Saving Mothers

The HPV vaccine Gardasil has been controversial ever since it received FDA approval back in 2006 for the prevention of certain strains* of the human papilloma virus (HPV) in women. Since the vaccine doesn’t work against existing infections, the FDA recommended that Gardasil be administered to girls around the age of 11 or 12, before the onset of puberty and sexual activity.

The recommendation that young girls be given a vaccine to present sexually transmitted diseases was hailed as a triumph of science by some and as a dangerous and unneccessary intervention by others. In recent weeks, the controversy has bubbled up again in the Republican Presidential Debates, with Texas Governor Rick Perry receiving criticism for mandating the HPV vaccination for young girls in Texas and Rep. Michele Bachmann claiming that the vaccine could cause mental retardation.

Examining the various responses to the use of the HPV vaccine in girls is an interesting study of peoples’ discomfort with vaccines, their lack of trust in medical science, and the continued stigmatization of sexually transmitted diseases. Ms. Bachmann’s claim that the HPV vaccine can cause mental impairments in children is patently false, but the fact that she would make such a statement speaks strongly to the fears that many people have when it comes to vaccinating their children. There is also the undercurrent of fear that giving girls this vaccine may in some way encourage them to engage in promiscuous sexual activity.

Which brings us to now. In recent days, the CDC has come out with the strong recommendation that pre-pubescent boys also receive the HPV vaccine, as the vaccine is also effective in preventing HPV infection in males. We here at Saving Mothers are curious to see the public reaction to this new recommendation. Will people respond the same way they have responded to the recommendation that girls receive the vaccine? Or will the reaction be different when it comes to administering the HPV vaccine to boys?

Feel free to write in and share your thoughts with us. We’re always curious to hear what our readers have to say. What are your thoughts on childhood vaccinations? Is the HPV vaccine something you would want for your own children?

*Strains 6, 11, 16 & 18 are prevented by the vaccine. Strains 16 and 18 are responsible for approximately 70% of cervical cancers in women and strains 6 and 11 are responsible for 90% of genital wart cases.

I love the New York Times’ Small Fixes section. Touted as “A special section on low-cost innovations that can save thousands of lives” it takes on everything from biodegradable toilets used to turn waste into fertilizer in the developing world to providing mother-baby packs to HIV-positive pregnant women. I find it endlessly fascinating to read about creative and inexpensive methods that people have thought up to address various global health issues.

Several of the articles in this series focus on providing better care to women and children, and I encourage you to take a few minutes to read through some of them (I was particularly interested in this one and this one). It’s wonderful to read about the various methods that are being used in these different health scenarios- what you come to realize is how many steps there are in trying to create and implement these types of “small fixes.”

Even if the concept behind many of them seems simple or obvious, the work and ongoing education that it takes to get these projects off the ground is considerable. I’m always so impressed by people who have the creativity and the endurance to make these projects happen.

Readers, do you have any examples of great “Small Fixes” related to maternal and child health you’d like to share here on Saving Mothers? I’d be very curious. Feel free to share comments here or email us at information@savingmothers.org

Happy Tuesday everyone!

This week, we have a guest post from Alexis Tran, a third year ob-gyn resident who’s volunteering with Saving Mothers in Guatemala. Alexis will be sharing the details of her experiences in Santiago Atitlan with us in a series of posts.

Five Days in Santiago Atitlan   

The days unfold slowly.  My walk through the highlands to the Hospitalito calms me as I pass local women, children, animals, and men on foot, in trucks, on buses or red-colored tuk-tuks. “Buenos Dias” resonates; a smile quickly establishes familiarity.   The sounds of morning remind me I am among new neighbors: roosters crowing, trucks passing, rainfall and distant morning chants. The sun behind the clouds hovering over the peaks of San Pedro welcome me into the warmth of the day.

At the Hospitalito, women crowd the prenatal and gynecology clinics clad in their traditional indigenous dress — waiting.  My first day, I was glad to help perform a cesarean section on a multiparous patient with a history of a previous cesarean section.  This is the first cesarean section performed here in months. The operating rooms are beautiful, well-lit, and the staff is dedicated. Hospitalito primarily serves the families here. The next closest hospital is nearly an hour by car, an untimely distance for a labor and delivery ward.

That same evening, a woman returned to the Hospitalito for retained placenta following a home birth by a comadrona nearly three weeks ago. She complained of persistent abdominal pain, foul smelling discharge and bleeding. Following confirmation with a bedside ultrasound, I performed a dilation and suction curettage for her that evening in the OR. She recovered well. I am grateful for the opportunity to use my training to serve a woman in her time of need.

My first week in Santiago Atitlan is teaching me to walk at a new pace. I realize too  when I see my patients in clinic that whether in English, in Spanish, or in Tzutuhil, Mayan women of Santiago Atitlan share similar health concerns as women everywhere.