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A is for Advocacy

USING ALL THE TOOLS IN THE TOOLBOX

From the Desk of
[...] the work (these projects) supported continues to drive change for Sara and her communities – unlocking her infinite potential by allowing her the live a fuller, healthier life.
That is the power of advocacy.

Dear Maverick Collective Community,

It is a pleasure to welcome you to this edition of ISSUE: A is for Advocacy: Using all the Tools in the Toolbox.

With sexual and reproductive rights come under increasing threat around the world, I could not think of a more timely or more appropriate topic to discuss.

Advocacy is an integral, yet often underrated or overlooked piece in the road to progress – especially in medicine and public health. It comes in many shapes and forms, connecting all of the pieces of a project, allowing them to build upon each other to enact change.

In this ISSUE, we explore how two project teams across geography and time, rolled up their sleeves and deployed all the advocacy tools at their disposal – and then some – to tackle one of the more insidious diseases affecting women that might not be top of mind: cervical cancer.

From changing private providers’ perceptions and increasing their comfort with additional approaches to screening  in Uttar Pradesh, to creating lasting partnerships that ensured preventative care continued after the project closeout in Trinidad and Tobago, the work Kathy, Julia, and the projects’ teams supported continues to drive change for Sara and her communities – unlocking her infinite potential by allowing her the live a fuller, healthier life.

That is the power of advocacy.

So, meet and be inspired by the relentless work of these extraordinary teams with Maverick Beat; explore and discover different types of advocacy and their uses in Heart Homework; and then come join me and a powerhouse of guests to discuss how we can learn from one another and our experiences in Master Class!

I cannot wait to see you.

Dr. Eva Lathrop
Global Medical Director, PSI

EPISODE 5 | A IS FOR ADVOCACY

Tune in to Episode 5 of Maverick Beat where, over the course of two segments, we spotlight two projects using all the advocacy tools at hand to prevent and treat cervical cancer Early Detection and Treatment of Cervical Cancer in India and Cervical Cancer Prevention in Trinidad and Tobago. You can explore more in the project pages including Kathy’s and Julia’s “journals,” stories from Sara, photos, and more.You can watch the full episode below or each part separately.

Preventing the Preventable
Cervical cancer afflicts a half million women across the world every year, but it’s most deadly in India. For many Indian women, seeing a doctor is the last resort and an unaffordable luxury. Special correspondent Fred de Sam Lazaro reports.

 

  • 150 private sector providers trained in VIA
  • +145k women aged 30-59 screened
It's an issue around women's health, and it is an issue of justice because it's the women with least resources, it's the countries with the lowest income where most of the women are dying from this disease. Kathy Vizas, Maverick Collective Member

In early 2017, the Government of Uttar Pradesh requested that PSI India serve as technical advisors to integrate cervical cancer screening and pre-cancer treatment into women’s preventive health services offered at district hospitals. This model, known as ‘Sampoorna’ clinics, also offered routine screenings for other non-communicable diseases like blood pressure and glucose checks. These services have now been scaled up throughout 28 districts across the state of Uttar Pradesh.

By the end of the project cycle, close to 150,000 women aged 39-50 had been screened using the visual inspection with acetic acid method (VIA), and over 5,000 women (72% of cases detected) were treated with cryotherapy.

A walk to remember…

The photo is one of Dr. Ruchi and I walking in an alley. This was my second trip to India with the project. I had just arrived in Varanasi, Uttar Pradesh State, India. Dr. Ruchi and I had visited a Sampoorna clinic in a very poor Muslim neighborhood, and we were discussing the project when this picture was taken. This picture is memorable because Dr. Ruchi was such a pivotal part of the success of the project, and I love how it captures us sharing our thoughts on best ways to encourage women to participate.

