity and complex medical systems and protocols in the host countries.
The lack of timely and affordable specialist care often result in women dying due to lack
of specialized treatment. PINCC continues to work with hospitals to develop priority
service for referrals from PINCC and its clinic partners.
c. Maintaining cryotherapy equipment, including gas tanks, is challenging. PINCC provides
technical support to each site on an ongoing basis.