Project for Breast and Cervical Cancer Screening Camp



Monthly Progress Report
April 2021

 
 
 


 A.List of Activities accomplished in the month
SN Activities Status Remarks
           FCHV Training  at Baluwa Health Post  Conducted on 6th April  2021  
2 FCHV Training  at Nayapati Health Post Conducted on  27th April 2021  
3 Screening camp at Baluwa Health Post  Conducted on 10th April 2021  
4 Screening camp at AMDA Nepal Office Conducted on 17th April 2021  
5 Coordination with Focal Person of Health Department of Gokarneshwor Nagarpalika Conducted on 5th,12 and 19th April 2021  
6 Procurement of Medical Equipment Purchase order has been placed  
 

B. Narrative Summary of Activities and Key Findings

1. FCHV Training at Baluwa Health Post 
In coordination with Health Department of Gokarneswore Nagarpalika, FCHV Training Program was conducted on 6th April 2021 at Baluwa Health Post , Ward no.3 . The program was conducted in the presence of Dev Shobha Shrestha, and Purna Bahadur Basnet, team of Health Department of Municipality, and all the Health Facility Staffs. The program was commenced with a detailed brief on the importance of breast and cervical screening camp that we are planning to conduct one in Amda Office and one in Health Post every month.
Before the commencement of training, Program Officer had provided the brief on program, its objective, the Doctors team including other team and schedule of camp. Also, addressed the importance of the program to the community women and its benefits to them.
The training was intended for Female Community Health Volunteers (FCHV) of ward no 3. The total number of FCHV participants were 20 and provided participant with:
  • pre-test was done before the commencement of session in order to know the knowledge of the FCHV on breast and cervical cancer.
  • an introduction about cancer and aboutmost common cancer in Nepal
  • briefed about breast and cervical cancer, and the incidence and highly impacted age group
  • causes, risk factors, sign and symptoms, diagnosis method, preventive measures, treatment
  • importance of screening, key notes that need to done before screening and its benefits as well.
  • post-test was done to evaluate the training session whether the FCHV understood the content or not. Among all those topic, causes, sign & symptoms of breast and cervical cancer was quite difficult to remember to FCHVs. But, after post-test those topic had been discussed once again with them.
 
During the training session, all the content was explained properly followed by brain-storming, information exchange, and shared opinions and experiences of FCHV. Overall, the program was conducted smoothly and effectively as per the set schedule. In the presence of Ward President, the Umbrella, Bottle and Bag was distributed to all the FCHVs which is quite useful during their door to door visit. With the closing remarks, the program was ended with the valuable keynotes about the program and its positive impact on women's health of the community. Also, disseminated the scheduled camp date on 10th April 2021 at Baluwa Health Post. All the FCHV were delighted to receive the free service to all the community women as this was one of the demanded health service that they were requesting to health desk of Gokarneshwor Municipality.
 
2. FCHV Training at Nayapati Health Post
 
In coordination with Health Department of Gokarneswore Nagarpalika, FCHV Training Program was conducted on 27th April 2021. The program was conducted in the presence of Dev Shobha Shrestha, and Dipendra Dhakal, team of Health Department of Municipality, and all the Health Facility Staffs at Nayapati Health Post. The program was commenced with a detailed brief on the importance of breast and cervical screening camp that we are planning to conduct in Amda Office and one in Health Post every month.
Before the commencement of training, Program Officer had provided the brief on program, its objective, the Doctors team including other team and schedule of camp. Also, addressed the importance of the program to the community women and its benefits to them.
The training was intended for Female Community Health Volunteers (FCHV) of ward 2.The total number of FCHV participants were 17 and provided participant with:
  • pre-test was done before the commencement of session in order to know the knowledge of the FCHV on breast and cervical cancer.
  • an introduction about cancer and aboutmost common cancer in Nepal
  • briefed about breast and cervical cancer, and the incidence and highly impacted age group
  • causes, risk factors, sign and symptoms, diagnosis method, preventive measures, treatment
  • importance of screening, key notes that need to done before screening and its benefits as well.
  • post-test was done to evaluate the training session whether the FCHV understood the content or not. Among all those topic, causes, sign & symptoms of breast and cervical cancer was quite difficult to remember to FCHVs. But, after post-test those topic had been discussed once again with them.
Adhering strict precaution, during the training session, all the content was explained properly followed by brain-storming, information exchange, and shared opinions and experiences of FCHV. Overall, the program was conducted smoothly and effectively as per the set schedule. In the presence of Ward President, the Umbrella, Bottle and Bag was distributed to all the FCHVs which is quite useful during their door to door visit. With the closing remarks, the program was ended with the valuable keynotes about the program and its positive impact on women's health of the community. Also, disseminated the scheduled camp date will be notified as soon this pandemic COVID 19 will be under control. All the FCHV were delighted to receive the free service to all the community women as this was one of the imperative service that community people are looking for.
 

