The slow pace in cancer solutions is detrimental to Zimbabwe’s women, girls. With only 2 radiotherapy machines nationwide and no human papilloma virus vaccinations, 60% of Zimbabwe's women face certain death from cervical cancer.
Young Grace recently visited her gynaecologist in Zimbabwe’s capital, Harare because she had been trying and failing to conceive for five years. The doctor orders a series of tests, among which were a pap smear; a first for Grace. Upon collecting her results, she is informed that she has a sexually transmitted infection called human papilloma virus (HPV), and pre-cancer cells had been detected on her cervix. Confused and barely grasping what this meant for her, the doctor informs her that there is no treatment for either the HPV or the pre-cancer, but he recommends that she goes for another check up in exactly six months after which he would determine whether or not there would be need for surgery. Essentially, Grace had just been informed that she had the first signs of cancer and an untreatable STI, but there was nothing the doctor could do for her. Meanwhile, before the next check up, she would wait it out while the pre-cancer cells had good chances of morphing into cervical cancer.
Grace’s case is a classic example of the big threat being faced by at least 80% of Zimbabwe’s women. Being diagnosed with cervical cancer has become a death sentence in Zimbabwe. The disease affects 1800 women annually, and of those, an estimated 1200 certainly die. Cervical and breast cancers are the leading causes of death among women in Zimbabwe and many developing countries. Treatment is often unavailable and expensive; or for those who get a small chance – they have month long waiting lists to deal with before getting their turn on either of the only two radio-therapy machines available in the country. Cancer is undisputedly a rising epidemic in Zimbabwe and there is an urgent need for investment in its screening and treatment. The disease has certainly but quietly become more fatal than HIV. Being diagnosed with the latter, you know there are ARVs and civil society providing all kinds of assistance.
Cervical cancer awareness month came and went in September, and many a Zimbabwean woman neither knew nor cared; and a myriad of reasons explain this.
A notorious virus called Human Papilloma or HPV in short is the established cause of 70% of all cervical cancers worldwide. It is a very common (residing in over 60% of the sexually active age group) and most commonly transmitted sexual infection that cannot be treated. Some countries now have vaccines available for the prevention of that HPV where three shots of the vaccine are administered to girls before their sexual debut. This vaccine is currently not available in Zimbabwe because - if recent media reports are to be believed – Health and Child Welfare Minister Dr Henry Madzorera said that currently the government cannot afford the vaccine. Costs aside, apparently the vaccine must be constantly refrigerated, a small but hopefully not permanent difficulty currently in Zimbabwe with the frequent power cuts.
But women are however encouraged to go and get regular check-ups, through for instance pap smear tests every six months. These are free in most public health institutions, but cost $50 or so in private ones. Half the time public hospitals lack reagents and other necessary things needed to conduct the pap smears. Treatment for advanced cancer including doctors’ fees, surgery costs and treatment cycle cost anything between $4000 – 5000. This means in short, majority of Zimbabwean women will not even try and will simply die.
Another problem is, 80% of Zimbabwe’s women lack awareness of the fact that they must be screened and cannot begin to decipher the gravity of the risk they face. Most cancers, including cervical, can be treated if people recognized the signs and sought treatment timeously. Education, early detection and early treatment can improve the quality of life for women and reduce unnecessary deaths from these diseases. However fewer options are currently available for treating early or advanced disease in Zimbabwe.
There are currently very little or no cervical-cancer screening programmes in Zimbabwe. This has seen fewer opportunities present to diagnose precancerous disease and consequently, most women only visit their doctor with the disease at an advanced stage.
A number of non-profit organizations operate in Zimbabwe in the health sector. They are constantly engaged in ‘consolidated appeal processes’ to access funds for humanitarian assistance which have never included procurement of cancer equipment. Perhaps there will be a time yet when donor organizations would look past the desire for ‘visible’ and immediate short term results to invest more in this long term need. There is a hesitancy to commit perhaps because the equipment is not only very expensive, but there is also a huge responsibility in maintaining it. Outreach programs that involve local physicians and hospitals, ministries of health, NGOs, and even traditional healers are needed urgently for education, screening, and early detection which can significantly extend and improve the quality of life of women.
Another big factor is that African women generally do not want to talk about gynecological cancers and other such-like problems; understandable - given the intensely personal nature of gynecologic cancer. But sharing experiences in this problem confronting women and creating platforms that provide knowledge can go a long way in saving the lives of other women. Recently, Zimbabwean Deputy Prime Minister Thokozani Khupe came out and announced that she was receiving breast cancer treatment in South Africa. Not only was this big of her, but it should serve as an example for other women in public office and high places to start to demystify this disease, and cultivate local solutions to this problem so that we can in earnest start moving forward on this issue as a nation. How can we make cervical cancer month for instance bring hope and real meaning to many of our women who cannot afford to fly to South Africa or Malaysia for treatment?
Zimbabwe’s President, Robert Mugabe has been discussed in recent media reports as currently undergoing treatment for prostate cancer. He reportedly flies out to Malaysia regularly for checkups and other things. One would think he would – in the situation – be foound championing for better cancer health care in his own country.
The Cancer Association of Zimbabwe has however said that the government has approved HPV vaccines being used elsewhere to also be used here in Zimbabwe. It is refreshing to know that guidelines for adoption of this critical service are currently being developed. Hopefully, young girls will be getting the HPV vaccines some time in the very near future, so that a lot of their lives can be preserved. Even then, it is a sincere hope that like with HIV - the government will also subsidize HPV vaccines which at normal rates are beyond the reach of the majority. We wait with bated breath to see if for once this very grave issue will be treated with the seriousness it deserves.