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Susan Cotton

Co-Founder and Chair of the Board, The Lily Project

What’s driving Lily’s success is something I learned decades ago – give talented people the opportunity, tools and encouragement to do their best work and they will do amazing things!”

When I was 56, I launched The Lily Project, a women’s health NGO that provides cervical cancer screening and treatment to women in Nicaragua’s rural villages.

The problem I’m trying to solve

Although cervical cancer is easily prevented with simple screening and early treatment, it is still Nicaragua’s number one cancer killer. The high death rates result from the country’s inadequate health care system, machismo culture that promotes sexual behaviors that spread HPV, and a general lack of knowledge about reproductive and sexual health. The problem is greatest in rural communities where there are low literacy rates and early initiation of sexual activity. Single mothers head up nearly 50 percent of the households in these areas, and each woman who dies prematurely leaves children on their own. The Lily Project is tackling this problem with mobile health clinics that deliver free health care to women and girls in rural villages. Our clinicians use a simple, cost-effective “screen and treat” procedure endorsed by the World Health Organization to apply vinegar (acetic acid) to detect precancerous cells and cryotherapy to treat them. For less than $10 per woman, women and girls receive cervical cancer screening and treatment, along with sexual/reproductive health education, and, when needed, trauma counseling.

The moment that sparked my passion

I was looking for a way to move forward after my husband and I divorced, my oldest son left for college, and my start-up health care company dissolved. I wanted to bring all I had learned as a business leader for 25-plus years to help solve a meaningful social problem. In 2014, I met Anielka Medina, a Nicaraguan native, whose mother, Lily, had died from cervical cancer. She dreamed of starting a cervical cancer prevention program in Nicaragua. I knew immediately that I was the right person to help her achieve her bold mission. In 2015 we launched The Lily Project and today our results are so encouraging that Nicaragua’s Ministry of Health (MINSA) has contracted with us to deliver women’s health services throughout rural Nicaragua.

Advice to others who want to make a difference

Start with one. I don’t know who first said, “Not everyone can make life better for one million people but everyone can make life better for one person,” but this thought helps us every day. Hortencia, one of The Lily Project’s leaders, told me a story about a young mother who came for a screening and needed cryotherapy to remove precancerous lesions. She was so appreciative, the next day she came back with her mother, sisters and extended family and insisted they all get a screening. Because we focus on one woman at a time, we have now screened more than 10,000 women.

Why this approach is  innovative

Much of the innovation in health care centers around medical treatments and devices. There’s very little at the delivery level. Our mobile clinics overcome many of the logistical and cultural barriers that prevent women from receiving care in Nicaragua. These “pop-up” clinics require no electricity and are set up in minutes, typically in a school or church, and are staffed by young Nicaraguan nurses trained to provide education, screening, treatment and first-level trauma counseling, as many women in the country have been sexually abused. Women who are seen by MINSA often complain they do not receive their results, that results are often wrong, and if they do have a problem, they don’t receive care. MINSA’s program is set up to simply measure the number of screenings performed. The Lily Project is designed to prevent cervical cancer. Therefore, we’re responsible not only for screenings but also treatment, ensuring that follow-up cancer care is available and that women who test positive for HPV are monitored.

How I know we’re having an impact

When our team found three out of the four cases of cervical cancer in one of the regions we cover, MINSA took notice and now we’re helping to improve their care of women. We’ve taken over a lot of MINSA’s training of nurses and staff to help them learn what it takes to do this work. So, we’re having a multiplier effect. We see ourselves being able to blanket the western half of Nicaragua within the next five to six years, improving the health and lives of many more women and families.

What’s next for The Lily Project

By 2022, The Lily Project will operate 10 mobile health clinics with a capacity to screen 25,000 women annually, and over 250,000 adolescent girls will participate in one of our educational programs to help each understand and value her body, her abilities, and her opportunities. A benefactor recently donated a house and farm to the project for a sustainability program, so young women can develop the skills to grow, craft, and sell organic products, creating sustainable incomes for themselves and the organization.