By Shermakaye Bass, Fara Foundation reporter and editor
Matagalpa — This week marks important news in our fight against cervical cancer in northern Nicaragua: Fara Clinic has announced that it will start taking up to 15 new referral patients per month from healthcare facilities in Matagalpa and Jinotega, the coffee-growing communities that we serve. These are women who suspect they have cervical cancer or its precursors, as well as women who know they have it and need treatment. This development allows us to help even more Nicaraguan women get screened and/or treated for the disease, which has become an epidemic in the country over the past three decades.
Already it’s been a busy 1st year at Fara Clinic. Between December of 2010 and December of 2011, we went from seeing 10 (general practice) patients in our first full month to more than 600 per month. And the number of those seeking gynecologic screenings has grown exponentially — from 0 women per month to more than 100 monthly since our gynecologist, Dr. Oneyda Chavarría, joined the staff in June of 2011. With this latest collaboration, we further expand our services to women who often slip through the cracks of public healthcare.
Fara Clinic director Dr. Nelson Lugo and Fara founders Manny and Maria Farahani announced the plans, which will help at-risk women who might otherwise have to wait weeks to get a pap-smear appointment and several more weeks for the results. This development dovetails with Fara Clinic’s mission of lowering cervical cancer rates in the region.
“We have reached an agreement with the Matagalpa regional hospital, as well as the local Centro de Salud, the (international nonprofit) Casa Materna, which has facilities in Matagalpa — and hopefully the smaller hospital in Jinotega, the region just to our north — to receive their cervical cancer patients,” says Dr. Lugo, who has been with Fara since the clinic opened a little more than a year ago. “We will be expanding our facilities and procedure rooms to accommodate at least three additional monthly patients from each of those facilities.”
“We’d like to be a reference center, as well as a treatment center. There’s a shortage of resources for women who don’t have any money. Until the clinic opened, there was really only one place in Matagalpa — the regional hospital — to get a pap smear. And they have something like a three-month backlog,” says Howe, an American epidemiologist who has lived and worked in Nicaragua for years, specializing in cervical cancer prevention. Howe co-authored a significant 2005 report on the disease in conjunction with the University of Texas at Galveston.
“One of the things we want to do is provide that service, because the problem for these women is that it’s so difficult to get in (public facilities). That’s one the reasons we started Fara Clinic — so women who already have abnormal screens can get their diagnosis and treatment. This (referral agreement) shortens the line, and we can do things much quicker at our clinic.”
That, in turn, will save lives in a country where cervical cancer kills twice as many women as do maternity-related complications. As we’ve often stated, the disease kills more women over 30 in Nicaragua than any other medical threat.
“As of now, we’re getting an average of about four patients per month who need actual treatment (cryotherapy or LEEP surgery),” Howe says. “We expect that to keep going up as word spreads through our outreach programs, and now, we hope, through this new arrangement with other (public) healthcare center.”
According to national statistics, Nicaragua’s Ministry of Health does about 15,000 CC screenings per year, and 1 to 4 percent of those are high-grade abnormal pap results (indicating pre-cancerous cells) that require immediate follow-up. That number is much larger if low-grade abnormal paps are factored in.
“The main thing,” Howe concludes, “is there are probably 300 women a year (in all of Nicaragua) who need follow-up after a pap smear. As more women find out that they can get paps here, and that we have our own pathology lab and can get it turned around quickly, the more patients we’ll receive. Lab results here take a week for the pap results, two weeks for a biopsy. The wait would be so much longer at the Minstery of Health facilities.”