Blind women in India help doctors to detect breast cancer early

Noorunnisa was three years old when a high fever left her completely blind. She had always longed to be a doctor, but her blindness robbed her of the opportunity.

But the 28-year-old is now living her dream of practising medicine – albeit in an unconventional way.

She is one of India’s 18 certified medical tactile examiners – all blind – who have been trained to screen for lumps, cysts or other abnormalities in breasts by touch, and to help raise awareness of breast cancer.

“I feel fantastic, because this job is saving the lives of people,” Noorunnisa told The National.

While breast cancer is the most common form of the disease globally, it ranks fourth in deaths worldwide but first in India, the Global Cancer Observatory reported in 2020.

There were 178,361 cases of breast cancer in India in 2020, and 90,408 deaths.

But a lack of education and guidance, rigid sociocultural norms and delayed screening mean awareness of the disease is alarmingly low.

To bridge this gap, in 2019 the charity Enable India started training blind women to detect cancer at early stages using their hands and fingers – a technique known as palpation.

The nine-month-long training course concludes with a hospital internship before the MTE certificate is awarded.

The women are also taught basic computer and English language skills.

“They work under a breast oncologist to get practical experience for three months, and once it is done, they have to take a practical exam,” said MTE trainer Ashwini Rao.

“Our MTEs have screened over 1,000 women and covered Karnataka and neighbouring Andhra Pradesh region including rural areas where scanning machines are not available.”

Noorunnissa and her colleagues are based in Bangalore, Karnataka, and are associated with Cytecare, an oncological hospital.

They conduct regular tactile breast examinations at hospitals, workplaces and universities, and organise camps in villages to reach vulnerable populations.

Each examination takes about 40 minutes during which five purpose-built Braille-marked tapes are pasted on a woman’s chest to divide it into four zones for orientation.

The MTE then palpates every centimetre to check for abnormalities.

The MTEs document their findings and report them to the hospital’s director of breast oncology, who evaluates each report and decides whether the patient needs further assessment, such as a mammogram or ultrasound examination.