During my work at the Welcome Center Medical Clinic, I would often guide newly arrived refugees through their first medical visit in Canada. During these visits, as part of a routine exam, I would ask women about PAP smears. In my 2 months of work at the clinic, I believe no more that 2-3 patients knew what I was talking about. At first, I thought this was due in part to a language barrier. However, I quickly realized most never had a women’s exam, and were scared of the notion because of it.
Physicians at the clinic held weekly group visits where various topics were explained. When women’s health was discussed, they explained every detail of a women’s exam, and the patients listened avidly to every word. There was an obvious patient interest, so I decided to look into the issue further to assess the need for improving women’s health promotion.
Looking at data in the Middle East, as most patients were from Syria or Iraq, I saw that national cervical cancer screening programs were virtually absent in most countries. Data was therefore lacking, but the few data collected on the IHME (Institute for Health Metrics and Evaluation) showed that aside from Iran, every other country in the Middle East and North Africa saw an annual increase in cervical cancers deaths from 1980 vs 2010. I noted that the highest increase was in Iraq. http://www.healthdata.org/sites/default/files/files/policy_report/2011/TheChallengeAhead/IHME_ChallengeAhead_RegionalOverviews.pdf
I encountered several Iraqis every day in the clinic.
And so, there is a need and an interest in learning. I attempted to explain PAP smears in detail and reassure patients during my clinics, but this wasn’t possible most of the time, as women would usually come with their children or had other issues to discuss. I attempted to find online resources I could print out, but none were comprehensive enough.
I therefore decided to create a very detailed and simple patient handout explaining PAP smears. I had it translated in Arabic, and left copies in every room of the clinic.