Nah, ini contoh lagi buat Karma I Nengah. Bagaimana negeri yang terus diblokade
sejak lahirnya sampai sekarang, kok bisa memberi layanan kesehatan gratis
kepada rakyatnya dan ilmu kedokterannya berkembang sampai mampu melahirkan
berbagai macam obat baru dan vaksin??? Gimana Indonesia yang sudah merdeka
lebih dulu dari pada Kuba dan sudah lebih dari 40 tahun, sejak Suharto,
bersandar pada modal asing, kok tidak bisa memberi layanan kesehatan gratis
kepada rakyatnya? Bukan hanya Indonesia, semua negeri dunia ketiga yang
bersandar pada modal asing, tak mampu memberi rakyatnya layanan kesehatan...
Coba anda jawab ini!
On Saturday, May 12, 2018 11:20 AM, "Sunny ambon ilmeseng...@gmail.com
[GELORA45]" <GELORA45@yahoogroups.com> wrote:
http://en.granma.cu/cuba/2018-05-09/prevention-is-better-than-cure
CERVICAL CANCER
Prevention is better than cure
In Cuba, women’s gynecological healthcare is fully guaranteed,Dr. Ana Margarita
Solares Asteasuanizarra, a member of the CubanSociety of Obstetrics and
Gynecology, and Assistant Professor atHavana’s University of Medical Sciences,
told Granma InternationalAuthor: Nuria BarbosaLeón | internet@granma.cumay 9,
2018 15:05:18Testkit produced by Cuba’s Immunoassay Center and distributed
acrossthe country’s network of community clinics. Photo: YaimíRavelo In Cuba,
women’s gynecological healthcare is fully guaranteed,Dr. Ana Margarita Solares
Asteasuanizarra, a member of the CubanSociety of Obstetrics and Gynecology, and
Assistant Professor atHavana’s University of Medical Sciences, told
GranmaInternational.She explained that there is a national structure is this
regard,based on primary care in health institutions at the local level,which
guarantee prevention, education and awareness actions aimed atwomen and their
families. The Federation of Cuban Women and othermass organizations are linked
to this work to provide preventiveknowledge about personal care and signs one
should see a doctor.“Cervical cancer is a preventable disease,” the second
gradespecialist in Gynecology and Obstetrics continued. It can be
detectedthrough regular cervical cytology tests (better known as Pap
smears),that women should undergo every three years from the age of 25through
to 64.According to global data, it is estimated that 466,000 new casesof
cervical cancer are diagnosed each year, and 231,000 women diefrom it annually,
of which more than 80% of deaths occur indeveloping countries. In Latin America
and the Caribbean, there arean estimated 68,000 new cases reported every
year.Dr. Solares, who is also Havana provincial head of cervix
disorderconsultations and chairperson of the colposcopy and lower genitaltract
diseases committee, highlighted the efforts of the Cuban stateto ensure the
necessary equipment and technologies are available ineach family doctor’s
office and local health institution, to carryout cervical screening tests on
one hundred percent of Cuban women inthe aforementioned age
range.“Unfortunately, 30% of women do not come for a Pap test. Simply,women at
risk of suffering from this cancer are asymptomatic, and atan age in which they
are developing socially, intellectually andprofessionally. So they don’t go to
the doctor of their ownaccord,” explained Dr. Solares, who also holds a Master
of Sciencein Contemporary Biotechnology Trends.Awareness on the importance of
visiting the doctor as apreventative measure is still something that needs to
be addressed,the specialist noted. Although records are held regarding
thelocation of at risk women, and they are advised of when they shouldhave a
Pap test done, there are a large number of cases of changes ofaddress, even
from one province to another, which are not reported toauthorities.Papsmears
are performed in all family doctor and nurses’ officesacross the country.
Photo: Nuria Barbosa “In this age range, women have an active sex life, not
alwayswith the same partner, and sometimes without using protection
againstsexually transmitted diseases. There is the possibility of beinginfected
with viruses with oncogenic risks such as humanpapillomavirus (HPV), which can
cause changes in the cells of thecervix, vagina, vulva and anal area. In
addition, we know thatmenarche and physiological development in girls occurs at
an earlyage, and they also become sexual active early. If we add drug
habits,the consumption of alcoholic beverages, nutritional disorders and alack
of physical exercise, all this favors the development ofneoplasms in the female
genital organs, as the immune system isweakened,” Dr. Solares added.Immediately
after receiving test results confirming anyabnormalities, patients are referred
to secondary or tertiary levelhealth institutions, where cervix disorder
consultations are held,although these cases are also followed by their family
doctor.According to the diagnosis, patients attend regular consultations orare
referred to research institutes for further treatments. If anadolescent is
suspected of having a cervix disorder, a Pap test isundertaken and their case
is closely followed.TIMELY MEDICAL CARECuba has 46 cervical disorder
consultation services throughout theisland’s 168 municipalities, providing full
coverage. All arestaffed with highly qualified and trained professionals to
providecare for any condition. High-tech equipment has been installed toensure
accurate diagnoses for quick decision making regardingtreatment.When the
results of a Pap test come back positive, the patient isinformed and given an
appointment with a gynecologist in the shortestpossible time (within 30 days).
