When her deteriorating vision finally ended in blindness two years ago, Neha Suri’s despair was complete. But just a year later, this lone breadwinner and mother of a teen, found not just a light in the darkness but a higher calling. For the past three months, she has been learning to use her highly developed sense of touch to detect those at risk of breast cancer.
She is now a medical tactile examiner, a job description coined especially for blind women trained to carry out intensive manual checks to detect lumps as small as 0.5cm. She is among the first batch of seven blind women trained over the year to conduct manual check-ups for prevention and early detection of breast cancer.
Starting next week, she will be part of a pilot that seeks to make inclusion of the differently-abled real. Neha will be working with a team of doctors at Fortis Hospital in Vasant Kunj to encourage women to undergo non-invasive preventive check-ups. Trained MTEs use “optimal sensory touch” which involves putting just enough pressure and releasing it with fingers that move from one centimetre to the other covering the entire breast region. The entire process can take anywhere between 35 to 45 minutes.
“Tactile tapes with specific Braille markings are used to define the breast region by dividing it into four parts. The examination involves the breast area, armpits, back and neck region to look for lumps and cysts,” tactile examiner Hasiba Rani, explained. She has examined around 30 women so far during her internship at Medanta super-speciality hospital in Gurgaon. Breast cancer is the most common cancer among women in India. It’s incidence rate is about 24 per 100,000 population. Early detection is key to successful cure and treatment of the dreaded disease.
Hasiba, who lost her eyesight completely when she was 21, said, “It is ironical but I don’t think I would be able to concentrate so much if I could see. At times while doing the examination, I close my eyes as a natural reflex action which people who can see use to focus or concentrate,” she said.
“Mammogram is not effective below 40 years, equivocal in the 40 to 50 age group and most effective after 50 yrs. Also 30% of Indian women have dense breasts not suitable for mammogram.. The only and most suitable option is MTE,” pointed out Dr Mandeep Singh Malhotra, head of department for head, neck and breast oncoplasty at Fortis, Vasant Kunj. He emphasised that manual check-ups by MTE should be seen as complimentary to mammogram and not a substitute.
“The good thing is that a check-up by an MTE can be done for women of all age-groups and at a lower cost. The focus should be on steering younger women towards prevention,” Dr Malhotra added. “If we detect a lump in the breast, we mark the exact point on the tactile grid. We carry out the examination under the doctor’s supervision. The doctor checks the accuracy of our findings and the information supplements the medical diagnosis and treatment,” Hasiba said.
Shalini Khanna, director, Centre for Blind Women of the National Association for the Blind, in Delhi, feels MTEs will fill a vacuum that currently exists in the preventive check-up category. “We will be focussing on reaching out to young women. We will be holding an outreach exercise in Vasant Kunj next week to begin with to tell women they need to choose prevention and in their 20s and 30s not just after they turn 40,” Khanna added.
On how patients respond to the fact that she is unable to see, Hasiba responded with a smile. “Not everyone is willing to put their faith in us immediately. So the doctor explains the process to the patient and then we show them how we will go about it. Most agree and feel comfortable when they undergo the examination. The fact that we cannot see allows them to shed their inhibitions and let us check them,” she said.
Centre for Blind Women started training women to be MTEs last year to empower them professionally and financially. The nine-month course is being conducted in collaboration with German gynaecologist Dr Frank Hoffmann’s project, “Discovering Hands”.
The training has been certified by Rehabilitation Council of Germany. “More than 12,000 successful examinations have been carried out by MTEs in Germany and Austria,” Khanna pointed. The first batch of seven girls who completed their MTE course have been doing an internship with a senior gynaecologist.