Breast cancer is currently the most common cancer among women in Romania and in the world. At least 3,000 Romanian women died from breast cancer in 2002, and more than 6,000 new cases were diagnosed. Furthermore, the mortality rate for cervical cancer in Romania is the highest in Europe - 10.5 per 1000 women. Although early detection increases survival, approximately half of women do not seek medical attention until their cancer has become advanced. Unfortunately, prevention is a new concept in Romanian health care, especially among villagers who normally see a doctor only when they are already very ill.

Marinela Pascalau, 40, lives in a remote rural area in Poieni, Romania with her husband and three children. Her house has no electricity or running water, and she must walk five km down the winding path of a mountain to reach the closest village. She heard that USAID was sponsoring health sessions at the women’s community center through the Romanian Family Health Initiative (RFHI) and wanted to attend. The seminars are held monthly on Sundays after church (the most convenient time for the women in the area).

USAID, working with RFHI, is helping to increase the availability and utilization of high-quality, client-oriented services at the primary health care level, and to assure sustainability of reproductive health services throughout Romania. Family doctors are contacted by RFHI to set up a village meeting to inform the community about cervical and breast cancer. After testing is completed, the tests are processed at the Oncology Institute and the results sent to the women’s family doctors. Along the way, the community center facilitator helps coordinate care and provide invaluable emotional support.

Marinela’s results were sent to her family doctor. The coordinator of the women’s seminars helped with one-to-one counseling to explain the meaning of the tests, provide psychological support, and assist Marinela with her medical visits. The goal was to treat the case within a month. The family doctor referred Marinela to a gynecologist, and two weeks later, she had a colcoscopy to remove the affected cervical tissues. The lump in her breast was diagnosed as a benign fibrotic cyst. Her family doctor continues to monitor her.

Marinela became a model for other women in her village to emulate. Many women, like Marinela, never miss a session. RFHI is working to increase the availability of health information and to empower rural Romanians to seek the services they need. Such community center seminars, combined with one-to-one counseling sessions provided by female physicians, are a new and innovative approach that has proved highly successful.