In bare room in a remote government-run primary health centre in Vapi, a city in the south-west Indian state of Gujarat, Meenakshi Gupta holds a diagram of a woman's breast with five Braille-marked orientation tapes pasted on it, reports BBC.
Speaking to the woman sitting on the bed, she says, "I'll paste these skin-friendly tapes on your breast and use my fingertips to check it for any abnormalities."
Gupta asks the woman to remove her upper garments, uses a hand sanitiser, and begins the routine examination. Dividing the chest into four zones with the tapes, she spends 30 to 40 minutes palpating every centimetre of the breast with varying pressure, before documenting her findings on her computer. Along with the patient's medical history, Gupta will later send her findings to a physician for a diagnosis of any abnormalities and advice on further assessment.Gupta is a Delhi-based medical tactile examiner (MTE), a new and emerging profession for blind and visually impaired women in India and Europe. She is a humanities graduate, blind since birth, trained for nine months in tactile breast examinations, a specialised form of clinical breast examination. Gupta's blindness is not incidental to her role, but something that greatly aids her work.
Studies have proven that in the absence of visual information, the brains of blind people can develop heightened sensitivity in hearing, touch and other senses and cognitive functions. Frank Hoffmann, a Germany-based gynaecologist who developed the idea of MTE has found that during their extensive examinations, MTEs can catch lumps as small as 6-8mm. According to his unpublished research, that is less than the 10-20mm lumps that many physicians without a visual impairment can find during examinations.
In India, 18 MTEs have been trained since 2017. Some of them are currently working at hospitals in Delhi and Bengaluru and a few are employed by the National Association of the Blind India Centre for Blind Women and Disability Studies (NABCBW), a non-profit in Delhi that also provides training.
But the practice of training MTEs goes back further, to Hoffmann's own concerns about his ability to detect tumours. "I always worried that as a gynaecologist I didn't have enough time to spend on breast examinations and could be missing out on tiny lumps," he says. Many doctors have little time to carry out 30-40 minute examinations, but a trained non-medical worker with an enhanced tactile sense could be ideally placed to do so, he reasoned.
In 2010 Hoffmann's idea was developed into Discovering Hands, a social enterprise based in Mülheim, in Germany, which trains blind and visually impaired women as MTEs. The first peer-reviewed study investigating the feasibility of the approach showed that MTEs' findings were similar to those of physicians.
Hoffmann saw potential for the method to have a broader impact beyond Germany, as an effective and relatively affordable technique. Breast cancer rates are worrisome across the globe, with female breast cancer the most commonly diagnosed cancer in 2020.
Bd-pratidin English/Golam Rosul
.jpg?v=1721154592)
.jpg?v=1721154592)
