SUMAN K SHRIVASTAVA
Ranchi, Dec 16: In 2013, everybody made fun of her, when the then Rural Development Minister Jairam Ramesh, while appreciating her diligence, said that she is not only physically stout, but she is like a road roller that can crush every problem coming her way.
Some nine years down the line, she has proved that it was not merely a joke cracked by Ramesh at an eye camp organised by her in the Naxal-hit Latehar district.
Conferred Nari Shakti Puraskar 2017, she has to her credit screening 20 lakh school children enrolled in government schools and enabling thousands of school dropouts to go back to school after performing cataract surgery and dispensing diseases.
As an ophthalmologist, she found her true calling in extending medicare to the poor and marginalised people living in remote parts of Maoist-hit Jharkhand. She established Kashyap Memorial Eye Hospital with her husband Dr B P Kashyap, in Ranchi in 1996, but chose to equally invest her time and skills in serving people in the hinterland.
Dr Bharti was only 15 when she lost her father to lung cancer and she felt the pains ones’ near and dear ones undergo after their kin get afflicted with the deadly disease. Though trained as an ophthalmologist, she dreamt to see women physically fit and to fulfil her desire she planned to make Jharkhand a cervical cancer-free state.
But she knew that the task was not easy. So, she jolted the state health department to do the desirable and persuaded the top-notch to launch a campaign for it and the state government responded positively to her call.
Leading the Women wing of State IMA and now as national co-chairperson of the IMA, Dr Bharti has evolved a unique model to eliminate cervical cancer in Jharkhand and translate it into concrete action.
Impressed by the work of IMA, women’s wing, which Dr Bharti led, the then Governor of Jharkhand and now President of India Droupadi Murmu took the initiative to equip six state-run Sadar Hospitals in the backwards districts of Santhal Parganas, with cervical cancer screening and treatment equipment.
Till now 12 big Government hospitals in Jharkhand have been equipped with cervical precancer detection and treatment equipment.
The state health department issued a fresh letter on December 2 to all the civil surgeons to hold a screening camp compulsorily in the first week of every month to detect cervical cancer among women of the reproductive age group.
The nodal officer, mother health, has reminded the civil surgeons that the Jharkhand health department and the IMA women doctors’ wing had held a high-level meeting along with the top gynaecologists of the country wherein it was decided to implement a modified model of WHO for the elimination of cervical cancer in Jharkhand. It was also decided to screen six percent of the total reproductive age women with an inflammatory pelvic disease who are at high risk of developing cervical cancer in future.
This apart, the screening of women, pre-delivery and post-delivery, has also been made compulsory during the period. The nodal officer has pointed out that 1,26,976 women have been screened out of the target of 2,70,678 fixed in 2021.
It all began as a Mega Women’s Health Camp in 2014, organised by Women doctors Wing, IMA, Jharkhand, under the stewardship of its chairperson, Dr Bharti Kashyap, to screen mainly underprivileged women for anaemia, genital infections and cervical cancer, has now evolved into a movement with Jharkhand steadily inching towards becoming the first cervical cancer free state of the country.
The Mega Camps turned out to be eye-openers. Sixty percent of women who turned up at these camps were detected to be suffering from genital infections and complaints of itching in their private parts, irregular menstruation, lower abdominal and back pain, severe anaemia etc. To add to these, unhealthy diet, weak immune system, unhealthy genital hygiene, early marriage, multiple pregnancies and tobacco addiction, made girls and women in rural Jharkhand, more prone to cervical cancer.
Women doctors Wing, IMA, Jharkhand, (WDW) was quick to realise that to achieve an ambitious target of a Zero rate of cervical cancer, there was much to be done within the shortest possible time. Soon enough, the team of WDW came up with a multi-pronged approach to achieve the goal of a cervical cancer-free Jharkhand.
