The Lily Project: Women’s Health Services in Rural Nicaragua
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Lives Worth Saving

2/12/2015

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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!
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