By Susan Cotton, Executive Chair
The Lily Project (Mission: To deliver preventive health care to women in rural Nicaragua reducing the number of women newly diagnosed with terminal cervical cancer 30% by 2020) launched at the end of January in Miramar, a small fishing village on the west coast of Nicaragua. The results of our work in the community are in – and just make us want to go out and do more!
In all, we screened 132 women for cervical cancer during a five-day period. The process we have developed in collaboration with MINSA (Nicaraguan Ministry of Health) calls for women 28 - 50 to be screened using Visual Inspection with Acetic Acid (VIA) and those under 28 or over 50 to be screened using Pap. The beauty of the VIA process, from a woman’s point of view, is it provides immediate results. Because of Anielka’s background as a bioanalyst, we have also overcome the major hurdle to Pap screening in rural Nicaragua: rather than wait months to receive results (if ever), The Lily Project delivers results in just a few days. Anielka heard over and over: “I just want to know if I have a problem and I have never been able to know before.”
But it is the results that move us: of the 132 women screened, 28 (21%) had precancerous lesions that could be treated by cryotherapy and 4 women (3%), ages 23, 28, 30 and 52 had serious pre-cancer (severe dysplasia) and were referred to the hospital for further treatment. For today, we will provide them whatever help we can to make sure they receive the care they need; but included in The Lily Project’s strategic plan is the development of a process to facilitate private treatment for women determined to be most at-risk for cervical cancer. Take these percentages and apply them to a population...Just imagine the number of families that will be saved by this one simple procedure!
We thought the problem we needed to solve is lack of access to preventive health care and we are well on our way to providing a solution. However the real problem is a woman’s inability to take care of her personal wellbeing because of the Machista attitudes that dominate her society. We expected to serve nearly 200 women in Miramar and what we found is many men did not allow their spouse or partner to participate. Anielka shared Maria’s story, a young mother of two married to an abusive and possessive man. Her mother, Gabriela, snuck Maria out of the house to attend the screening, since her husband refused to allow her to get a health check-up. This poor young woman was terrified of defying her husband but her mother insisted she know if she had a health problem. Equally awful is that of the 28 women requiring cryotherapy to treat precancerous lesions, 7 (25%) refused treatment, primary because their partner would not permit it. Anielka explains that women are counseled not to have sex for 30 days after treatment and to use condoms when sexual activity resumes; some men are just not willing to accept these conditions. To succeed, not only must we deliver cervical cancer screening and treatment, but we must educate the community to foster the growth of knowledge, attitudes and lifelong behaviors that enable women and men to assume responsibility for sexual health decisions and their personal well being.
With this learning, The Lily Project is launching a women’s sexual health education campaign Se´saludable. Se´feliz. Se´mujer. (Be healthy. Be happy. Be you.) to empower women in the communities we serve. As this photo shows, there are many men committed to keeping the women in their lives – wives, mothers, daughters, sisters – healthy and safe - and they are joining us in our campaign. Our goal is to educate dozens of communities and screen more than 2,000 women this year. We would be thrilled if you support our Crowdrise campaign and follow our progress on Facebook. Thank you!
by Anielka Medina
Such an interesting week for me, as if I have lived 100 years! It may seem like an exaggeration, but truly everything I've learned and witnessed in these last several weeks has led me to the conclusion the purpose of life is to share joy and help others.
Talking with the women in the community and listening to their stories has been one of the most difficult things I’ve ever done. In so many ways it affects me emotionally because I relate to their lives due to my own upbringing.
Last week I met a woman who came in for the exam and when I explained to her the procedure of the examination she began to cry. At that moment I felt helpless because her story really touched me. She was middle-aged woman who suffered sexual abuse when she was 11 years old. She had been married for many years, but she explained that she never wanted to have sex and now its worse because she is starting menopause, and her husband always forces her. My mind was so disturbed listening to her. I wanted to help but did not know how, so I wrote a note to her husband explaining the changes one suffers when going through menopause and a plea to let her choose when she is ready. Also, the treatment I was giving her required a break from sexual relations for 30 days.
