It happened in the year 1935 whence Pap smear screening became mandatory for all women in the United states . Cervical cancer was picked up at very early stage, women were getting cured and the intensive awareness programs brought to control the incidence of this disease. Even though the prevalence of this disease is quite high in Indian women, till about 2 decades this was the most common cancer in Indian women , even in2018 it is a toughgame getting women to undergo a Pap Smear test.Women have advantage over men in the sense that the 2 commonly occurring cancers in them – Breast & uterine cervix– are slow growing ,especially cervix cancer which takes close to 25 years ; have easy methods to detect them early. Women seldom enjoy this privilege. Similarly tobacco related cancers too are slowly growing and can be detected in the premalignant stages itself but no man by choice will get himself examined.
We from the trust have literally put up a struggle, coax them or lure them with a gift to get people to come for detection camps. Some people show up for these camps merely to show solidarity to the organization that promotes this camp. A substantial number does not even bother to collect the results of the tests done during the detection camp.
In the last decade we have seen that an awareness program precedes a detection camp and this increased the attendance and also the willingness to get screened. The Mumbai chapter has certainly a better response compared to others and over the years the camps here have increased quite significantly. Secondly organizations are keen to hold these camps as a goodwill gesture and this has also stepped up the numbers. Timely support from organizations like association for India’s development has eased our push to the detection programs.
These screenings for cancer have value only if done regularly and little value if done only once. But what we believe is that the attendance at the first camp will remove the fear associated and people will be emboldened and motivated to get themselves checked annually. Hope attitude will change with times and getting screened for cancer will become an act by choice.
The first camp was held at Suriyur near Trichy on 23rd Oct 1994. This camp screened 82 women, 2 of them had frank cancer of uterine cervix and 8 of them had premalignant conditions. This was shocking!
This camp showed us in real the state of rural India with respect to cancer and urged us to do more in villages. For the next 3 years screening camps was on top of our minds and we had detection camps in several villages around Coimbatore Of these the one at Melkaraipatti , near Palani, drew the largest number , 400 persons were screened on a single day.
The First camp at Anamalai , near Pollachi , had very good response both in terms of numbers & interest. It seemed possible that Camps could be held here on a regular basis. Association for India’s Development consented to support the camps and we took up 3 villages with this support and planned to conduct detection camps every 3 months for the next 3 years. The first camps like the one in Anamalai, generated a good response, second a mild response & by the 3rd camp the villages lost interest. Secondly patients with frank cancers refused treatment even if we offered it free !
Over the years we have reduced camps to bare minimum and in Chennai they are held only on anniversaries. Last 2 years there has been a slight improvement in Chennai . Women have come more easily and this year 55 women enrolled in advance for this camp. It is heartening that 80% of them turned up voluntarily to collect the report of the Pap smear tests. Such responses will encourage us to conduct more of these and more often.
Aayiram Mammogram project, Chennai.
Aayiram in Tamil means a thousand and we envisaged to sponsor Mammograms in 1000 women from October 2012 to September 2013. Women had to attend a session on Breast cancer awareness and learn breast self exam. After that women above 40 yrs were offered a free Mammogram. Campaign was then taken up on a war footing amd nearly 40,000 women were contacted but the turnout remained poor. In one year’s time 713 women were offered free mammograms of which it is sad that only 563 actually underwent mammography.
The second 1000 mammogram was launched with the Support of Sri Matha trust in October 2017 .In one year’s time we managed to coax only 283 women to get this test done. At the Madras high court 500 women were educated and 99 of them wished to avail this facility .Of these only 44 got it done in actual. Only 50% got themselves screened even when this offered free !
Though the western world advocates only Breast consciousness today , it is very useful to get one baseline mammogram done at 40yrs. Knowledge about breast cancer creates this ‘consciousness” which we successfully created but the latter couldn’t be accomplished successfully. The fear & perception about mammogram still persists.
The first camp was held in April 2000 in Kalina where our office was situated then. It was in association with an organization that was welcoming the Shankaracharya of Kanchi. 35 men & 47 women were screened . A second camp was held at the same venue 3 months later. Soon we got calls from several groups & organization to hold camps and in next few years this activity gained steam.
Since the time our own centre opened in 2011 and even before that at the spaces provided to us , screening camps were held regularly. From September 2013 it is regular feature at the Centre, , Pap smear camps are held on Wednesdays and on Sunday oral cancer detection is done.