Dr Bharti says, “At all these camps, women were welcomed with Folic Acid, iron and calcium tablets to assure them that they would be well looked after, without loss of continuity. Kit 2 and Kit 6 tablets, which were distributed free at camp sites, ensured a permanent cure from genital infections. Awareness sessions on personal hygiene and balanced diets were also organised at the camp sites to boost morale and strengthen women’s resolve that they were better equipped to take better control of themselves and their families.”
She said that we got in touch with the state health department and encouraged them to join hands with Women Doctors Wing, to tackle the menace. We roped in Onco gynaecology experts from Chittaranjan Cancer Institute, Kolkata and Rajiv Gandhi Cancer Institute and Research Centre, and Max Hospital, New Delhi, to train gynaecologists working with the state health department on VIA Screening and Colposcopy guided cryo treatment for early detection and treatment of pre cervical cancer in women. All gynaecologists across Jharkhand working with the state health department have got trained in cervical cancer diagnosis and colposcopy-guided pre-cancer cryo treatment, thereby helping create a pool of trained manpower in Jharkhand to ensure timely delivery of healthcare. Thus, began a process of creating a pool of trained manpower to enable the state health department attain its goal of a cervical cancer-free state, within a fixed time frame, Dr Bharti said.
The pandemic years brought fresh challenges. Though movements were restricted, the year 2021 was a turning moment. Dr Bharti who is the National Co-chairperson of Women Doctors’ Wing IMA Hq. and also, Chairperson of WDW IMA Jharkhand has set a Jharkhand Module for all the states WDW chapters to emulate for cervical cancer eradication.
Women Doctors Wing, IMA, Jharkhand, under her stewardship, commenced consultations with senior onco gynaecologists of the country, to kick start a low-cost, yet effective Cervical Cancer eradication strategy vis a vis the WHO Cervical Cancer eradication guidelines 2030, to begin saving thousands of women, from dying, each year.
After extensive consultations, the Women Doctors’ Wing and Health Department, Govt. of Jharkhand came up with a multi-pronged cost-effective strategy under which it was suggested:
- Mandatory screening of at least 6 percent of women in the reproductive age group who are in the high-risk category or have symptoms suggestive of pelvic inflammatory disease, a major cause of cervical cancer.
- Mandatory screening of all pregnant women, along with their female companions, turning up for ante-natal and post-delivery checkups in the first week of every month at the Government Hospitals under Surakshit Matritwa Yojna.
“This screening of a targeted group of six percent women of reproductive age enabled us to screen hundred percent reproductive age group women suffering from the cervical disease. We ensured that 100 percent of women, identified with cervical cancer, receive proper treatment,” she said.
In 2022, the Women Doctors Wing further suggested that Cervical Cancer Screening be dovetailed with screening for Breast Cancer to effectively combat the two most common forms of cancer that kill thousands of women, each year. “We have started equipping government hospitals with Breast cancer screening machines also since 2022,” she added.
Hopes of thousands of women across Jharkhand and Women Doctors Wing, IMA, Jharkhand, were fulfilled after the state government in a series of directions to all Civil Surgeons of the districts, stressed that it has agreed in principle to implement the modified version of the WHO 2030 cervical cancer eradication policy strictly, as per suggestions of the state health department and Women Doctors Wing,
In 2021 the State Health Department further directed all civil surgeons in each of the 24 districts of Jharkhand to ensure that at least 6 percent of women in the reproductive age group suffering from pelvic inflammation diseases should be mandatorily screened for cervical cancer with an overall annual target of screening 2,70,678 women.
“All pregnant women, falling under the high-risk category, turning up at Sadar Hospitals of Jharkhand on the first week of each month for an antenatal checkup, along with their female attendants would have to be compulsorily screened for cervical cancer” the State health department directives, read.
The State Health Department, further directed that cervical screening camps be organised in each district, every month so that early detection and timely treatment. could be ensured.
Figures compiled by the State Health Department have revealed that against the annual target of screening 2,70,678 women in the reproductive age group falling under the high-risk category or having suggestive symptoms for the period 2020-2021, 1,26,976 or roughly 50 percent of women have already been screened up to March 31, 2022.
