Executive Summary:

Medical Ministry International (MMI) will develop a pilot project with Medical Ministry International Amazon (MMI Amazon) to provide much needed preventative health care for men in extremely remote areas of the Amazon River. To date, MMI services have included primary, dental, vision, audiology, and preventative health care, including the cervical cancer screening program with HPV testing launched in 2017 with Stronger Together. As a result of the HPV program for the women, the men of the villages were specifically asking if MMI could do anything for them with regards to prostate cancer. In response to this request, MMI Amazon would like to expand its services to provide a Prostate Cancer Screening Program by introducing Prostate-Specific Antigen (PSA) testing to identify men at risk of developing prostate cancer.

Over a twelve-month period, MMI Amazon expects to screen 500 men from 14 villages along the Amazon River, and its tributaries, surrounding Leticia, Colombia. MMI Amazon is currently the only provider of health care services to these villages which have populations of the three indigenous unreached people groups: Ticuna, Cocama, and Yaguas. MMI Amazon is making regular visits to these villages with local staff and they host MMI medical teams with volunteers from North America. During future visits, trained health promoters will collect urine samples which will be tested using mobile phone technology. Results will be collected by the MMI Amazon staff and the results of the PSA levels will be tracked and communicated back to women. MMI Amazon will ensure these men are monitored and connected to the available government funded services for appropriate follow up care. MMI Amazon has successfully bridged this gap in the Colombian health care system over the past two years by ensuring follow up care for women at risk of cervical cancer. MMI Amazon has navigated the comparable government systems in the Peruvian Amazon and the Brazilian Amazon, so regardless of what side of the rivers people live on, follow up care will be arranged with the appropriate authorities.

MMI is seeking the support of Stronger Together Granting Partners for a grant of $73,000 to carry out the pilot project as described. However, due to the nature of this pilot project, it is scalable. With a granting budget of $37,000, the project could take similar form, but for a reduced number of men, approximately 250 in 7 villages.

Upon review of test results, MMI will be able to analyse the health of the men in these remote villages compared with national rates for Colombia, Peru, and Brazil and design follow up plans of education and ongoing service, including the addition of PSA screening to outreaches in future years.

Pending a successful pilot project in the Amazon, MMI has the ability to add this service to all MMI medical teams in 20 countries at a relatively low implementation cost in future years.

Measurable Outcomes:

1. Provide prostate cancer screening, specifically PSA level testing utilizing TestCard mobile technology, for 500 men from 14 villages in the remote Amazon Regions of Colombia, Peru and Brazil.
2. Monitor 105 – 185 men with abnormal PSA levels and refer to government funded services for further diagnosis and intervention (immediate and in future years), to address causes including hyperplasia, urinary tract infection, prostatitis, parathyroid hormone, and prostate cancer.T8
3. While introducing PSA screening, a comprehensive men’s health program will provide an estimated $1.5M of health services including the screening, medical and dental services, and education counselling on male focused topics including diabetes, alcoholism, sexual and physical abuse.
4. Pilot TestCard’s other mobile tests including Urinary Tract Infection and Glucose (approx 100 each) and review results, with the goal of increasing laboratory testing for patients on all MMI Project Teams from 4% to 20-30% in 2021.

*Content provided by Medical Ministry International Canada