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VIA Army: Winning Battles in Nicaragua

VIA Army

Dr. Barinia Osejo (center, looking down) and just a few of the VIA Army

Friday, September 27th

Dr. Barinia Osejo smiles from ear to ear as she addresses the foot soldiers of what she calls the “VIA Army” – a group of local doctors, nurses, medical directors, and community health promoters who are fighting on the front lines of cervical cancer prevention in northern Nicaragua.

It was the ceremonial closing of Grounds for Health’s sixth clinical training and cervical cancer prevention campaign in the department of Madriz. The VIA Army had just completed a three-day campaign that provided screen-and-treat services to over 200 women. Dr Osejo is Grounds for Health’s lead clinical trainer in Nicaragua and like all Nicaraguans of her generation, she has experience going up against a tough opponent. In this case: cervical cancer, which is the number one cause of death among women of reproductive age in Nicaragua, despite the fact that it is one of the simplest cancers to prevent.

Signing women up

Left to right: Cynthia (local volunteer), Karla (Grounds for Health staff) and Zayda (PRODECOOP coordinator) register women for the screening

September is the rainy season, and running water and electricity came and went throughout the week as torrential downpours made their way across the sky accompanied by thunder and lightning. A few women from PRODECOOP’s coffee-growing communities in Las Sabanas and San Lucas ventured down muddy dirt paths to meet the co-op truck that would take them to Somoto, the capital city of Madriz. The Regional Ministry of Health provided transport for women from neighboring communities while others arrived on foot, following community health promoters.

Once inside the clinic, women received additional information about the “rapid test”, as VIA is sometimes called. One community health promoter, armed with the educational materials she had received from Grounds for Health, displayed a picture of three women of different ages.

“The first woman,” she explained, “is happy because she’s young and doesn’t need to worry. It’s the second woman, who is between 30 and 49 who needs screening.”  She then flipped to a drawing of a healthy cervix alongside a cervix with a pre-cancerous lesion. Pointing to the lesion, she explained that if a “white spot” were found, the doctors would freeze it in order to prevent it from becoming cancer. The health promoter explained that there was nothing to fear about the screening and answered questions the woman had.

Explaining the screening

A community health promoter uses the image flip book she received in the Grounds for Health training to explain that “white spots” on the cervix can lead to cancer if untreated.

During the previous training sessions, the health promoters had learned how to use simple language and teaching aids to communicate the importance of cervical cancer screenings and prevention. These materials form the backbone of Grounds for Health’s newly created Community Health Promoter Curriculum, which is now available, and there’s clear evidence that our methods work.

Recently, Madriz was recognized by the Nicaragua National Ministry of Health as a model for other departments for cervical cancer prevention. With the help of Grounds for Health and co-op partners, the local health authorities in Madriz have been able to expand access to cervical cancer screening and treatment services throughout the region, to significantly reduce the waiting list for treatment, and to ensure that all women receive the follow-up care they need.

We salute Dr. Osejo as she marches on with her VIA Army and continues to win battles all over northern Nicaragua through community engagement and successful screening campaigns.


Women waiting for their screening test with their Community Health Promoter (right) at the health center in Somoto.

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