3 .Details on Screening Camp

The activities undertaken in the camp have been listed in the points below in a sequential manner.
  • Registration of clients was undertaken.
  • Written informed consent was taken from the clients in the consent form.
  • Breast and Cervical Cancer Screening Forms were filled which included personal details, medical history, family history and detail on procedure conducted and findings.
  • Blood pressure and height of the clients were measured and recorded.
  • Cervical cancer screening was performed through visual inspection of the cervix with acetic acid (VIA).
  • After the cervical cancer screening, clinical examination of breast was performed for breast cancer screening.
  • The findings from both the cervical and breast cancer screening was disseminated by the medical team with necessary health information and counseling.
  • Those women who were screened positive (VIA positive and suspected lump in the breast) in the screening tests were referred to the Teaching Hospital for confirmatory diagnosis and prompt treatment.
  • The client who had suspected lump and VIA positive will be followed up during screening camp conducted at Amda Office in April 2021.
 I. Composition of the team members
SN Name of the Team Designation Organization
Camp at Baluwa Health Post 
Camp at AMDA Office Remarks
1 Dr. YP Singh Consultant  TUTH OD OD  
2 Dr. Neebha Ojha  Consultant  TUTH OD OD  
3 Dr.Rupam Pandey MO BCH   OD  
4 Dr Namrata Khadka  General Surgeon  Bir Hospital OD OD  
5 Dr Aliza Hamal MS Resident TUTH OD    
6 Punya Lal Mahato Sr. Assistant Admin Finance AMDA   OD  
7 Srijana Shrestha PO AMDA OD OD  
8 Subash Dulal CF AMDA OD OD  
9 Niru Thami Clinic Aid   OD OD  
10 Parbati Bhatta  Receptionist AMDA OD    
11 Laxmi Koju Registration AMDA OD    

a. Screening Camp at Baluwa Health Post
 
This was a one day event conducted on 10th April 2021 (28th Chaitra 2077) at Baluwa Health Post, Baluwa. The camp was executed from 9.00 am to 3:00 pm. A total of 9 team members comprising of doctors, nursing staffs, clinic aid, and project staffs (see section I form, complete list of team members) were mobilized for the camp administration and service delivery. The event was targeted to women between 30 to 60 years of age. A total of 63 women attended the camp and 49 clients benefitted from cervical cancer screening services and 51 clients benefited from breast cancer screening service.


I. Service Details Age Group wise :
SN Age Group of Clients Total Registered Clients Breast Cancer Serviced Clients Cervical Cancer Serviced Clients Remarks
1 20-24 years 7 0 0  
2 25- 29 years 4 0 0  
3 30-34 years 13 13 13  
4 35-39 years 14 14 13  
5 40- 44 years 10 10 10  
6 45-49 years 5 5 4  
7 50- 54years 5 5 5  
8 55-59 years 3 3 3  
9 60-64 years 2 1 1  
  Total 63 51 49  

II. Outcomes from the Screening Client

Screening Results of Cervical Cancer
Result No. Remarks
VIA Positive 5  Referred to TUTH for HPV DNA Test and Cytology
VIA Negative 44  
Cervical Erosion 1 Advised for PAP Smear Test
Not being screened 14 11 clients age group 20-29 yrs - For Gynae Check up and 2 Clients rejected  due to menstruation and 1 cleint 64 yrs of client arrived for Gyane Check up
Total  64  

 Screening Result of Breast Cancer 
Result  No. Remarks
Suspected (Benign Lump) 4 Advised Mammogram and Breast USG
Suspected (Suspicious Lump) 1 Advised for Mammogram
? Fibroadenoma 1 Advised for Mammogram
? Fibroadenoma with nipple inflammation
 
