Hope as a flag against cancer

“I got depressed.

People told me that cancer cannot be cured, ”Madalo Gwaza whispers from his bed at Queen Elizabeth Hospital in Blantyre, Malawi.

"Mom, don't cry, don't be sad, don't lose hope," her children told her.

Those words gave him the strength to fight.

With Madalo and his testimony begins the second episode of

a mini documentary made by Doctors Without Borders to make visible the urgency of bringing more resources and improving treatments for this type of cancer in the African country.

Here, more than 3,600 women are diagnosed each year, and more than two-thirds of them end up dying from the disease.

It is the most common type of carcinoma among the female population of the country and the number of affected is very high, especially considering that it is a disease that can be easily prevented through the vaccine against the human papillomavirus ( HPV).

More information

• Why Rwanda could become the first country to eradicate cervical cancer

• Georgios Papanicolaou, the discoverer of the uterine cancer test

• A decade of the human papillomavirus vaccine: debunking myths

This high mortality is due to a combination of factors:

- The limited availability of the vaccine against human papilloma in the country.

- The lack of routine controls and awareness campaigns, which often means that cancer is only detected in very advanced stages of the disease;

- Access to treatment is very limited (only two hospitals in the entire country offer specific care for women diagnosed with cervical cancer and there is not a single place in Malawi to receive radiotherapy).

- The economic barriers to be able to carry out a simple biopsy, whose cost, of about 25 euros, is far from the reach of many women who live on just one dollar a day.

In Malawi, a high percentage of the population cannot afford to pay for quality health care.

- The high prevalence of HIV among the population only makes things worse: for women living with HIV, the risk of developing cervical cancer is six to eight times higher compared to other women.

Doctors Without Borders (MSF) is running a free cervical cancer program together with the health authorities of Queen Elizabeth Central Hospital.

It went live in 2018, initially offering outpatient screening, consultation, and treatment for precancerous and cancerous lesions.

At the end of 2019, activities to promote health, specialized surgery and palliative care began to be carried out for those patients who are in more advanced stages of the disease.

All this, within the hospital structure and also through support to various health centers in the district.

Awareness sessions are also held in the communities and we offer palliative care at home for those patients who have very limited mobility.

And finally, in 2020, vaccination campaigns against the human papilloma virus have been started together with the Ministry of Health.

Having access to free and specialized surgery has saved the lives of women like Madalo, now a resident of Monkey Bay, a village by Lake Malawi that she describes as “a beautiful place, where people come to fish and swim. ”.

The 56-year-old trader made her living by buying fish from local fishermen and then selling it at the market.

Her life changed dramatically in late 2018, when she began experiencing vaginal pain and bleeding.

"My symptoms kept getting worse and I had to stop working," he says from bed.

Her words could well be those of any other woman in that room, as they have all been through similar experiences.

“I was diagnosed with cervical cancer and I had to start making regular trips to Blantyre for chemotherapy.

I quickly ran out of money.

My oldest son helped me with his savings, but I also had to borrow 25,000 kwacha [30 euros] from a group of moneylenders in my community.

I still don't know if I can return them ”.

Despite all the difficulties, Madalo considers herself lucky to be among the minority of Malawian women who have managed to access effective cervical cancer treatment and be cured.

Now, your intention is to fully recover and go back to work.

In the next episode, some of the women with more advanced cancer and very poor living conditions explain their difficulties in accessing treatment.

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