On PIMA’s first Women’s Health Team visit to Christmas Island last year, hundreds of island women came forward who had been suffering in silence with female infections, many for months, afraid to be seen by a man doctor.
This year, the team brought speculums and microscopes and trained all the female nurses to identify and treat these infections at the village level. For the second year, the team was led by Dr. Theresa Woehrle from LaCanada, California, who teaches medical students at the University of Southern California Keck School of Medicine, and was aided by USC clinical instructor Dr. Lori Levi, OB/GYN, from Pasadena, California.
By Dr. Theresa Woehrle
Give a man a fish and you feed him for today; teach a man to fish and you feed him for a lifetime.
This was the guiding principle of the Pacific Islands Medical Aid Women’s Health Team during our recent visit to Kiritimati (Christmas Island) to teach the nurses to evaluate and treat women for common gynecologic conditions.
Last year, the team had the honor of visiting Kiritimati and evaluating and treating nearly 300 women who had not had access to vaginal exams. Although we were able to help many women during that visit, we realized the greatest impact would be to train the nurses to see and treat women at the village level.
This year, we returned armed with PIMA-donated microscopes for each village nurse and all the materials the nurses would need to evaluate their patients.
On the first day of our visit, we had a class on how to perform a speculum exam and how to differentiate vaginal infections using the microscope.
The nurses were eager, enthusiastic, and very quick learners.
The following days, we went to each of the villages to set up the microscopes and work with each nurse as she examined her patients in her village clinic where both patients and nurse feel comfortable and at home.
In addition to performing a speculum exam and using the microscope to identify vaginal infections, the nurses learned how to perform a cervical exam using acetic acid (vinegar) to assess for possible early changes similar to what is discovered in a pap smear.
This is known as visual inspection with acetic acid (VIA) and is used in resource-poor areas such as Kiritimati where there is no pathologist who can read a pap smear.
In more than 15 years of teaching similar skills to medical students in the U.S., I have never encountered learners as competent or enthusiastic as the nurses of Kiritimati.
We felt a great amount of pride in our students as they each received a certificate of learning on the final day of our visit and a great deal of gratification knowing that by teaching the nurses, we were able to impact the health of thousands of women who would receive much needed care at the village level for years to come.