1 Advised for Mammogram
1 Bilateral Mastalgia 1 Advised for Breast USG
Nothing Detected Abnormal 43  
Not being screened 12
  • 11 clients - Age group 20-29 yrs [7 clients (20-24years) 4 clients (25-29 years) ]came for Gyane checkup and refused to do breast screening
  •  1 Client - 64 years age just arrived for her Gyane Check up only also refused for Breast Checkup.
Total  63  

b. Screening Camp at AMDA Office

This was a one day event conducted on 17th April 2021 (4th Baishak 2078) at AMDA Office, Jorpati-6. The camp was executed from 9.00 am to 3:00 pm. A total of 8 team members comprising of doctors, nursing staffs, clinic aid, and project staffs (see section I form, complete list of team members) were mobilized for the camp administration and service delivery. The event was targeted to women between 30 to 60 years of age. A total of 67 women attended the camp and 57 clients benefitted from cervical cancer screening services and 64 clients benefited from breast cancer screening services. 1 client visited for the follow up with the report of PAP smear test and the report was normal.

I. Service Details Age Group wise :

SN Age Group of Clients Total Registered Clients Breast Cancer Serviced Clients Cervical Cancer Serviced Clients Remarks
1 30-34 years 14 14 10  
2 35-39 years 15 14 15  
3 40- 44 years 13 13 10  
4 45-49 years 12 12 11  
5 50- 54years 7 6 7  
6 55-59 years 3 3 2  
7 60-64 years 2 2 2  
8 65+ years 1 0 0  
  Total 67 64 57  

II. Outcomes from the Screening Client

Screening Results of Cervical Cancer

Result No. Remarks
VIA Positive 6  Referred to TUTH for HPV DNA Test and Cytology
VIA Negative 49  
Suspicious malignancy 1 Referred to TUTH for HPV DNA Test and cytology.
Endocervical Polyp 1 Referred to TUTH for excision
Not being screened 10
  • 5 Clients – Menstruration History
  • 3 Clients – Suspected pregnancy
  • 1 Client – Known case of CA cervix
  • 1 client – She is FCHV. Due to high flow of client, she agreed to do checkup in next following camp. 
Total  64  

 Screening Result of Breast Cancer 
Result  No. Remarks
Suspected (Benign Lump) 12 Advised Mammogram and Breast USG
Suspected (Suspicious Lump) 2 Advised for Mammogram
Nothing Detected Abnormal 50  
Not being screened 3
  • 2 clients – refused to do Breast Checkup as one is 70 yrs old and other one refused due to shyness.
  • 1 client – She is FCHV. Due to high flow of client, she agreed to do checkup in next following camp.  
Total  67  

4.Coordination with Focal Person of Health Department of Gokarneswore Nagarpalika

On 5th April 2021, coordination was done with Hari Psd Upadhaya Sir (Health Officer) regarding program planning of April i.e. FCHV meeting and Screening Camp. Likewise, on 12th April 2021 submitted the report of screening camp to health desk team and also disseminated the camp date and coordinated with FCHV for the referral of clients at AMDA office. On 19th April, coordinated with Health Desk Team for FCHV meeting at Nayaparti Health Post and also, coordinated with health post incharge for the program.


4. Procurement of Medical Equipment
After completion of Technical Evaluation of the supplies the best vendor was selected by the procurement team and purchase order had placed. Hopefully, we will soon receive the equipments and commence the service.

The following list of items had been procured in the month of April 2021 for the distribution to FCHV.
SN Name of Items Quantity Remarks
1 FCHV Bag 111  
2 Bottle 111  
3 Umbrella 111  
 

5. Lesson Learned

  • Including FCHV training, we had meeting with FCHV during their monthly meeting at their respective Health post which had been instrumental in increasing of Breast and Cervical Cancer Screening service numbers.  As we restated the imperative aspect of breast and cervical cancer screening services for their community women. Due to which, the client flow at Baluwa Health Post and AMDA office was optimum and all the client including FCHV were satisfied with the service they received. Also, requesting for another camp to organize soon as the need is very high in both area.
  • Regular coordination and meeting with Health Desk Team, proper planning with implementation of activities and good team work always lead the program to success and till date we had provided the services to women as mentioned.