The response to camps has been good at Mumbai and has encouraged us hold more and more. It has also taken us beyond Mumbai. Gynecologists have been particularly cooperative & so are the dental surgeons, they readily accept our invitation and spend quality time at our camps .Similarly our volunteers ¶medical staff show great enthusiasm and conduct camps
smoothly & efficiently.
Screening Camps for Women
The majority of camps done in and around Mumbai are for women. While both Breast examination & Pap smears are done, the latter takes predominance. These camps were held at several venues and at times at the same venue many times. The numbers are huge and it is not possible enlist them here.
The first place where a series of camps was held was the Railway hospital at Bandra in July & Aug 2004. The second place was the L& T Health Centre. 233 women were screened over 8 camps. Similarly a number of camps were held at several other places in association with a number of organizations.
The Municipal Corporation of Navi Mumbai took It a notch up. They permitted us to hold Pap smear camp in each of their primary health centres and had their health workers campaign for the camp weeks before. In 17 days we had screened 578 ladies and 423 of them underwent the Pap Smear test, averaging 25 women per camp! The second stint was from 11th to 31st Dec 2009. During this period 228 women were screened over 7 camps and 168 Pap smears were taken. Hope other municipalities follow this example.
The Women cancer clinic came into being on 25th September 2013 and screening camp was held once a week on Wednesdays. For a year or so, Fridays too had these camps to accommodate the increased attendance. A lot of home work is done before the camps are actually held. Our health workers go on a house to house campaign in Vikhroli and also conduct awareness programs in the locality. Women are explained the importance of Pap smear and the availability of this free facility at our centre.
In the period from Sept 2013 to March 2015 ,1140 women were screened in 89 camps .Of these 80 women had abnormalities and 18 of them needed advanced colposcopies and 3 of them required cervical biopsy. 232 women did not bother to collect their reports despite several reminders. This was very sad and defeated the very purpose of conducting this screening. In a measure to overcome this, from Jan 2015 we started giving gifts to all women who came to collect their report. In the next few months the difference was obvious.
1000 Pap smears in 9 months!
The success of our camps encouraged us to do it in a bigger fashion and it received support from Association for India development (AID). The AID supported project took off on 3rd June 2015 completed on 27th Feb 2016. In this period of 9 months, 1000 women were screen cervical cancer. 88 women had local infection 73 women n e e d e d d e t a i l e d colposcopy and there were 2 ladies with frankcancers. Both these women were sent to Tata Memorial Hospital and treatment has already begun. Of the 73 women advised colposcopy , 14 have got it done and are on follow up , the remaining have been constantly reminded .
Camps in 2016 – 17
At the Centre, 65 Pap smear camps were conducted this year at the centre and 786 women were screened by our gynecologists. 27 women were advised for colposcopy. With the support from AID a digital colposcope was purchased by the trust. This was inaugurated on 30th June 2017 at the centre so that the women who come for screening could also avail this facility.
In addition to screening camps held at the Vikhroli centre, camps have been held at other places such as residential societies, colleges and in low income group dwelling areas such as Reay Road, Govandi and Kalwa. They were held as Vision Rescue, Lions Club Mumbai Airport etc. . Over the year 11 such camps were held screening 264 women.
Camps in 2017 – 18
At our Vikhroli centre, 41 camps were conducted and 572 women were screened, details in the table.. 18 colposcopies were done this year. 6 of the women had to undergo biopsy, out of which one was malignant and has been sent to Tata Memorial Hospital. The others were advised regular follow up with the Gynecologist ,We also conducted Pap smear camps at various places not only in Mumbai but also in the interiors of Maharashtra. Camps at residential societies is a now a regular feature. The big ones this year was those conducted for police women, staff of Naval Armament Depot, teachers & construction site female workers.
Airport Authority of India (AAI) arranged for 4 camps. One camp was conducted in Vakola and the remaining 3 in Asalpha, Ghatkopar where we got a very good response. Total of 212 women were screened and advised. There were 7-8 cases for colposcopy & biopsy which were later done . A special mention needs to be made of Dr Geethanjali Amin ,who incidentally was instrumental in getting these camps organized, and Dr Reena Upadhyay who have accompanied our staff and volunteers for the camps in the suburbs near and far.