A clinical record is put together,patients provide their informed consent
regarding any tests andtreatments that they may require, and they are evaluated
with acomplete gynecological clinical examination, including a colposcopy,to
confirm the diagnosis. Patients are also informed as to the doctorwho will be
following their case, and of the possibility ofconsulting with other
specialists.A program is then prepared to provide specialized care for
thepatient and their families, which is institutionally evaluated withtrained
professionals, Dr. Solares noted, highlighting that Cubaspends considerable
resources on treatment, and all services areoffered free of charge to the
population.She explained that some developed nations such as Australia
andItaly, among others, have changed their cervical screening process,with
samples now tested for HPV first, instead of the traditionalcytology test.
However, it would currently be very expensive for Cubato introduce this test
for one hundred percent of its femalepopulation.“Today efforts are being made
to corroborate the specificity andsensitivity of the results of cytology
testing through the HPV test.We are aiming for this type of more specialized
test to be conductedat least once from the age of 30, as a check associated
with thecytology test, because we have been evaluating feasibility
anddiagnostic predictive values, but we still don’t have all theresources,” she
added.“I think we have a good program according to what is practicedin the
world. It just needs to be fully complied with. Today thisdisease appears in
Cuba in women between the ages of 30 and 40, whilea decade ago it appeared
after 45. Cervical cancer mortality exceeds450 Cuban women per year, which
positions us with a mortality rateper 100,000 of between 8 and 8.5, and
rising,” the gynecologistexplained, noting that she finds this data concerning
given the stateguaranteed healthcare available to everyone.TESTING AND
CONSULTATIONSGraduate Nurse Ana Teresa Díaz Piñeiro performs the Pap test
forwomen who belong to clinic 3-4 of the Marcio Manduley polyclinic, inthe
municipality of Centro Habana. She records the women in her areawho must attend
a consultation during the year, and she reminds thempersonally, through a
family member or through neighborhoodorganizations.
The simple procedure only takes a few minutes andsamples are sent to the
nearest maternity hospital for processing.The result arrives in about 15 days
and if positive, it isaccompanied by a scheduled appointment with a
specialist.Both interviewees emphasized the need for increased awarenessamong
women about the importance of regular screening and theirresponsibility to
comply with the established guidelines to ensuretheir own health.
•••••Cervical cancer arises from malignant
neoplasms that develop inthe lower fibromuscular portion of the uterus
(cervix).Cervical cancer risk factors are related to lifestyle and thepresence
of other diseases, and include:
1. Having several sexual partners
2. Living with amale partner who has several present or past sexual partners
3. Becoming sexually active at a young age
4. Having many pregnancies
5. Persistent infectionwith human papillomavirus (HPV) or other STDs
6. A weak immune system
7. Long-term use of oralcontraceptives
8. Toxic habits (smoking, drugsand alcohol)
Levels of cell abnormality
CIN(cervical intraepithelial neoplasia, or dysplasia)
CIN I:Dysplasia (abnormal cells) is only observed in the lower third of
theepithelium. In most cases, these cell changes return to normal overtwo
years, but 10% progress to a higher grade CIN.CIN II: There is dysplasia in the
lower twothirds of the epithelium.CIN III: The epithelium is dysplastic in
itsentirety. This is also called “carcinoma in situ.” In most cases,cells do
not return to normal if untreated, and in 10% of cases, thisprogresses after
two years to become an invasive cervicalcarcinoma..SymptomsWomen with
pre-cancers or early-stage cervical cancers usuallyhave no symptoms. The
symptoms often do not start until aprecancerous condition becomes an invasive
cancer and grows into theadjacent tissue.Symptoms of cervical cancer can
include abnormal vaginal bleeding,such as bleeding after having intercourse,
bleeding after menopause,bleeding and spotting between periods, and
menstruation that lastslonger or is heavier. Bleeding after a pelvic exam is a
commonsymptom of cervical cancer, but not of precancerous conditions.Other
symptoms are an unusual vaginal discharge (the discharge maycontain some blood
and may occur between your periods or aftermenopause), and pain during sexual
intercourse.
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