I Climbed Three Mountains, those four words alone seem outlandish, but that is exactly what I did when I traveled to Enshi, in Hubei Province China, August 16th – 18th, I climbed three mountains. I didn’t mean to climb three mountains. Honestly, I thought I was going to look at a canyon that was as majestic as the Grand Canyon in Colorado -- that should’ve been my first indication that something was askew here; the Grand Canyon is in Arizona.
Aside from the sheer insanity of climbing three mountains, in August, in extreme heat, and completely, utterly unprepared for that type of a trek, I learned something valuable from the experience that translates well with my global health fellowship. Ask questions. Ask clarifying questions. Ask detailed questions. Ensure that everyone has a common understanding when you have completely finished asking questions, because something invariably will get lost in the translation.
The trek also made me think about the situation the Chinese women are encountering in the far reaches of Hubei province in which the city of Enshi sits and the five mountains in the Mufu mountain range, of which three I climbed on Friday August 17th. The necessity to ask questions to ensure that women and physicians have a common understanding is critical, especially to removing barriers that will culminate in the reduction, if not eradication of cervical cancer among Chinese women. Notwithstanding, the Mufu Mountains (Mùfù Shān幕阜山) aka the Enshi Grand Canyon (ēnshī Dàxiágǔ 恩施大峡谷), are beautiful as is the view of the lush green valleys, the river and partial view of the canyon, all of which I would’ve enjoyed more if I was prepared for the trek.
That’s the key, being prepared for the trek, the journey, and that is what Project HOPE endeavors to do, to Build the Capacity of Community Health Providers. And that was the charge for the weekend in Enshi where over 80 health care professionals, mostly gynecologists and pathologists gathered to learn the latest techniques in preventing, diagnosing and treating cervical cancer during the Women’s Health-Cervical Cancer Prevention Program Training.
It so happens that this section of Hubei has the highest incidence of cervical cancer in Hubei and is second highest in all of China, per data collected by Project HOPE. The data on the Ministry of Health (MoH) website has data for the entire province. The MoH calculates the prevalence of cancer per 100,000 women. The Provinces with the highest incidence of Cervical Cancer, according to data collected in 2011 are Qinghai 47.7, Xinjang 38, and Shanxi 35.1. Hubei’s province rate is 16.9. Enshi’s population is ~3.6 million, this makes it a small city in China. To put this in perspective, the population of Tibet is just over 3 million. Tibet has the second highest rate of Condyloma Prevalence at 220.7, however the incidence rate of cervical cancer is only 11.3.
With China’s incidence rate of cervical cancer being six times higher than the rate in the rest of the world, early diagnosis and treatment is critical. This is where Project HOPE comes in, in partnership with BD, Project HOPE has launched a three year training, awareness, and screening campaign which should stem the tide and turn those statistics around.
The outcome of the Cervical Cancer Prevention Program is, through a series of training and education activities, to enhance health care professionals’ capacity, improve women's awareness, and promote a combination of social concern, thereby ultimately reducing the morbidity and mortality of cervical cancer in Chinese women.
So, where do I come in? The key words are “build capacity” and that is what I will be working with Project HOPE in Shanghai to do. We are currently working on the business requirements to secure a hosted Learning Management System (LMS), which will enable Project HOPE to make eLearning courses available for health care providers. This is critical for building and enhancing the skills of health care providers in rural communities. I attended the training to obtain a firsthand understanding of the complexity of reaching health care providers that are not located in the major urban centers such as Shanghai and Beijing and to experience part of the training class so we can focus on how to translate the instructor led training into eLearning courses. Although I will not be climbing three mountains anytime soon, at least not without being prepared, so too is the expectation with the cervical cancer prevention training program, in that the diagnosis and prevention of cervical cancer among Chinese women will no longer be an uphill battle. With adequate skills and resources cervical cancer can be prevented, and if it is diagnosed, the intent is that diagnosis will occur when the cancer is in Phase 0, where the cure rate is 100%.