Outside Mumbai we had Pap smear and oral screening camps at Sindkhed, Jalna and in Goa.. Both places together, 72 women underwent Pap smear tests. We thank Dr. Archana, her brother & sister for the excellent arrangements and great hospitality given at both these places. Like last year, this year too in association with Sathya Sai group the trust conducted awareness and screening camps at Palghar.
The awareness campaign in construction companies brought in added benefits. It resulted in detection camps for oral cancers. Marathon
Realty & Wadhwa Constructions permitted us to hold camps at several sites of theirs. In one of sites of Wadhwa constructions 450 men were screened at one go and therein 53 men were found to white patches in their mouth, which is a premalignant condition for oral cancers. At other sites too there was a sizeable number of number who had white patches or their mouths were narrowed (Oral sub mucous Fibrosis, Gutka is particularly notorious for causing this within 2 years of usage). These men were advised follow up with Dental practitioners & some prescribed drugs.
Oral detection camps at VMCC , Mumbai
These camps made beginning with World No tobacco day, 31st May 2014. The proximity to BEST bus depot to our centre got the conductors & drivers to the camp and slowly men in the neighborhood too trickled in . Doctors, interns and final year students visit the centre on alternate Sundays and on rest of the days dental surgeons practicing nearby pitch in help.
60camps have been held so far screening 1137 persons. 5 men were found to have frank cancers & they were referred to TATA Memorial hospital or to their hospital of choice. 108 men were found to have premalignant conditions and they have been advised to quit smoking and take treatment. 11 men had severe narrowing of the mouth due to Sub mucous fibrosis , they too have been advised similarly .Of these men 3 come to the centre for exercises to increase the size of mouth opening.
The trust has been conducting oral screening camps in association with the women’s wing of MCHI Credai at different construction sites. These regular programs at the sites has brought in the much needed awareness in these men about the critical need to stop tobacco chewing & smoking habits . The trust would like to thank the women’s wing team for organizing these awareness programs on a regular basis.
180 plus labourers were given the cancer awareness talk prior to the detection camp. The nine steps for checking and the four finger test were also explained to them.
Oral cancer awareness camp was held at Kanakia site in Bandra East. 160 plus workers were given the talk. Many of them said because they have this habit for long, giving up may be very difficult. Consulting a doctor and counseling will definitely help urged the speaker. The dental doctors too advised them during the detection camp.
In Mulund near the P&T colony for the workers of the construction site of Marathon group awareness and detection camp was arranged. 90 workers were spoken to on the signs and symptoms of cancer and Dr. Ashwini screened the patients and advised them on oral hygiene.
oral cancer awareness & detection camp for 200 men and 20 women were done at the construction site of Dosti Builders at Mumbra in Thane. Reiterating on the ill effects of tobacco and the benefits of quitting, we felt a little bit of awareness had definitely set into the minds of these workers. They were also screened by the Doctors and 3 men with pre cancerous lesions were identified and advised.
At the Marathon site at Panvel, the construction workers gathered for the power point presentation specifically stressing on oral cancers as many of them were regular tobacco chewers. An appeal to all the 580 labourers were made for quitting this habit and the benefits of quitting were emphasized by the speaker. After the talk, many wanted to know how they could stop this habit and what test they should do. The message was well taken, and this was very satisfying for us after having come so far.
In association with MCHI Credai, the trust conducted an oral cancer awareness and detection camp for 150 workers at Rajesh Torres site in Thane. Drs. Sachin Tudme & Pratiksha Borwankar advised the patients after screening.
Oral cancer awareness camp for the workers was conducted at Tridhaatu Kshitij site in Matunga for 80 workers.
Mr. Gaurav Menariya of Marathon group, who has been taking initiative in conducting the camps at Marathon group, arranged for one more site at Byculla. 450 labourers attended the cancer talk and stress was laid on tobacco related cancers.
80 workers of the Gundecha Developers in Andheri were given the cancer awareness talk. The spouses of these workers were also given a separate talk on women specific cancers. They were later screened by the dental team. It was alarming ! Of the 80 workers more than 10 had pre cancer lesions.
The trust conducted an oral awareness and screening camp at Balkum, Thane for the site workers of Dosti constructions. The sessions were conducted in batches for the workers and also one for the staff & management. Here too, in a total of about 200 workers more than 10 of them had pre cancer lesions. Drs. Sunita Chheda & Shruti examined the workers and advised them further.