Stories

My name is Enid Kajura from Karago, Bukuku in Uganda. I am 46 years old. For a long time, I had been experiencing irregular vaginal bleeding, discharge and lower abdominal pains which greatly worried me. I then decided to go to a local health center where the nurse suggested that I undergo a screening test for cervical cancer, which I did. I cannot begin to explain how I felt when I was informed that the tests were positive. I almost collapsed, thinking that I now had to have my uterus removed. The uterus is the essense of a woman’s being, so I didn’t know what would become of me if it was removed. I was then referred to Mulago Hospital for further treatment, but this only compounded my problems because I did not have any money to get there from my home. All I could do was cry and pray. Two days later, and after composing myself, I decided to go to Reproductive Health Uganda (RHU) because I had heard that they offere cervical cancer treatment. There, I met helpful nurses who took me through some treatment regimen. They asked me to return after six weeks, which I did. By this time, the discharge I had been experiencing before had stopped, and this made me very hopeful. When the nurses confirmed to me that my health was indeed improving, I went through mixed emotions. I wasn’t sure whether to cry, laugh or just stare at the nurse. For some reason, I found it hard to believe that I was getting better. This is because I had heard of women who had died of cancer even after they had accessed treatment in big hospitals, so at at the back of my mind I had been fearing that my days were numbered too.  But the nurses at RHU counselled me and told me that I was lucky because I had sought treatment at an early stage. The nurses told me that most of the cases of people who succumb to cancer are those whose cancers were detected at a late stage when it was already too late –even for the best of treatments. The nurses told me to make sure I told my friends back home about the importance of cervical cancer screening for women –regardless of whether they are feeling sick or not, as this would help detect any precancourous cells and consequently help them access treatment and eventually save their lives.   The nurses gave me an appointment for one year later and by the time I went, the vaginal bleeding and lower abdominal pains had stopped long before then. I was now living a comfortable life as a woman. When the nurses told me that I was well, I was overjoyed and I have since been spreading the gospel of early detection through cervical screening. But you know what is even better? The fact that my uterus is still intact!   Thank you RHU!

Gertrude Mugala is a teacher in Fort Portal town, western Uganda. While Gertrude considered herself fairly knowledgable about cancer, she had never thought of taking a screening test or imagined herself ever having the disease. That was until she one day chanced on a radio announcement urging women to go for cervical cancer screening at a Reproductive Health Uganda (RHU) clinic. “The radio presenter was talking about cervical cancer and in her message, she encouraged all women to get screened. I decided to go and try it out,” she says. Gertrude then made her way to RHU's Fort Portal Branch clinic for the free cervical cancer screening. There, she met Ms. Irene Kugonza, an RHU service provider. Together with other women, Ms. Kugonza educated them about cervical cancer and the importance of routine screening. The women then took the cervical cancer test. But Gertrude's results were not as she expected. The news was not good. Gertrude was found to have pre-cancerous cells in her cervix. The good news however was that it was at the pre-cancerous cell stage, and with the right intervention, it did not have to develop into cancer. Cervcial cancer is treatable if detected early and appropriate medical interventions undertaken. “I was so shaken when I was told I had pre-cancerous cells. I did not know what was happening and I didn’t believe what I was hearing. I had no idea that along, while I thought I was healthy, I was actually harbouring a potential killer disease in me. What would have happened if I didn’t go for the screening? If I hadn't heard the radio announcement?” Gertrude was then referred for cryotherapy, which is a treatment for precancerous lesions. This method involves freezing abnormal tissues with a probe - cooled by liquid nitrous oxide or carbondioxide. It has an overall effectiveness rate of 80-90 percent in women with suitable lesions. Cryotherapy is inexpensive, does not require electricity, and is practical for low-resource settings. It has been safely performed by nurses and other non-physicians in low level facilities and at the primary care level. “Following cryotherapy, I am now in the process of healing, and I am supposed to go back for review after three months,” Gertrude says. Today, Gertrude advocates cervical cancer screening in her community. She talks to women about cancer, especially cancer of the cervix at her workplace, at the market, in meetings and any other opportunity she gets. “I decided to let women know that cervical cancer is real and it is here with us, and that it kills. At the moment those are the platforms I have and I will continue educating women about cancer and encourage them to go for routine testing. I am also happy that I was near my radio that day, where I heard that announcment encouraging all women to get tested for cervical cancer. It might be because of that radio announcement that I am here today,” she says. Cervical cancer is one of the two most common causes of cancer-related deaths in Uganda. According to Uganda’s health ministry, more than 3,500 women are diagnosed each year with cancer, with more than 2,400 dying from a disease that is preventable and curable when detected early. RHU has accelerated access to services such as cervical cancer screens in response to this growing need. Story by RHU and Maryanne W. Waweru, IPPF Africa Region

Kellen Mbabazi, 25, is married with two children aged 10 years and 4 years. She recently faced one of her greatest fears: getting screened for cervical cancer. “Cancer is a big deal in the community today. There are so many people -including women that I know who have the disease. I also know of families that have lost a loved one to cancer. For a long time, I was so terrified of testing for cervical cancer because I was scared I would get a positive result. I imagined that this would be an automatic death sentence for me, yet I’m still young and with a great future ahead of me. I still plan on getting more children, so I didn’t want to be told that I have cervical cancer,” she confesses. However, one day, Kellen decided to take charge of her own health and mustered the courage to get screened for cervical cancer, having learnt of its importance through a community outreach conducted by Reproductive Health Uganda (RHU) –Kampala branch. “During the outreach, I heard one of the mobilizers say that with cancer, the key is to detect it early because when it is discovered at a late stage, then it is what might kill you. This information convinced me and that is why I decided to screen for cervical cancer,” she says. Also Read: "The Radio Announcement that Changed My Life" -Gertrude Mugala Kellen then went to the nearby Kiswa Health Center in Kampala, where she met a team from Reproductive Health Uganda who screened her for cervical cancer. Following her experience, which she says was eye-opening, Kellen then decided to become a cervical cancer mobilizer. “My mother and my sisters were the first people I encouraged to come for screening. I then informed my friends and encouraged them to test too. This is something that I will continue doing, because I have realized that it is not the disease that kills people, but fear for testing. Yet, early screening is one of the best solutions to cervical cancer. This is the information that I have been sharing with my female networks, and I will not relent in doing so,” she says. RHU implements the Cervical Cancer Screening and Preventative Therapy (CCSPT) Initiative, which uses static clinics and outreaches as the main service delivery modes. The CCPT initiative aims at maximizing the number of cancer services offered to women through a validated, low-cost screening and preventative therapy approach. Screening is carried out using Visual Inspection with Acetic Acid (VIA) -an evidence-based and affordable alternative approach for cervical cancer screening in low-resource settings. The CCSPT Initiative offers instant treatment for clients with pre-cancerous lesions using cryotherapy –a method that involves freezing of precancerous lesions. Related: Reproductive Health Uganda: Effectively Responding to the Cervical Cancer Burden Ms. Annet Kyarimpa, the Special Projects Coordinator in the IPPFAR Member Association in Uganda –Reproductive Health Uganda (RHU) says that CCSPT Initiative outreach activities provide the biggest bulk of clients (over 75%). The success of this approach is largely attributed to the fact that the outreaches are conducted in lower level health facilities (including government health facilities) that provide a conducive service delivery environment. Story by Maryanne W. Waweru, IPPF Africa Region.