An unforgettable meeting…

There are a couple of memories of meeting with Indian women which come to mind for me. The first happened in a poor neighborhood in Delhi where we were taken to meet a group of women who were gathering to discuss the issue of cervical cancer. They all knew each other in some way – they were women from the same family, friends, neighbors, etc. They explained that even though cervical cancer is an issue that women do not discuss often, they were all ready to go for screening, and understood the importance of it. They were beautifully dressed, in their brightly colored saris. What stood out in my mind was their clear focus and determination to go for screening. I was also surprised by their awareness of the disease itself, which I often find lacking with my friends and colleagues in the United States.
Another memorable moment for me was attending a screening camp where women came for screening. There, we met two young female gynecologists who were volunteering their time that day to screen women. The event lasted for hours, and they diligently and patiently saw each patient. To me, this was a testament to the value these young doctors saw in this work.

Reading to prepare…

First, I read A Fine Balance by Rohinton Mistry. This sweeping novel tells the story of very low-class tailors as they navigate pre-partition India until the presidency of Indira Ghandi. The author uses their stories to explain the cultural, political and economic changes the country went through during this period.
Behind the Beautiful Forevers by Katherine Boo. It is challenging to summarize the impact that this book has on a reader. It tells the stories of many families living in one of the poorest and largest slums in Mumbai and highlights the challenges facing modern day India.
Third, The Last Mughal by William Dalrymple. This historical account tells the story of the Sepoy Rebellion of 1857 and the transition from governance from the East India Company to the British Crown as well as the downfall of the Last Mughal, Zafar.

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An Intergenerational Approach
Malea had asked for the HPV vaccine at her local health center, but had heard they were out, and was calling to inquire where she could receive the vaccine.

HOW A NATIONAL COMMUNICATIONS CAMPAIGN IS DRIVING DEMAND FOR THE HPV VACCINE

By PSI Caribbean

At the start of December, we received a call at the office from a woman named Malea who had seen our vaccination ad on TV.  She had asked for the HPV vaccine at her local health center, but had heard they were out, and was calling to inquire where she could receive the vaccine.

PSI Caribbean took down her information, and upon contacting a few health centers, discovered they were in fact out of the vaccine. The team was able to reach out to the Expanded Program on Immunization (EPI) unit and obtain an update as to when new vaccines were expected to be at the health centers.

When the team followed up with Malea to let her know when her health center would receive their supply, she then proceeded to ask questions about HPV DNA testing. She was able receive information about this type of testing and learned where in the private health sector she could access the test. She also about screening more broadly. Malea left the call super motivated to get screened and where to receive screening – all due to that one TV ad.

PSI Caribbean

  • ^33% increased screenings for cervical cancer
  • 92 providers trained in cervical cancer care and treatment
(The project's) impact on me, both as a funder but also as a human being, will continue to play out and reveal themselves to me in years to come. Julia Lourie, Maverick Collective Member

Overcoming the Barriers to HPV Vaccination and Screening for Cervical Cancer

Trinidad has one of the highest cancer mortality rates in the Caribbean. Over 549,000 women over the age of 15 are at risk of developing cervical cancer in Trinidad. It is the most frequent cancer among women aged 15-44 and the second leading cause of cancer death, after breast cancer. Despite being a highly preventable and treatable disease.

This project worked to prevent unnecessary deaths and illness resulting from cervical cancer by taking a life cycle approach: offering preventative care through the vaccine before instances of cancer become likely, while bolstering the capacity and quality of screening and treatment options for mature women.

A fascinating moment…

On one trip down to Trinidad and Tobago, at the time I was taking oral hormonal birth control and I totally forgot my pack! I was able to go to a normal pharmacy and just get over the counter for $5 a pack of birth control. And I called my OB-GYN. I said, “Is this compatible? Is this similar dosage?” And she said, “Yes.” That would not have been possible at home.

