Visually impaired women in Colombia are using their enhanced sense of feel to improve early breast cancer detection

As a child, Francia Papamija started progressively losing her eyesight due to a retinal detachment. Today, everything is darkness for the 36-year-old – except for the job she holds in a clinic in Cali, Colombia, where she contributes to the early detection of breast cancer.

Papamija is a medical tactile examiner (MTE), a role created especially for women who are blind and have higher sensitivity in their fingertips.

According to Dr Frank Hoffmann, a gynaecologist, who created Discovering Hands to improve early detection, visually impaired women can detect about 30% more tissue alterations than doctors. Moreover, those changes can be 50% smaller than those usually identified by medics.

Papamija sees about 10 women a day in her consulting room at La Rivera health centre. She believes it’s easier for her as a blind woman to create a more relaxed atmosphere with patients “because they feel less nervous to talk openly about sensitive issues”.

Using her fingertips, Papamija explores a woman’s breasts, underarms and neck during a 45-minute examination. She is guided by five adhesive strips marked in braille, so wherever she finds a lump she can report to the doctor its exact location. No centimetre will be ignored.

If she detects any lumps, Papamija will arrange an appointment with the doctor – she doesn’t make a diagnosis - to arrange more tests.

Papamija is one of three visually impaired women who have been working as MTEs across several health centres in Cali, in Colombia’s south-west, for the past two years. Training to become a professional examiner takes nine months. They are currently the only MTEs in the country, where their work is supported by the Development Bank of Latin America. Mexico recently launched a similar scheme.

Facebook Twitter Pinterest Francia Papamija examines the breast of a patient at La Rivera health centre. Photograph: Elena del Estal

“They [MTEs] have this gift in their fingers. If they are trained, their disability can become a talent, a strength, and can be used for helping other people,” says Dr Luis Alberto Olave, the surgeon who coordinates the project. “Nodules are the first cancer symptom. The faster we find them, the faster we will have any impact on the projection of the illness, and that may mean saving lives.”

Globally, more than 2 million women are diagnosed with breast cancer each year, according to the World Health Organization. In 2018, 627,000 women died.

In Colombia more than 8,000 new cases are diagnosed each year. Experts say death rates from the disease are rising, because many new cases are diagnosed too late.

“Our breast cancer rates are not so high as in developed countries but we have a huge disadvantage: we are failing on early detection,” says Olave, who wants the MTE programme to be rolled out countrywide.

Preventive mammography is still the best screening method, but it is expensive and only offered to women over 50, even though cases of breast cancer in younger women are growing.

“The exhaustive scans performed by blind examiners are available to all women who come for the pap test and those are not replacing mammograms, they are only supplementary,” says Paubla Lucumi, chief nurse of the breast cancer programme at La Rivera. “Although many women come without any symptom, these tests serve a useful educational purpose as here girls begin to learn about how important self-care is around breast cancer.”

Facebook Twitter Pinterest Leidy Garica calls her next patient into her consulting room in the Meléndez health centre in Cali. Photograph: Elena del Estal

Every day the Meléndez clinic in southern Cali is full of women waiting to be seen by Leidy Garcia, 27, a visually impaired examiner who has examined more than 2,500 patients. After suffering a cerebral thrombosis eight years ago, she can no longer see through her left eye and is only able to make out blurred shapes through the right one.

Losing her sight was traumatic, says Garcia, but working as an MTE has been empowering: “This job gives me huge self-confidence. Now I feel free, independent and useful. I can contribute to the community.

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“For people with disabilities, it’s so hard to find a job because of bias and boundaries inside companies, so this is a great opportunity based in our talent. It’s also a good way to change the mindset of society, which usually patronises blind people, thinking we are not able to do many things,” she says.

Garcia believes that because of her work people now see her for what she does, not for what she lacks.

She appreciates how this has started to change in her own patients, such as Maria*, who did not hesitate when her gynaecologist offered her a breast examination by an MTE. “Her blindness is not a problem: every single person has abilities. It doesn’t matter which disabilities she has. If she knows how to do this, and she does even better, is great for all of us.”

*Name has been changed

This story is part of the project “A Light in Darkness”, funded by the European Journalism Centre via its Innovation in Development reporting grant programme