I had the opportunity to see her the next day and to my surprise she was smiling. She told me she handed the note to her husband and he said he would respect it and told her not to worry; he understood. I felt so happy. I realized in that moment that sometimes little things have great value.
Our team is really focused on the biggest problem for women in Nicaragua: cervical cancer, and we know our culture is something that has created the problem. We developed a banner that explains how culture influences health, and we try to get the women attending to think about it. Regardless, there is always an objection. I examined a woman who is just 29 years old. Utilizing VIA, I explained that she needed to return for cryotherapy treatment. Unfortunately, she did not return so I decided to call her. I actually had to listen to the husband tell her that treatment was not necessary and just a lie. My mind was exploding with rage, and I told her to bring her husband to talk with me, but he wouldn’t agree. She never arrived. How can a man tell the mother of his children not to go to treatment for something that could kill her?? It's so sad to see how sexism is killing our women.
If our women received a screening at least once in their lifetime, cancer in Nicaragua would be reduced to 20%. We must be strong. Our culture must change for the sake of our children; for the sake of ourselves!
Today was our last day in the small fishing community of Miramar. It was so amazing to partake in the lives of the women for the past two weeks. I believe the women in the community are strong. They wake up every day to make tortillas, pelicanear (a term used for women who work cleaning fish), gathering firewood to be able to cook, washing clothes and taking care of their children. Laborioius tasks are just a part of their life because they also have to deal with their husbands who pay them no respect and only use them for selfish needs and desires. Women here rarely have time to take care of themselves.
I have so much respect for the ladies that received the exam and treatment w. I know that for so many it must have been very dificult to find a way to tell their husbands that they could not have sex for one month after the treatment. Its incredible how life just goes on for these women. Even right after treatment, I saw many of them in the town working to feed their families.
I’m thankful to all the women who left their homes for a moment to be part of this important project. We cannot do this alone. It truly takes brave women in the community to really make our vision into a reality; a vision that at the core simply wants women to be healthy for their families. Together, we will make it happen. We are strong.
By Susan Cotton, Executive Chair
As we prepare to launch The Lily Project later this month (Mission: To deliver preventive health care to women in rural Nicaragua reducing the number of women newly diagnosed with terminal cervical cancer 30% by 2020) I have had the wonderful opportunity to meet with a quite a number of potential partners, donors and supporters. As I’ve shared our story, the most common reaction I’ve received is ”I honestly had no idea…” about this cancer, its prevention and why the work we are doing in Nicaragua is so important. To do my part for Cervical Cancer Awareness Month, I will be sharing information with all of you, with the hope that this knowledge will spread and do good things.
#4: The Lily Project Blossoms in Nicaragua
The Lily Project is a direct result of the commitment and compassion of a young woman, Aniekla Medina Escoto. Anielka’s mother, Azucena, lived a life fairly typical of women in rural Nicaragua - a mother by 16, she was raising seven children on her own by the age of 25. Not able to find work in their village, she took a four-hour bus ride to Managua, where she cleaned homes and cared for children of wealthy families, returning back to her family just every other weekend. But she was determined that Anielka and her siblings rise above their life of poverty and pushed Anielka to study hard and go to school. Azucena passed away from cervical cancer at the age of 48 – just days after Anielka graduated from high school.
Anielka went on to obtain a scholarship, study, and receive training at the National University of Nicaragua in cervical cancer prevention and upon graduating last summer, Anielka, Jonathan Butcher and I started The Lily Project in honor of Azucena (‘Lily’), with a vision of the day when every woman in rural Nicaragua can enjoy a long and healthy life through access to proactive, preventive health care. Over the last few months we have built our foundation:
During the last month we have worked with the town’s leader, Ivania, who has organized and mobilized women, and even a few men, to prepare the community. Ani reports that The Lily Project has created quite a bit of buzz in Miramar – with most of the excitement due to what we believe are the unique benefits of our approach:
On a personal note – I am very proud to be part of The Lily Project, inspired by our mission, pleased about our progress and excited by our future. If Azucena were alive today, she would be about my age – and I believe it is my privilege to help her strong leader-daughter accomplish great things in her name.
To learn more about The Lily Project, please visit Thelilyproject.org.