The following was written by: Gena Macasinag, Field Coordinator (Carles)
Cervical cancer continues to be a major public health concern in the Philippines, particularly in Geographical Isolated and Disadvantage Areas such as the island barangays of Carles. Limited access to healthcare services, transportation challenges and low awareness contribute to delayed diagnosis and poor health outcomes among women in these communities.
Municipality of Carles was fortunately to be selected together with Lemery and Estancia as one of the recipient communities of the HPV DNA testing program initiated by the Cancer Warriors Foundation Inc. This opportunity significantly enhanced the municipality’s capacity to provide accessible and effective cervical cancer screening services, particularly for women residing in geographically isolated and disadvantaged areas.
To operationalize the program, the Cancer Warriors Foundation Inc. Headed by the CEO Ma’am Carmen V. Auste collaborated with Department of Health, Provincial Health Office, Western Visayas Medical Center, Local Government Unit of Carles, Municipal Health Office and support from international partners such as Expertise France and Unitaid. These partnerships enabled the provision of technical expertise, training of healthcare workers, procurement of testing kits and thermal ablation machine for treatment and strengthening of referral systems.
The implementation of the program in Carles marked an important step towards strengthening local health services through the introduction of innovative screening technology. It enabled early detection of high-risk HPV infections and improved referral systems for timely management and treatment. The program ensured that even women in remote island barangays were reached. This initiative contributed to reducing health disparities and advancing the goal of cervical cancer elimination in underserved communities.
A key feature of the program was the introduction of self-sampling for HPV DNA testing, which significantly improved participation among women, especially in remote barangays like CALAGNAAN and BINULUANGAN group of islands, GIGANTES NORTE AND SUR and SICOGON ISLAND where cultural barriers and access issues often limit facility-based screening. In partnership with Western Visayas Medical Center where samples collected sent and processed. Iscerv do the sending results and our medical specialist systematically communicated to patients with appropriate counselling.
Under the leadership of Mayor Arnold Betita II and Dr. Ronald Betita, the Carles PCF provides direction, technical guidance, and supervision in HPV DNA screening. The medical team ensures that the program properly executed and monitored.
The Local Government Unit of Carles serves as a strong pillar of support by providing necessary resources. Their commitment enables the health sector to carry out the program efficiently.
Barangay officials play a crucial role at the grassroots level. They demonstrate their commitment through active participation in planning and coordination. They work closely with the Rural Health Unit (RHU), midwives, Barangay Health Workers (BHWs), and other stakeholders to organize schedules, identify target populations, and prepare the community for screening. Their influence and authority help build trust, making community members more receptive to the program. They also provide logistical and operational support. This includes preparing venues, ensuring order during activities, and assisting in the overall flow of the screening process. In some cases, they help facilitate transportation especially in the islands and ensure the safety and convenience of both health workers and participants. Their leadership ensures that activities are well-coordinated and accessible to all eligible women.
Midwives and nurses conduct screenings and provide education, while doctors oversee the process, counselling and manage cases that require further attention. Also trained Doctors assigned in counselling made sure the data privacy is implemented. Also treatment of positive patients was closely monitored. In scheduled rollout days, designated barangay health stations and temporary screening sites were prepared to accommodate clients.
Our trained Peer navigators also assist in community mobilization. They help identify eligible women, encourage them to participate in screening. Their support helps reduce hesitation and increases compliance with the program. Women who consented to participate were registered and oriented on the procedure.
Collected specimens were properly labelled, documented, encoded to the system and safely stored before being transported to the Western Visayas Medical Center Laboratory.
In addition, counselling services were provided before and after specimen collection to address concerns and reduce anxiety among participants. Clear referral pathways were also established for individuals who may test positive, ensuring treatment, timely follow-up and management.
