An ‘eye opening’ experience

Sudhanshu Sharma
Life sometimes throws experiences at you that completely change your mundane outlook towards it two years ago, I got involved in a unique programme that trains visually impaired girls to examine breasts and work as ‘medical tactile examiners in a breast clinic.
This novel concept of utilising the tactile abilities of visually impaired women in the clinical setting was started under the name of ‘Discovering Hands’ by Dr. Frank Hoffmann , in Germany in the year 2005. Discovering Hands trains visually impaired women with their highly developed sensory skills to detect the early signs of breast cancer. This is a successful model in Germany, Austria and Columbia.
The clinical breast examination by the visually impaired MTEs (medical tactile examiners) is based on a specially developed, standardised and quality-assured concept of examination.
Through this training, discovering hands® utilises the focus of blind women and their keen sense of touch to trace the slightest signs of irregularity in the breast to enable a faster and much earlier diagnosis, all in a completely natural and manual way.
In India,the course has been conducted for the first time by NAB India Centre for blind women which has expertise of training blind women for last 15 years in different vocations. Prior to starting the course, numerous delebrations were held by different stakeholders, including scientists from PHFI, Indian Cancer society, National association of blind Delhi ,and NGO’s .
Dr Kanchan Kaur who was the expert doctor in the team went to Germany and observed how this programme is conducted and gave feedback on how to adopt it to the Indian setting. Bayer foundation is sponsoring the entire programme.
The MTE course was then conducted in a nine-month training programme in India, where blind and visually impaired women were trained as CBEs or MTE’s by special trainers who were trained by teachers in Germany. The training took into account, general medical basic knowledge as well as patient-centered social behavior.
The girls are also trained in using a specially designed computer software (“documentation and orientation system (DOKOS)” to document patient details and findings,using medical terminology
In order to carry out her activities, an MTE needs a workspace which is
equipped with a test bed (with hygienic support and storage cushions) and a workplace sufficient for the fulfillment of the documentation tasks.
MTE use sinnovative tactile orientation strips (based on Braille), developed by discovering hands® to perform the scanning tests.
During the examination, five of these special adhesive stripsare placed around a woman’s breast that allow any abnormality/to be pinpointed by two dimensional coordinates. This allows the visually impaired MTE’s to carry out breast examination with complete autonomy. They take around 20-30 minutes at one single examination in which the MTE takes thorough patient history, conducts the examination and also does patient counselling on importance of self breast examination and of early detection of cancer.
This method humanizes medicine by giving more attention to patients through individual contact and, more personal examinations. MTE reports to the doctor as an assistant.
Trained as MTEs- a complete new profession that is created through this standardized training curriculum- they are also capable of accomplishing other tasks of a medical assistant, including the maintenance of medical records.
A group of 5 Indian MTE’s , who recently cleared their theory exams , started their internship with Dr Kanchan Kaur in the breast clinic . It is quite impressive to see how well they conduct themselves in terms of confidence and bed side manners.
Every patient who was asked for consent to be examined by these girls, agreed to be checked, and gave a very positive feedback.
In the Indian setting where 80% patients present in a late stage due to widespread ignorance and misinformation, early detection is key to improved outcomes of treatment.
In the long run, these trained MTE’s could be a useful adjunct to outreach and ‘ in -hospital’ screening programmes. Also by using the extraordinary sensory capabilities of visually impaired women, a perceived “disability” is transformed into a capability, thusopening a completely new field ofmeaningful employment for them.