In preparation for CP Nepal’s massive sickle cell disease (SCD) screening program scheduled for the next day, our agenda consisted of two important tasks: a training session for Female Community Health Volunteers (FCHVs) and a forum theatre!
The FCHV program was initially
created to promote and improve access to contraception. Decades later, the program has quickly grown and these women now play important roles in implementing many community-based maternal and child health programs – including sickle cell disease screening! To prepare for screening day, CP Nepal scheduled a comprehensive training session for these volunteers, covering topics such as transmission, symptomatology, screening, diagnosis and treatment. They emphasized the importance of screening for Tharu people, due to the high prevalence of disease in this population as well as the dangers of being undiagnosed and therefore untreated. As we observed the teaching session, we noticed that the FCHVs were taking quite an interest in us! They were curious to hear about our backgrounds and how we came to be involved with our project.
The training ended with a menstrual cup tutorial from us! We were ecstatic to see how open the women were to learning how to use the menstrual cups and how quickly they picked up the instructions! It was interesting to compare this experience to just this morning when we had taught the same material to a group of younger girls. Although decades of life separated the two groups of students, the FCHVs approached the learning with the same eagerness and determination as the young girls!
Next, we made our way to the community forum theatre where a stage had been set for CP Nepal’s play to increase awareness and knowledge about SCD. When we arrived, many members of the community had already gathered around the stage in anticipation of our performance. This was admittedly a little nerve-wracking given our less-than-stellar grasp of our Tharu lines. But our audience didn’t seem to mind and in fact found it quite hilarious as we stumbled our way through our parts. Perhaps they were taking pity on us after witnessing our attempts at dancing to a popular Nepali song during the opening of the show.
Both the play and the FCHV visit served to spread awareness about SCD screening
and the no-cost testing that was taking place at the health post the next day. CP Nepal’s methods proved to work very well! Over 300 people arrived for screening, and the line spanned the entire health post. Of those screened, 13 tested positive for SCD. Dinesh (Director of CP Nepal) took us to meet with one woman who was found to have SCD, and she described the painful symptoms she was experiencing. We could even see some of the outward manifestations of the disease, including jaundice in her eyes. She was very grateful to finally have an answer to her health concerns and to know that there was a plan in place going forward.
Though our team is not specifically involved with SCD, it is important for us to understand the community we are working with and the concerns they have. In fact, our Adolescent Reproductive and Sexual Health project was actually started by a previous SCD team who had identified a need in the community! It was incredible to see so many individuals come together, all with the goal of improving the health of their community!