As the hired Field Coordinator of Cancer Warriors Foundation Inc. for the HPV DNA testing program in the Municipality of Carles, together with my Data Support staff played a central role also with the guidance of our Community Engagement Specialist Sir Norberto Quite in the implementation, and monitoring of cervical cancer screening activities especially engaging the local government and barangay officials. Also coordinating field operations across geographically isolated island barangays. This included organizing outreach schedules, ensuring availability of supplies, and sending specimen to WVMC laboratory. Given the logistical challenges in GIDA settings, careful planning and close coordination with local government units and barangay officials were essential to ensure smooth implementation. I also worked closely with healthcare workers, including doctors, nurses, midwives, and barangay health workers, by supporting training sessions on HPV DNA testing procedures, client counselling, and proper specimen collection, including self-sampling techniques. Community engagement was another key aspect of my role. Facilitating health education sessions to raise awareness about cervical cancer prevention and reduce stigma associated with screening. By working directly with community leaders and women’s groups like KALIPI, they serve as active advocates for women’s empowerment and health awareness. As organized groups, they help disseminate accurate information about HPV, cervical cancer prevention, and the importance of early screening. Their involvement helps increase awareness and understanding among women, especially those who may have limited access to health information.
Despite challenges such as difficult terrain, weather conditions, and initial hesitancy among participants, the program was implemented through strong teamwork and community collaboration. The experience highlighted the importance of adaptive strategies and grassroots-level coordination in delivering healthcare services specially in GIDA communities.
With strong partnerships with Local Government Unit especially working with Municipal health office helps the program easy and field management is possible to deliver life saving interventions. House-to-house visits together with the very active assigned midwives in barangay health stations, and of course the very energetic barangay health workers, women who had limited access to healthcare services and were unable to attend scheduled community screenings was reached.
During these visits, barangay health workers identify eligible women, particularly those aged 30–49 years old, and provide them with information about cervical cancer, its risks, and the importance of early detection. Many women were initially hesitant due to fear, lack of awareness, or cultural beliefs. Through direct engagement and personalized counselling, we were able to build trust and encourage participation in the HPV DNA testing program. House-to-house visits also allowed us to introduce and explain the self-sampling method for HPV DNA testing, which was well accepted by many women due to its privacy and convenience. This strategy significantly increased participation, especially among those who were uncomfortable with facility-based procedures.
During the implementation of the HPV DNA testing rollout in the barangays of Carles, a series of coordinated community-based activities like the Health Fair of Carles PCF, Women’s month celebration, some medical and dental mission were carried out to ensure effective delivery of cervical cancer screening services to eligible women.
In the house-to-house visits conducted as part of the HPV DNA testing rollout in the barangays, several challenges were encountered that affected the efficiency of community mobilization and client engagement.
One of the primary challenges was the limited availability of eligible women at home, as many were occupied with work, household responsibilities, or were temporarily residing outside the barangay. This required repeated visits and extended time to reach the target population. Another major challenge is community acceptance and awareness. Some women are hesitant or fearful of undergoing HPV DNA screening due to misconceptions, were I’ve experienced the women run away because they thought they will get vaccinated with a new virus again. Lack of knowledge, or cultural beliefs is also a problem.
Midwives, BHWs and Peer Navigators must invest time and effort in educating families, addressing fears, and building trust before successfully conducting the screening. This requires patience, effective communication skills, and cultural sensitivity. Another challenge was difficulty in locating households, especially in geographically dispersed or hard-to-reach areas like in Bryg. Barangcalan that you need to ride on a small boat to reach one of the sitio. Despite the hardships encountered during the HPV DNA testing activities, I remain deeply grateful and fulfilled to have been part of this initiative. Serving women—especially those in underserved communities—has been a meaningful and rewarding experience.
Despite our challenges such as limited resources and demanding fieldwork, our Peer Navigators, BHWs, midwives, nurses, doctors and barangay officials remain dedicated to their role. Their commitment greatly enhances the reach and effectiveness of the HPV DNA program.
This experience has strengthened my dedication to public health service, reinforcing the importance of compassion, perseverance, and community engagement in delivering quality healthcare at the grassroots level.