Few people know about the work PHASE are doing to reduce the incidence of Cervical Cancer. According to the World Health Organisation, Cervical Cancer is the most frequent cause of female cancer mortality in Nepal. When a women dies from something such as cancer, as the primary care giver, it has huge impact on her whole family – particularly if she has young children. Cervical Cancer is preventable by screening, however no formal government-led cervical cancer screening programme currently exists in Nepal
PHASE has been working in close partnership with the Nepal Network for Cancer Treatment and Research (NNCTR) to improve existing cancer screening in Nepal.
In 2002 the Nepal Network for Cancer Treatment and Research (NNCTR) started the task of introducing mass screening for cervical cancer in collaboration with WHO (World Health Organisation) and the IARC (International Agency of Research on Cancer). To date over 20,000 women have been screened. However the management of patients who screen positive was problematic as colposcopy services (Cervical Cancer diagnostic services) were poorly developed and many patients subjected to overtreatment. A project was therefore agreed between the PHASE colposcopy group and NNCTR to develop colposcopy services and training. The PHASE colposcopy group is a collaboration of UK colposcopists working voluntarily to assist the partnership.
This month we talked to Dr David Nunns about the partnership. David has visited Nepal three times to support this work, “In 2002 Nepal introduced mass screening for cervical cancer and to date over 20,000 women have been screened. The management of women who were screen positive was problematic as medical services are poorly developed and many patients were overtreated. The PHASE colposcopy group are working with their Nepali partners to develop colposcopy services and training, this involves a collaboration of UK colposcopists voluntarily offering their time and expertise. Colposcopy of the medical procedure carried out to assess and treat precancerous cells of the cervix”
PHASE and their partners have made some great achievements through this work including:
- Two weekly colposcopy clinics at the Maternity Hospital, Kathmandu, offering diagnosis and treatment to those who have been referred from the regional screening programmes
- Three 3 day colposcopy workshops with lectures and hands-on training for Nepalese gynaecologists
- Four exchange visits to the UK of six senior Nepalese doctors and two Nepali nurses to train in colposcopy.
- An increase in the number of colposcopists working in the country.
- Advocacy for a cervical screening programme in the country.
- One 2 day workshop for pathologists in cervical pathology attended by 25% of the countries pathologists
- Funding from the UKAID programme for a two year project to train more colpscopists and pathologists
- A two day pathology conference which trained one third of the countries pathologists in interpretation of cervical pathology
In 2013 we aim to consolidate the work carried out so far by building up the capacity of the trained pathologists and colposcopists in the country. Quality will be a clear focus of our work. In 2013 we plan to carry out the following:
- A visit to the UK by two Nepali training colposcopists (doctor and a nurse)
- Ongoing quality assurance programme for colposcopy and pathology – data collection
- The development of web- based educational material for pathologists
The UK team includes Dr Rafiat Adekunle, Dr David Fenton, Sherryl Goodhall, Esther Moss, Dr David Nunns (Chair), Dr Jane Panikker, Dr Gerda Pohl. Our Nepal partners include Network for Cancer Treatment and Research NGO (Dr Surendra Bade). Paropkar Maternity and Women’s Hospital (Dr Verma) and the National Public Health Laboratory (Dr Shakya)