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Surgical training and cervical screening in rural India hospitals
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  1. Santiago Domingo1,
  2. Yadamala Balasubbaiah2,
  3. Sundari Nyndala3,
  4. Irene Garcia2 and
  5. Manel Barahona4
  1. 1Gynaecology, La Fe University and Polytechnic Hospital, Valencia, Comunidad Valenciana, Spain
  2. 2Gynecology, RDT Hospital, Anantapur, Andhra Pradesh, India
  3. 3MS Ramaiah Medical College, Bangalore, Karnataka, India
  4. 4Hospital Universitario de Puerto Real, Puerto Real, Andalucía, Spain
  1. Correspondence to Dr Santiago Domingo, Gynaecology, La Fe University and Polytechnic Hospital, Valencia 46033, Spain; santiago.domingo.delpozo{at}gmail.com

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Rural Development Trust is a project supported by the Spanish NGO Vicente Ferrer Fundation aimed to provide the best social and educational resources and healthcare facilities, especially for women and children of Anantapur District in India.1

The Vicente Ferrer Foundation initially established two hospitals in Kalyandurga and Bathalapalli 25 years ago (Figure 1), providing care to a population of 2.5 million people. These hospitals are run by the charitable trust of the Vicente Ferrer Foundation and provide free or low-cost medical services to those in need.

Figure 1

Kalyandurga Hospital Hall

Surgical Training in Rural Development Trust Hospitals

At the beginning of this century, Dr G. Lazaro, began skill-based educational programs in obstetrics and gynecology for the doctors employed in these hospitals. This program has been working for the last 25 years thanks to many anonymous Spanish doctors.

Dr Balasubbaiah, who started learning vaginal and laparoscopic surgery through this program, has remained working in this institution and has become a role model for the younger generation. Our main job as external visitors is teaching surgery and managing oncological cases and complications (Figure 2). These programs would not have been posible without the support of a group of highly skilled surgeons from India (Dr Patil, Dr Magdum, Dr Kubde), who regularly participate and impart their knowledge and skills of surgery without any financial benefit.

Figure 2

Surgical session in Kalyandurga Hospital

Women with gynecological cancers are treated with suitable surgical procedures. At this junture we would like to fondly remember and pay tribute to Dr Praveen Rathod, a great oncosurgeon from Kidwai Institute of Oncology (Bengaluru, Karnataka), who used to operate regularly and transfer his patients to Kidwai Institute for further management. His untimely demise has created a large vacuum in the field of oncology in Bathalapalli. He is just one example of the great gynecological surgeons India has given to the world.

Preventive Oncology Work in Rural Development Trust hospitals

Lancet Oncology reported that India could eliminate cervical cancer by 2079 with effective implementation of primary and secondary prevention stategies.2 But sadly, these screening programs have not been effectively implemented. There are regular educational program meetings, not only for gynecologists and heathcare practitioners from Rural Development Trust hospitals, but also for all community doctors, and we support them with our Spanish experience (Figure 3).

Figure 3

Surgical session in Kalyandurga Hospital

WHO recommends a screen and treat policy for low resource setting countries to diagnose and treat women at the same visit in order to prevent multiple visits to the hospital. VIA (visual inspection with acetic acid) is an option.3 Bathalapalli has been conducting population-based screening programs, but it is not reaching all the population, as it is done opportunistically. In 2015, 59 million women worldwide received at least one vaccine, but only 1.4 million were from low income, and lower or middle income countries.4 If we want to change the history of cervical cancer, a true commitment is needed from all the national health programs, whatever the country, to extend the use of vaccines.

Poverty is not to be understood, but to be resolved. (Vicente Ferrer)

I would like to dedicate this article to our beloved late Dr Praveen Rathod.

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References

Footnotes

  • Contributors All of the authors (SD, MB, YB, SN, IG) of this paper declare that there are no conflicts of interest and have actively participated in the work, providing input including: (1) substantial contributions to conception and study design, (2) drafting of the article, and (3) final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.