For many Filipino women this was the first time they had accessed a women’s health service with the exception of delivering children. I therefore recognised the importance of making the women as comfortable as possible, delivering personal questions in a sensitive manner. Some new patients were nervous, which I related to the first time I had a pap smear. So I endeavoured to explain the procedure simply via an interpreter to alleviate anxiety. In this clinic, like in much of the developing world Dr Charlotte Hespe has adopted the VIA/VILA method of pap smear. A speculum is used to view the cervix and a solution of weak acetic acid is applied to observe changes, iodine is used in addition where further differentiation of cells is required. The wonderful thing for the patients was that they were able to get their results on the spot, a few will return in November to monitor low grade changes while many won’t have to return for two years. Despite the challenges of using a head torch to guide the speculum and dripping with sweat while doing so, working in the women’s clinic with Dr Hespe was an invaluable clinical experience as a first year medical student. There were some educational gaps identified in this population of women. To address these, Team Philippines plan to explore contraception options where patients seek advice, provide fertility education and create a customised women’s health brochure to improve understanding and dispel common myths about pap smears. I have no doubt we will see many of these friendly faces again for their second preventative women’s health check.
Jess Medland (MED 1000, Notre Dame University Sydney)