Early in the morning the women began lining up in the hall with noticeable excitement on their faces. Some fidgeted with their heavy winter shawls. Others craned their necks to get a glimpse of the bustling clinic room, filled with unfamiliar utensils. All of this excitement was for something we consider far less glamorous in America: a routine pap smear.
For all of the 78 women served by this free screening clinic supported by the Cancer Foundation of India, this was their first pap smear. Cervical cancer remains a disease that largely affects women living in poverty due to the lack of primary care infrastructure. On average it takes 10 years for cervical cancer to develop from detectable pre-cancer to in situ cancer, leaving a critical window for intervention to prevent otherwise avoidable deaths. The technique used, visualization inspection with acetic acid (VIA), is an especially effective and inexpensive method for detecting suspicious pre-cancerous cells and is a technology approved by the World Health Organization. In it, vinegar reacts with abnormal cells and a trained clinician can determine whether or not a woman should be referred for a colposcopy (cervical biopsy), also provided free of cost for those who need it. Furthermore, anyone who tests positive for cervical cancer throughout the screening process will receive treatment free of cost thanks to the generosity of the Cancer Foundation of India.
In addition to VIA, this clinic offered pap smears for further testing and also complete breast examinations and tutorials. For the handful of women who tested positive for potential precancerous cells, they were met with warmth and clear guidance on next steps for free biopsies at a nearby hospital.
It was incredible to witness the trust the women placed in the hands of strangers during such a vulnerable process. In every stage of this program there was a clear sense of sisterhood and empowerment. For women who give so much to everyone else in their lives, this clinic was a space for celebration of health and self care, even though the discomfort and newness.