With You, Women in Sierra Leone Can Survive Cervical Cancer

by Dr. Hannah Ashley | Jun 5, 2024 | Global Health

Today, cervical cancer disproportionately affects the poorest women in the poorest parts of the world. But global, collaborative efforts to eliminate cervical cancer are accelerating, and World Hope International is part of the solution in Sierra Leone.

Signs Point to Future Without Cervical Cancer

Data shows vaccination against HPV, the virus that causes more than 90% of cervical cancers, combined with cervical screening radically reduces the risk of developing cervical cancer. A 2020 World Health Organization (WHO) strategy to eliminate cervical cancer worldwide has been adopted by 194 countries, and it’s likely that elimination will occur within our lifetime.

In March during the first Global Forum on Cervical Cancer, a collaboration of The Gates Foundation, UNICEF and the World Bank announced a commitment to accelerate the elimination of cervical cancer. This is our next opportunity to eradicate a disease. Australia, experts predict, will be the first country to eliminate cervical cancer as early as 2028.

Progress in Sierra Leone

The news gives hope to women in Sierra Leone, too. The Sierra Leone Ministry of Health started a cervical cancer screening program in 2021, primarily in the capital city, Freetown, and neighboring suburbs. World Hope has complemented this approach, piloting a cervical cancer screening project across the rural district of Bombali in northern Sierra Leone in 2022. Our small, dedicated mobile screening team visits every peripheral health unit in the district at least twice a year. We’ve screened more than 7,000 women in more than 80 villages.

Screening involves “see and treat,” a low-cost way of identifying, assessing and treating precancerous disease of the cervix during one short patient visit.

Treating advanced cervical cancer, however, is difficult. Patients have no access to radiotherapy in Sierra Leone and only limited access to specialist gynecological oncology surgeons. Only a few women who can afford international travel can find treatment for advanced cervical cancer.

But the precancerous stage, which typically lasts five to 10 years, offers an ideal opportunity for prevention. The screening method used is known as visual inspection with acetic acid, or VIA.  Acetic acid — vinegar — is readily available and inexpensive compared with the resources required for high-tech medical tests. Medical staff simply apply vinegar to the cervix, and after one minute, precancerous lesions take on a typical white appearance. Medical staff can treat these spots immediately with a portable, handheld, battery-powered thermal ablative device designed for use in places with limited resources, such as Sierra Leone.

The team’s ability to reach women in their own communities has yielded high turnout for screening and community acceptance of the see and treat approach. Of the 7,500 women World Hope has screened, 363 have had positive screening tests, and 343 were treated the same day.

The local communities trust and support our team partly because of our strong mobilization messaging. Milton, our community mobilizer better known as “Stuntman,” is key to our successful awareness campaign. A local musician whose songs impart important social messages, Milton has a recognizable voice that is trusted and enjoyed by many. His jingle about cervical cancer screenings brings joy and dancing to the women who wait in line for screening.

Challenges Remain

Still, many hurdles exist for women in Sierra Leone who need to be screened for cervical cancer:

Many women cannot afford to travel to the nearest town or city, and fuel cost has tripled in less than two years.
In May, plentiful mangoes disappear as the rains arrive. The approaching season is the hungry season, where women must work hard to plant rice, groundnut and cassava.
Even if women have transportation funds and time, they must have their husbands’ permission to be screened.

The women of Sierra Leone need you now so World Hope can screen them in their communities. Cervical cancer affects women when their families need them most: typically after early childbearing years when women are responsible for several children and are more economically active.

Today, children in Sierra Leone are still losing their mothers to cervical cancer. Death of a caregiver, studies show, directly increases childhood risks of mortality, poor nutrition and neglect. But it doesn’t have to be this way. We know how to prevent cervical cancer and give young girls in Sierra Leone hope for their futures. We can change children’s lives and save their mothers’ lives by eliminating cervical cancer. Screening will be needed in Sierra Leone for many years. And it is possible.

A Personal Story

Aminata, a 28-year-old mother of three children, lies in her hospital bed. She has severe abdominal pain and is anaemic. For the past week, she has had multiple blood transfusions; they haven’t worked. Her husband, one of our security guards, pleads with me to help her, but the news is bleak. She has advanced cervical cancer.

In less than a week, she dies, her youngest child is abruptly and prematurely weaned from breast milk.

A few months later, her husband asks me about my work, and I explain about cervical cancer screening. We encourage all our staff to attend screening. Aminata’s husband is a strong advocate who recognizes a simple test and treatment could have saved his wife and his children’s mother.

You Can Help

With you, we can screen more women in Sierra Leone. If we screen each woman for cervical cancer just once in her lifetime, we can cut the death rate from cervical cancer in half. We already are reach the most unreachable, the most vulnerable and the poorest. Will you help us reaching our goal of screening more women for cervical cancer in Sierra Leone? Because of you, they can have opportunity, dignity and hope.