Not always glamorous…

There’s the hi-fi stuff with the lo-fi stuff. On one side, we had this global health NGO with over 50 years of experience called PSI behind us, and we have experts on experts and such a deep bench of resources and partnership. And on the other, there are moments when we’re cutting out pictures from magazines to make collages to talk about what we think the storyline should be like. And that’s very humanizing.

A force for good…

Wendy and Paige have really made it their mission to bring awareness about cervical cancer to Trinidad and to the region and help prevent it. To see the advocacy efforts of Wendy and Paige and joining forces with ASDF, it was pretty serendipitous. And for me, very, very meaningful.

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A is for Advocacy

From influencing policy to intimate conversations with friends, advocacy is an important tool to change opinions and create an enabling environment for change.Join us to examine how experts are using all the tools in their toolbox to advocate for necessary change for increased prevention and treatment of cervical cancer at every level of influence, and how you can do the same for the issues that are near and dear to you.

In this Master Class you will learn:

  • The difference between “big A” and “little a” advocacy, and their roles promoting change;
  • The formal and informal ways in which women advocate for the issues they are passionate about;
  • The importance of advocacy at all levels of influence when tackling challenging global health issues like cervical cancer.

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Dr. Ruchi Pathak

Lead Medical Officer, Center for Cancer and Epidemiology

Dr. Ruchi Pathak is a practicing obstetrician and gynecologist, and a leading researcher and advocate in the elimination of cervical cancer in India.

Dr. Pathak is the master trainer of the Government of Madhya Pradesh’s Cervical Cancer Prevention Program, a governing council member of the Indian Society of Colposcopy and Cervical Pathology (ISCCP) and works closely with academic institutions advancing research and innovation in cervical cancer.

Dr. Pathak is currently lending her expertise to various projects including preventive oncology in Mumbai, and a multinational AI integration in cervical cancer screening. She has worked extensively with WHO, contributing to publications and leading trainings throughout Southeast Asia.

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GEORGE PHILIP

Chief of Party and State Lead, Project Concern International (India)

George has had a career in public health, spanning over two decades; effectively leading large and diverse teams to provide techno managerial support for government health, nutrition and sanitation programs; in multi-year projects supported by international donors.

His multifaceted expertise extends from strategic purchase of health services to adolescent sexual and reproductive health, polio eradication, and emergency public health response, to list a few.

George credits his Masters in Population Sciences and M.Phil, with specialization in public health, from International Institute for Population Sciences (IIPS) as having contributed greatly in his professional achievements.

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MUKESH SHARMA

Executive Director, PSI India

Mukesh is a multi-faceted professional with strong expertise in program management, knowledge management and organizational development.

He possesses a wealth of knowledge on reproductive health, urban health and maternal and child health issues and is a much-acclaimed Urban Health specialist.

In his 20-year professional journey, he has worked with several renowned organizations such as FHI360 under Urban Health Initiative project, Urban Health Resource Centre and CARE international.

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KATHY VIZAS

Maverick Collective Member

Kathy Vizas co-founded TogetHER for Health with Celina Schocken in 2017. As a Founding Member of the Maverick Collective, Ms. Vizas worked in India to develop a PSI-led cervical cancer screening program.

While pleased to be supporting women in India, Ms. Vizas felt frustrated by the extremely low levels of support she saw globally for the fight against cervical cancer and felt motivated to examine the root problems – a lack of funding and knowledge about the disease. And ultimately, TogetHER was born.

Prior to her work as an advocate for global health, Ms. Vizas practiced law for more than 20 years in law firms and corporations.

She serves on the San Francisco Committee of Human Rights Watch, the Board of the Human Trafficking Legal Center, and the Board of Trustees at Bucknell University. She also recently completed a 6-year term as Board Chair for Spring Impact, Inc., which works to support social sector organizations to scale their impact.

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MOIRA LINDSAY

Executive Director, PSI Caribbean

Moira Lindsay is the former Executive Director of PSI-Caribbean. She worked with PSI-Caribbean for the past decade and is passionate about increasing access to health services to more persons in the Caribbean region.

