For many people, there are specific moments, experiences or encounters that define the course of their lives. For Leeya Pinder, MD, MPH, FACOG, there have been several of them.
The first was when she was 7 years old and someone asked her what she wanted to be when she grew up.
“I said heart doctor,” Pinder recalls. “I had no idea why I chose that, but as I grew up, I understood the importance of being a physician and what that can mean in the community. I had lost family members and people I was close with, and it brought home that people should be able to know their disease, understand their disease and get the care for what they needed.”
A change of heart
Some 15 years later in medical school, though, Pinder realized her 7-year-old self had missed one important detail.
“I realized I hated heart physiology,” she says with a laugh.
Pinder ditched the EKGs and started looking into other areas that might spark some excitement for her, and she soon found surgery. It was on this new medical track, during a gynecologic oncology rotation, that she had another life-defining moment.
It came in the form of a 19-year-old patient who, like Pinder, was black. The teenager had a devastating diagnosis: She had HIV and advanced vulvar cancer.
“I was looking at someone who looked exactly like me and was around the same age,” Pinder says. “In my mind, I just knew there was no reason that someone this age should be in this state. This was in South Carolina, so there are discrepancies along racial lines and barriers to healthcare in our community. Someone should have done something at some point to prevent her from being there.”
After that patient encounter, Pinder knew her true calling was in gyn-oncology, specifically for underserved populations.
A leap of faith
After finishing her obstetrician-gynecology residency, Pinder joined a private practice. She spent the next five years enjoying her work and her ability to help her patients, but deep inside, she knew this wasn’t what she ultimately wanted to be doing.
“I loved my patients, I loved my partners, I loved what I did, but I wasn’t taking care of a marginalized population — immigrants, refugees, underserved communities — that I felt I needed to be taking care of,” she says.
Never one to ignore a gut feeling, Pinder decided to leave her life in private practice to pursue a global health fellowship. She ended up at Harvard University in a program that allowed her to rotate between Massachusetts General Hospital and Boston Medical Center in Boston and a small, rural hospital with an HIV clinic in western Kenya.
For the next two years, Pinder flew back and forth between the sites every two to three months. Not only did she end up with a lot of airline miles, but she had another life-defining experience. This, she realized, was what she was meant to be doing.
“Pursuing public health was the greatest decision I ever made,” Pinder says. “It was really life changing and life affirming.”
A fight for every life
After earning her master’s degree in public health, Pinder wanted to get more experience working with gynecological malignancies. She spent the next two years doing just that at the University of Zambia, first as a Fogarty Fellow and then through a fellowship at the University of North Carolina, Chapel Hill.
While there, Pinder was struck not only by the inequities and extreme barriers to care, but also by the resulting consequences for her patients and her fellow doctors.
“In the United States, we take for granted things like having blood available,” she says. “We cancelled so many surgeries in Zambia because blood wasn’t available, anesthesia had something else they needed to do that day or the power was out.”
It all crystalized for Pinder when she met another 19-year-old patient, this one from a nearby village. The young mom had, what would be in the United States, a very treatable ovarian tumor. And yet, her care was delayed for two months and she eventually died.
“There are so many barriers that prevent women from getting adequate care,” Pinder explains. “In the U.S., it could be that you’re working two jobs and taking care of your kids, so you don’t have time. It’s the same thing overseas. Maybe you have abnormal bleeding but you’re not going to get care immediately because your priority this season is farming. Or, if you get care, it’s going to take you two hours to get there so you need it all done in one appointment.”
The system is broken, Pinder acknowledges, but rather than let that numb her to inequities, it simply encourages her to continue fighting.
“One of the residents there said, ‘Oh, it just happens,’” she recalls. “My personal challenge is to make people realize that, no, it doesn’t just happen. Every person is worth fighting for.”
A desire to change the world
By fighting the good fight through her work, Pinder hopes to find more ways to get women around the world accessible care.
In Zambia, her team did a large pilot study comparing same-day treatment techniques for precancerous cervical cells. They found that a portable thermal coagulator — a battery-operated device that uses heat to destroy abnormal cells — was just as safe and seemingly just as effective as more difficult-to-implement methods like cryotherapy, which requires large tanks of gas, and LEEP procedures, which rely on electricity being available and specialized training and equipment.
The portable device is being further tested in Honduras and Malawi. If it’s scaled up for use around the globe, Pinder believes it could be a game-changer to prevent delayed care for women.
They’re looking at how effective a single dose of the HPV vaccine might be and whether it provides enough protection to patients. The current HPV vaccine guidelines are two doses for those younger than 15 and three doses for those 15 or older.
“The challenge with having to get two or three doses is you have to go back multiple times,” Pinder says. “Also, the cost of vaccines is really expensive. If we find that one dose is effective, countries can buy more doses and vaccinate more people, and we could revolutionize primary prevention of cervical cancer.”
After the study concludes in two years, Pinder is looking forward to the next way she can fight for every woman’s life.
“I want people to be aware that things extend beyond the U.S. border,” she says. “One of my goals is to translate what we do here overseas because it’s not a woman’s fault that she just happened to be born in a different place.”