Zambia - Cervical cancer – "fighting a battle we can win

Citation

(2012), "Zambia - Cervical cancer – "fighting a battle we can win", International Journal of Health Care Quality Assurance, Vol. 25 No. 4. https://doi.org/10.1108/ijhcqa.2012.06225daa.014

Zambia - Cervical cancer – "fighting a battle we can win"

Article Type: News and views From: International Journal of Health Care Quality Assurance, Volume 25, Issue 4

Keywords: Cervical cancer management, Healthcare screening, Vaccination programmes, Quality healthcare improv

Cervical cancer is an aggressive disease which affects millions of Zambian women each year. But it is quickly being brought under control thanks to new vaccinations, screening programmes and possibly even George Bush.

Cervical cancer has never been a top killer in Zambia compared to malaria which claims about 50 thousand lives annually, but it is an untold horror that many Zambian women have to endure.

The World Health Organisation says cervical cancer is the second biggest cause of female cancer mortality worldwide and in Zambia it accounts for 30 per cent or 1,650 of all cancer cases and 81 per cent of patients die from the disease.

Over 65 thousand women have been screened in 17 heath centres across Lusaka since 2006. Although the disease usually affects older women, it is becoming increasingly common amongst younger women, notes Groesbeck Parham, director and gynaecological cancer surgeon at the Cervical Cancer Screening Program in Lusaka.

“We are now finding the disease is more common amongst young women under 24. Part of the reason for Zambia’s situation is the high HIV prevalence, early sexual intercourse and cultural practices which include vaginal douching and the use of herbs. Also lack of screening and treatment is a problem which we are now trying to address as well as poor lifestyles and diet”, says Groesbeck.

Catherine Mulembi was suffering from severe bleeding. Luckily, she was aware of her local health centre’s cervical cancer screening program which helped save her from developing full blown cancer of the cervix.

“I have benefited a lot from the program and I hope that many other women will receive this kind of help as much as possible. The disease breaks the backbone of a household – the woman who struggles to feed her family”, says Mulembi.

Mulembi acknowledges that vaginal douching and the use of herbs for dry sex are things she has practiced since her teen years. She is now 32 years old.

To help combat the disease, specialised clinicians have been trained to offer fast track testing services and ease the burden of treating minor cancer lesions for top experts such as Parham.

“Since 2008, I have screened over one thousand women, treated many women for per-cancer lesions and referred many for specialised attention“, says Chalwa Hamusimbi is one of the 70 healthcare providers trained under the program.

Using new and cheaper testing techniques, the cervical cancer screening program has allowed many poor women to access the service and get treated free of charge.

“We use See and Treat meaning a woman walks in without an appointment, within a few minutes she is screened or treated for her pre-cancer, so this has encouraged more women to come forward“, says Hamusimbi.

Hamusimbi believes the new easier testing methods which use household vinegar are more effective and affordable than the pap smear which she says was time consuming and expensive to implement on larger scale.

From her point of view, Dr Precious Kapambwe, a gynaecologist working on the project says logistical challenges make treating cervical cancer a huge challenge.

Zambia’s health care system is under intense pressure with a mere 500 doctors working in the country. Lusaka alone has 12 gynaecologists to attend to almost a million women.

“We have 3.2 million women eligible for screening. This will take a lot of funding, but it will save lives. If we have a comprehensive program where we will vaccinate young girls and screen older women for the disease, then we are fighting a battle that we will win”, Dr Kapambwe.

According to the Centre for Infectious Diseases Research in Zambia, over 6,000 women have been treated for per-cancerous lesions by nurses using cryotherapy (freezing skin lesions) in primary health care facilities. The Lusaka University Teaching Hospital referral clinic has been using the method to treat 4,000 women for per-cancerous lesions since 2006.

Recently, former US President George Bush visited Zambia and two other Africa countries to help boost the fight again cancer. Mr Bush’s new initiative, the Pink Red Ribbon Campaign which has swallowed close to $80 million in grants over a five year project is expected to drastically reduce cervical cancer rates in Zambia.

“It’s not acceptable to save a woman’s life from HIV/AIDS and watch her die from cervical cancer”, said Bush.

Under the project, Zambia will also roll out a cervical cancer vaccination program that will see many young girls get vaccinated against the disease.

In 2005, the Zambian government with support from the International Atomic Energy Agency-IAEA commissioned its first ever $10 million cancer hospital in Lusaka. But there is still a long way to go before the influx of cancer patients is adequately addressed.

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