Page 40 - Johns Hopkins Nursing Magazine Spring 2023 - Johns Hopkins School of Nursing

In India, She feels a sense of urgency given that breast and
cervical cancer are the most prevalent cancers among
women in India (more than 300,000 new cases and
Breast Health Via 167,000 deaths in 2020), and especially since the
World Health Organization recommends for women
age 30-49 (or 25-49 for those living with HIV) to be
Wellness Centers screened with a high-performance test.

Giving women a sense of ownership and control of
their own health care motivates Pal and her team—
Babli Pal’s posting last year to serve as the community an auxiliary nurse midwife and eight accredited
health officer in a small health center in the heart of social health activists (ASHAs)—to go door-to-door,
a farming village in Uttar Pradesh presented no end counseling clients and building relationships with
of challenges for a young nurse. Among the most husbands, influential elders, and village leaders.
pressing and hefty: convincing an insular, patriarchal These ambitious efforts have resulted so far in 184
community—one situated far from the influence of women being tested during eight center-based cancer
city hospitals and medical colleges—to prioritize screening sessions, with several being referred for
breast and cervical cancer prevention services aligned further investigation. Also, ASHAs have distributed
with global goals. kits and provided instructions for HPV self-sampling
to women, some of whom were referred to the
“[Women] avoid and procrastinate coming to the community health center for treatment.
health center, either denying that they have any
problems or hoping for their issues to resolve on Delighted to be among 225 health care providers
their own,” says Pal. across India to be supported by Jhpiego in screening
more than 4,500 women for cervical cancer and
Undaunted, the 28-year-old nurse aims to make quality conducting clinical breast exams for more than 73,000
38 health services accessible and attractive to women women, Pal says, “If a small effort on my part can
whose low literacy and workload leads them make a big difference in someone’s life, what can be
to prioritize farm and family over personal care. better than that?” ◼
She’s also resolved to expand on what constitutes
“primary” care. Reported by Indrani Kashyap, Jhpiego’s India-based
associate director of regional communications. Writer-
Her commitment to broadening that concept editor Maryalice Yakutchik also contributed to this article.
manifests itself in the practice of teaching women Photos by Shivani Agrawal.
to do regular self-breast examinations; in informing
them that most cases of cervical cancer are caused
by long-term infection of certain types of human
papillomavirus (HPV), a common sexually transmitted
infection; and, importantly, in offering a less invasive,
more private screening option that involves the self-
collection of samples for genetic testing of HPV.
JOHNS HOPKINS NURSING SPRING 2023 governments in India to strengthen women’s breast
Jhpiego has worked with national and state

cancer awareness, screening, early diagnosis, and
management since 2017, in recent years adding
cervical cancer prevention work.

It was through a Jhpiego-supported training, in
partnership with the government of Uttar Pradesh,
that Pal learned how to raise awareness about women’s
cancers, conduct breast exams, and screen women for
oral and cervical cancers.