D. Plan for Next Month (April 2021)

SN Planned Activities Planned Date Remarks
1 FCHV Training  at Sundarijal Health Post On 4th May 2021  
2 Screening Camp at Nayapati Health Post On 8th May 2021  
3 Screening Camp at AMDA Office On 15th May 2021  
4 Screening Camp at Sundarijal Health Post On 29th May 2021  
5 Follow up on purchase order of Medical Equipment’s namely Mammogram, USG machine and Colposcopy By 2nd week of May 2021  
 

Note: The plan for the next month has been scheduled and also discussed  with the Health Desk team of Nagarpalika. But for now, it has been halted because of COVID19 surge and prohibitory order.


7.Success Stories:

  She just came out from the screening room of breast cancer with a prescription card in her hand. Her name is Jamuna Shrestha, 37years old women. Though she was wearing a mask but her eye expression was like so confused and quite blank one and that expression lead me toward her to clarify my queries towards her. Initially, I asked her if all is okay and how is the service she received whether she has any complains or queries on the advice. She replied,” yes I have received both services that is provided here. There is no any problem or complain rather I’m glad to receive service nearby my home for which I was looking for since so many months ago”. She showed me her prescription card with doctors advice on it.
 
In breast screening, she was diagnosed with Bilateral Breast Mastalgia and prescribed her with some analgesic medicine with Vitamin E. I asked her, since when she had problem and why she didn’t went for checkup. She replied, it had been since 5-6months that I had slight breast pain in both but due to household work I was not being able to manage my time for checkup. As my husband is quite busy in his work, and there is no one I can go with at hospital and its quite far from here and also, I have to go early at Teaching Hospital to get token for OPD ticket and it may take whole day for checkup. Also, there is no one to take care of my childrens. But, today finally I am here for checkup all because of this camp conduction to nearby our home with such an expert doctors who took the detail history, examined and provided advice so clearly. I am very much thankful to FCHV didi who advised me for this checkup. Hopefully, with this medication I will be fine and would like to do the further investigation as advised by doctor. But, I am worried for the report as well. I hope there won’t be any worse one.
 
Furthermore, she stated that I would not know about my cervical condition if I won’t be here for service. Though my VIA test is negative, I got the opportunity to know my other gynecological problem and I am happy, there is no any problem expect some wound in cervix. As I saw in prescription earlier there was mentioned with cervical erosion and had been advised for Pap Smear test for further investigation. So, I asked her, where she will go for test then she told me, nearby to them is Nepal Medical College and she will go there for test and for Breast Screening test she would like to come at AMDA office for USG of Breast.
 
After this conversation, I advised here to take the prescribed medicine and please let us know the report of PAP smear test and also, advised her not to be worried and we won’t be assured until and unless we won’t do screening test and lets be positive for the good results.This aforementioned picture was captured after all this conversation and she was quite relieved after this conversation and also, thanks to AMDA Nepal for organizing such a needful camp which is utmost important to the women as most of the women suffer either from Breast problem or from Gyane problem and this camp had brought a solution for both and we all are glad to receive this service nearby our health facilities.
 
Well, those gratitude words made me feel so satisfied with my own work and made me feel glad that we are being able to provide service to those needful people who had no time for themselves for their health checkup.
AMDA Nepal

Contact Details

AMDA Nepal
Gokarneshwar Municipality - 6, Jorpati
P.O. Box 8909, Kathmandu
Phone: +977 (1) 4910235, 4911140
Fax: +977 (1) 4911141
E-mail: amda@amda.org.np

AMDA Hospital
Damak Municipality-2, Kharkhare, Jhapa
Phone: +977 (23) 580046, 580667
Fax: +977 (23) 580186
E-mail: ah.damak@amda.org.np

Siddharth Children & Women Hospital
Butwal Sub-Metrpolitan -7, Rupendehi
Phone: +977 (71) 502097
Fax: +977 (71) 502085
E-mail: scwh.butwal@amda.org.np

AMDA Mechi Hospital
Mechinagar Municipality-10, Dhulabari, Jhapa
Phone: +977 (23) 560550
E-mail: amh.dhulabari@amda.org.np

AMDA Institute of Health Science
Damak Municipality-2, Kharkhare, Jhapa
Phone: +977 (23) 580186, 582186
E-mail: aihs.damak@amda.org.np