Throughout this project, Moira led the country team and worked in close collaboration with the Ministry of Health to increase prevention by supporting and boosting the HPV vaccination efforts and by offering new technologies while strengthening the existing screening services. She worked closely with partners from local business to NGOs that are passionate and committed to working together to reduce the prevalence of cervical cancer in Trinidad and Tobago, to make sure the work continued after the project ended.

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JULIA LOURIE

Maverick Collective Member

Julia Lourie is a 200 RYT certified yoga teacher who is currently pursuing further training and accreditation in Yoga Therapy, rooted within the teachings of Non-Dualist Shaiva Tantra yoga, while also applying to graduate programs focusing on Human Consciousness and Spirituality.

She previously worked at the Bard Prison Initiative (BPI), a program of Bard College that opens access to high-quality college opportunity to people incarcerated in New York State prisons, and which supports returning citizens with Reentry and Continuing Education services. She also has extensive experience in exhibition production and studio assistant work with various contemporary arts organizations and artists, including Hauser + Wirth, Creative Time, Alicia Framis, and more. Lourie serves on the board of directors of ARRAY Alliance and Hivewild contemporary dance company.

She holds a BS with Honors from NYU Steinhardt in Media, Culture, and Communication.

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DR. ROOPA DHATT

Executive Director (Observer), Women in Global Health

Dr. Roopa Dhatt is a passionate advocate for gender equality in global health and a leading voice in the movement to correct the gender imbalance in global health leadership. Determined to build a movement to transform women’s leadership opportunities in health, Dr. Dhatt co-founded Women in Global Health (WGH) in 2015 to challenge power and privilege for gender equity in health by mobilizing a diverse group of emerging women health leaders, by advocating existing global health leaders to commit to transforming their institutions, and by holding these leaders to account. With more than 15 chapters worldwide, WGH is changing the conversation about women’s leadership in health at global, national, and local levels.Dr. Dhatt is particularly committed to addressing issues of power, privilege, and intersectionality that keep many women from global health leadership roles and to opening spaces for the voices of these women to be heard. She is a practicing primary care physician in Washington D.C.

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DR. ISABEL C. SCARINCI

Associate Director for Globalization and Cancer, University of Alabama at Birmingham

Dr. Scarinci is a behavioral scientist with a deep commitment to the elimination of cancer disparities in the US and in low- and middle-income countries. The focus of her work is on the application of behavioral science to public health by promoting behavior change at the population level.Her primary area of interest is cancer prevention and control among low-income, racial/ethnic minorities, and immigrant populations – particularly Latinos and African Americans. She is particularly interested in the development, implementation, and evaluation of community-based programs that are theory based and culturally relevant to underserved populations in the U.S. and abroad.Dr. Scarinci is also very dedicated to community service. One example of her community work is a 10-year program to promote breast and cervical cancer screening among Latina immigrants in Alabama that relies 100% on the work of committed volunteers – Sowing the Seeds of Health. She is currently the Honorary Consul of Brazil to Alabama.

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DR. EVA LATHROP

Global Medical Director, PSI

Dr. Eva Lathrop is the Global Medical Director for PSI, where she oversees a service delivery portfolio that spans over 30 countries and focuses on sexual and reproductive health, legal abortion and post-abortion care, and cervical cancer work. She also works to evolve PSI’s quality approach within primary health care.Dr. Lathrop has over 20 years of experience in clinical care, teaching, research, and practice in global reproductive health. Her clinical and research interests include increasing access to contraception, legal abortion and post-abortion care in low-resource settings, restricted settings and in the context of complex emergencies. Most recently, Dr. Lathrop served as an Associate Professor of Gynecology and Obstetrics and Global Health at Emory University’s Schools of Medicine and Public Health. She credits her years as a Peace Corps volunteer in Malawi (1992-1994) as her inspiration for pursuing a career in medicine and public health.