SEATTLE, Washington — Every year, around 3,600 women are diagnosed with cervical cancer in Malawi. This is the second-highest cervical cancer rate of any country in the world. Around two-thirds of the diagnosed women die from the disease. This is an alarming statistic since cervical cancer can be prevented with the human papillomavirus (HPV) vaccine and is easily treatable when diagnosed early.
Cervical Cancer and Poverty
According to the World Health Organization, most cervical cancer deaths occur in low- and middle-income countries. Malawi is one of the poorest countries in the world, with more than two-thirds of the population living in extreme poverty. These financial barriers prevent women from accessing the healthcare necessary to fight this treatable disease.
Several organizations have recognized the challenge and are spearheading initiatives to fight cervical cancer in Malawi. The various efforts have different focus areas like prevention, treatment and training.
UNC and the University of Malawi College of Medicine
In 2019, the University of North Carolina (UNC) and the University of Malawi College of Medicine launched a program focusing on cervical cancer prevention. The United States Agency for International Development (USAID) has awarded the program $5.1 million to help accomplish their goals.
This program is especially focused on providing cancer screening for Malawian women. As Dr. Jennifer Tang, a member of the UNC Institute for Global Health and Infectious Disease Malawi site explains, “Because women in Malawi weren’t getting screened, they were getting diagnosed very late. A late cervical cancer diagnosis is usually a death sentence in Malawi.” For this reason, the program focuses on screening as many women as possible and treats those with precancerous lesions on the very same day.
By focusing on same-day diagnosis and treatment, the program helps Malawian women save money on transportation. Transportation is a major barrier to treatment for women in Malawi since many women do not have the money to fund multiple trips to health clinics.
Doctors Without Borders
Doctors Without Borders has been running a program fighting cervical cancer in Malawi since early 2018. The program offers free screening, consultation and outpatient treatment. It also offers free vaccinations against HPV since HPV has been shown to cause cervical cancer. Doctors Without Borders has also expanded its services to include specialized surgery and palliative care for patients with advanced-stage cancer.
Access to free specialized surgery has been crucial for Malawian women. Women undergoing cervical cancer treatment are often unable to continue working due to physical pain and reduced mobility. In addition to needing to pay for treatment, the loss of a stream of income is extremely detrimental to families.
Malita Kulawale, a Malawian woman, was diagnosed with cervical cancer in April 2019 and went through several chemotherapy rounds. Due to the Doctors Without Borders’ free specialized surgery initiative, Kulawale decided to undergo the removal of her uterus and was able to make a full recovery. This is a surgery that she would have been otherwise unable to afford.
Malawi Polytechnic and Rice University
Students at Malawi Polytechnic and Rice University have developed a gel-based model of the cervix that medical students can use to practice cervical cancer biopsies. They call this model the Low-cost Universal Cervical Cancer Instructional Apparatus (LUCIA). The total material cost of a single one of these models is around $47. Malawian students often use raw meat models, which are impractical for Malawi’s warm weather. These models present a cheaper and more sanitary alternative to meat models or more expensive plastic and silicone models.
While the development of this product does not directly treat cervical cancer patients, it allows for affordable and accessible training for Malawi’s doctors and medical students. This will allow more doctors and medical professionals to receive the training necessary to effectively treat cervical cancer in Malawi.
By prioritizing low-cost initiatives to assist women living in poverty, these organizations encourage Malawian women to seek care without the fear of financial stress. It is hopeful that these multi-pronged efforts will help lower the rate of cervical cancer in Malawi.
– Antoinette Fang