How have you and your organization been impacted by and adapted to COVID-19?

The short answer is it has impacted everyone and everything. Our teammates have lost family members and friends to COVID-19. Most tragically for The Lily Project our esteemed board member and medical director, Dr. Alvaro Garcia, died from the virus after catching while it treating others.

Prior to the pandemic, Lily’s model centered on providing in-person screening and treatment with mobile health clinics traveling to rural communities. With the growth of COVID-19 temporarily grounding Lily’s mobile clinics, we initiated a pilot program to evaluate the potential to deliver sexual health services virtually via mobile phones and WhatsApp. Digital Health Education is delivered to increase women’s understanding of their bodies and encourage actions to improve their sexual health. Telehealth is used to support Lily’s mobile clinics’ delivery of in-person care with appointment setting and personal health reminders. It also makes it possible for The Lily Project to deliver more services and address complex sexual health needs by providing virtual consultations with medical and mental health specialists. Results of the pilot test are extremely positive and we are working toward a future where Lily is delivering essential sexual health services through an integrated in-person and virtual women’s health platform.

What concerns you most about women’s health in low-resource countries during the pandemic? What is your organization doing about it?

The pandemic has had an outsize impact in low-resource countries where basic women’s health women’s services were already limited. This is definitely the case in Nicaragua, which has been experiencing a socio-economic crisis since 2018. With the arrival of COVID-19, the overall availability of women’s health services to prevent and treat disease, including basic medications has declined significantly. In many countries, not just low-resource, violence against women is increasing. Nicaragua is experiencing this with a documented increase in gender violence and femicide.

The Lily Project offers:

• Navigation – We are able to resolve simple problems, such as lack of medication for a vaginal infection, to more complex needs, such as hospital care for late-term miscarriage.
• Virtual care – We are building a network of mental health specialists who provide pro-bono services to women experiencing abuse and trauma.
• Advocacy – We believe the plight of women in Latin America deserves more attention. Armed with Lily’s data and stories of the women it serves, The Lily Project is creating awareness of the needs of these women to encourage others to advance the sexual and reproductive health and rights of women in Nicaragua.

How do you see cervical cancer prevention – the HPV vaccine and screen-and-treat –coming back after the pandemic? What can we do now to prepare for the resumption of services?

Even before the pandemic Nicaragua did not have a national program underway for the HPV vaccine or HPV test – primarily focusing on Pap testing to prevent the disease. We believe this is the likely to continue post-pandemic, at least for the near-term. But when they become available in Nicaragua, The Lily Project plans to become part of the distribution process.

Until the COVID vaccine is widely available, The Lily Project will change its process from large screening and education events that typically would serve 80-100 women per session to scheduled individual screening and treatment appointments. First priority is to serve women on Lily’s ‘watch-list’ – those requiring treatment or are “Pap-positive” and being monitored. Virtual appointment setting and reminders makes Lily’s new in-person delivery model possible. Additionally, sexual health education and interventions to encourage special actions will be delivered virtually.

What is something you have learned during COVID-19 that makes you hopeful?

This pandemic has taught us so much!

For one, we have discovered how important it is to collect and update our data. When COVID-19 started to hit, we realized we still had a way to connect with our 20,000+ clients via phone and Whatsapp. The vast majority of women in rural communities have their own mobile phone and it has become a lifeline.

As the pandemic has progressed, we’ve committed more time to our team’s development. I am so proud of how much genuine empathy and respect each shares with her clients. This translates into a ‘listen-first’ approach and with it clients are opening up and sharing more about their physical, emotional and mental health concerns. No longer are we simply the organization helping them stay cervical cancer free but Lily is now also helping them understand how to be healthy. 

I am full of hope when I realize that the impact we will make in the lives of other women is even greater than before!

Thank you TogetHER for this opportunity to share our story. We admire your work so much and appreciate your interest and support of The Lily Project. Women’s health is in women’s hands!

For more on the Lily Project’s cervical cancer prevention activities in Nicaragua, visit their website at www.thelilyproject.org as well as a recent TogetHER case study.

Interested in reading more TogetHER Interviews with leaders in the global cervical cancer response? Click here for the full list.

Anielka Medina is co-founder and Executive Director of The Lily Project in Nicaragua. Anielka created the project to protect women from cervical cancer, which killed her mother and is a leading cause of death of young women in her country. Anielka is a graduate from the Autonomous University of Nicaragua-Leon (UNAN), where she studied bioanalysis focused on cervical cancer detection. Anielka was trained and certified in VIA and cryotherapy by the foremost educators Dr. Sonia Cabeza & Dr. Alvaro Garcia at Bertha Calderon Hospital in Managua. She is currently responsible for the overall development and delivery of The Lily Project’s strategy in the most at-risk communities of Nicaragua.