4 February 2013

Zimbabwe: 'Cancer - Did You Know?'

Every 4 February is World Cancer Day on the international calendar. Many countries take the opportunity to educate their citizens about cancer, how to prevent it and improving the quality of life for cancer patients. This year, World Cancer Day is focussing on target five of the World Cancer Declaration, "Dispel damaging myths and misconceptions about cancer" under the banner "Cancer: Did you know?"

The World Cancer Day website lists four myths namely, cancer is just a health issue; cancer is a disease of the wealthy, elderly and developed countries; cancer is a death sentence; and cancer is my fate.

Indeed, myths exist in our societies and in particular African communities. Reproductive health is not something discussed with ease. We do not talk about our private parts. We do not discuss them. If there is something wrong with them you seek medical help quietly or you secretly hope if you ignore the problem, it will eventually go away.

So, one day in 2012, I nervously walked into the waiting-cum consulting room for cancer screening. I had undergone screening several times before, but I still felt my heartbeat race at an elevated pace and my breathing became more and more laboured - just what happens when I have anxiety attacks.

However, on this day I also took my helper of 20 years along. She had never done cervical cancer screening before. At one point, she looked composed but grew very quiet within seconds. I assured her that the test is pain free and that whatever the result, we would deal with it together. I had to be strong, not just for my being, but my helper whom I had dragged along.

We sat in the waiting room for counselling and listened to the nurse tell us the importance of cervical cancer screening. About 26 of us sat shame faced starring at our hands. I could see that like me, the other women were wishing they were anywhere but in that waiting room.

Many women who have undergone cervical cancer screening will tell you it is not the test they dread but the result. I try to get screened the recommended twice a year and in 2012 I felt guilty about not encouraging my housekeeper to be screened too.

Cervical cancer is the most common cancer among African women. The high statistics of women living with HIV and AIDS have also seen a rise in the number of young women getting cancer.

According to Zimbabwe's Health Ministry, cervical cancer accounts for 33.4% of all cancers in the country. The 2009 Zimbabwe's National Cancer Registry (ZNCR) recorded 3519 new cancer cases, 1427 males and 2092 females.

In the past, the cost used to be prohibitive and few centres provided cancer screening. However, the Zimbabwean government is making a concerted effort to get as many women screened as possible.

Recent developments might even make it easier for more women to access screening services and treatment in cases where this might be required. Zimbabwe has introduced a less expensive cervical cancer screening using Visual Inspection with Acetic Acid and Cervicography (VIAC). Many municipal clinics now encourage sexually active women of all ages to have a VIAC or pap smear.

However, challenges remain.

According to a 2012 research by the Southern Africa Litigation Centre (SALC) titled Tackling Cervical Cancer: Improving Access to Cervical Cancer Services for Women in Southern Africa, cervical cancer is "the prime example of global inequality in health." Most countries in the region for example Namibia, Zambia and Zimbabwe lack a comprehensive national policy on cervical cancer.

Cancer screening service provision is in some cases erratic. Statistics of the different cancers are thin on the ground and the latest cancer statistics by the ZNCR are from 2009. Collection of data, let alone sex-disaggregated data is a problem shared by other countries in the region.

While getting screened is the first step, the real challenge comes in treatment if one is diagnosed with the disease. Vaccines against the human papilloma viruses that cause cervical cancer are not always available. Some countries in the region can barely provide simple drugs for common ailments let alone high-end cancer treatments. In some cases having a hysterectomy is the most prevalent form of treatment.

Personnel shortages throughout the region compromise the number of citizens who can be screened. In some of the main hospitals in Zimbabwe screening is carried out twice a week but there are clinics that now do daily screenings. However, some only take between 26 and 30 women per day.

In the past poor laboratory services compounded by staff shortages meant that one would have to wait for anything from a week to two weeks for pap smear results. I always found the two weeks waiting period agony.

Now a digital (Cervicography) picture of the mouth of the womb is taken and viewed on a television or computer screen. In three minutes I experienced the latest screening method and had my results.

As we commemorate World Cancer Day, let us demystify cancer and as women and men encourage each other to go for screening. Early detection will go a long way in reducing mortality. My helper's wide smile showed a sign of relief.

We headed back home, a spring in our step but deep down knowing that in six months we would be doing it again and will be just as scared as if it will be our first time.

So as my helper and I wait, encourage and take a friend for a cervical cancer screening. Fighting cervical cancer in Southern Africa is possible, only if women take agency!

Grace Mutandwa is a freelance journalist based in Zimbabwe. This article is part of the Gender Links Opinion and Commentary Service, bringing you fresh views on everyday news.

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