Pascalau Marinela was a forty-year-old woman who lived, with her three children and unemployed husband, in a remote rural area of Poieni Romania. Their home had no electricity or running water, and was a five-kilometer walk down winding mountainside paths to Tranis, the closest village.
Throughout Romania, rural communities lack access to up-to-date basic health information. The Romanian Family Health Initiative (RFHI) worked to increase the availability of health information to empower rural Romanians to seek the health care services they need. RFHI was able to achieve this by going to rural areas and conducting monthly women's health seminars. When Marinela heard that the women’s community center would be having health talks after church, she decided to go because she had high blood pressure and wanted to know more about it. But it was what she learned at the seminar on breast and cervical cancers that wound up saving her life.
In preparing for the seminar on breast and cervical cancers, RFHI worked closely with family physicians and the Oncology Institute of Cluj to arrange for the utilization of the Institute’s mobile clinic. With the assistance of the family physicians, RFHI held village meetings with clients and village stakeholders —priests, mayors and teachers— to inform them about cervical and breast cancer. The mobile clinic followed to conduct breast exams and Pap tests, which were processed at the Oncology Institute, which sent results back to the women's family doctor. Throughout the process, the community center facilitator helped to coordinate care and provide invaluable psychological support.
When the breast and cervical cancers seminar came to Tranis, Marinela attended, as she did all the seminars, and went to the van for testing, too. Her Pap test indicated Stage 2 mild dysplasia of the cervix. A palpable lump in her left breast was found in her breast exam. Whereas Marinela's family doctor gave her test results, the coordinator of the women's seminars helped with individual counseling to explain the meaning of the tests, provided psychological support, and assisted her with medical visits. The goal was to treat her case within a month. The family doctor referred Marinela to a gynecologist, and two weeks later she had a colposcopy, a procedure that removed and cauterized the affected cervical tissues. The lump in her breast was diagnosed as a benign fibrotic cyst. Her family doctor was in charge of follow-up.
In Romania, the mortality rate for cervical cancer is 10.5 per 1000 women and the highest in Europe. Marinela became a model for other women in her village, where prevention was new concept for rural women, who are usually only able to get to a doctor when very ill. Thanks to RFHI's combination of outreach efforts, this began to change. The community center seminars and their one-on-one counseling sessions with the facilitators (female physicians), were new, innovative, and highly successful ways of reaching rural Romanian women. The women of Tranis learned firsthand how early detection can stop a life-threatening disease in its tracks. Diseases can be prevented and lives can be saved.
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