Cervicusco

My practice experience this summer will be volunteering in Cusco, Peru with the NGO CerviCusco, a non-profit dedicated to addressing the exceedingly high rates of cervical cancer in rural Peru.  All health care services are free of charge to the impoverished, disenfranchised, and indigenous women living in the remote Andes of Peru.

In low-resource settings such as Cusco, Peru, structural barriers to cervical cancer screening include lack of access to health care, shortage of clinics, few trained personnel, irregular hours of operation and long waiting times at the facilities. In addition, cultural barriers include lack of preventive health seeking behaviors, less exposure to biomedical procedures, low knowledge of cervical cancer, language barriers, negative views of health care providers, lack of spousal support for health care seeking, anxiety and fear over potential negative diagnoses and of cancer, shortage of female providers, and modesty over exposing one’s body.

A relatively recent article in The Lancet describes the progress made in Quiquijana, high in the Andes mountains, where birthing centers have been erected since 2004, have virtually eliminated maternal deaths as part of Peru's Ministry of Health's initiative in the area.  Though the national average of maternal mortality still ranks much above the Millenium Development Goal of 66 maternal deaths per 100,000 births--at 571 per 100,000-- remote areas of the Andes have estimated mortality rates to be as high as Haiti's (Fraser).  
The mixture of both structural and cultural barriers to adequate maternal health is quite monolithic, with cervical cancer being the number one cause of death of women in Peru.  These barriers similarly parallel the De Villier’s “Needs Assessment Survey,” where a participatory survey was conducted to obtain a comprehensive overview of the community, and the “relationship[s] between [the] healthcare system, the environment, and the consumer system.”  It strikes me as essential in providing a participatory means to provide feedback based off CerviCusco’s impact and long-term sustainability, and I look forward to witnessing such verbal and written feedback on the ground level.  The article also describes the “holistic nature of health” in conjunction with the “interaction between the physical, spiritual, social, and economic and ecological dimensions of life.”

 I hope such a bridge between two profoundly different worldviews, histories, and cultures, can manifest itself soon within Peru.  I wish for a starkly different picture of women suffering with little access to medical care. I look forward to witnessing Cervicusco's largely effective change in the coming months, and hear the stories of those also effecting monumental change within the world. 

Works Cited:

Fraser, Barbara.  The Lancet.  "Peru Makes Progress On Maternal Health."  Vol 371, Issue 9620.  April 2008.