Cervical cancer is the number one cause of cancer deaths in Malawi; not breast cancer, not lung cancer, not colon cancer, but cervical cancer which can be prevented by early detection and treatment of precancerous lesions on the cervix. Cervical cancer cases are much lower in developed countries due to screening, specifically with the Pap smear. However, Pap smears are not affordable and are not feasible in Malawi: there is only one pathologist to read them in the country and he is based in Blantyre. Visual Inspection of the Cervix with Acetic Acid (VIA) was developed previously by international healthcare providers as an inexpensive, effective way to detect precancerous changes in the cervix. If changes are detected, there are treatments available to remove the lesion to prevent it from developing into cancer.  The Ministry of Health in Malawi is pushing for more VIA testing throughout the country.

As part of my work at Partners in Hope (PIH), I will be responsible for its cervical cancer prevention program.  This is an especially important program among our clients who are infected with HIV since the precancerous changes happen as a result of an infection with the human papilloma virus (HPV); HIV-infected clients’ immune systems may not fight this infection as well as others and therefore these lesions may grow more rapidly, progressing faster to cancer if unchecked.

Although I am still in language training until mid-February, I recently attended a VIA training hosted by PIH and arranged by the Ministry of Health. It was a challenging week of meetings because not only was I a participant in the training, but one week before the training started, I was asked to oversee last-minute preparations because the organizer of the meeting was called out of town. He assured me these preparations would only involve” a few phone calls and a few visits to PIH.” Then later I discovered I would be the point person for the entire VIA training. So … while learning VIA along with the other participants and preparing how I would speak to clients in the clinic with my limited Chichewa, I also had to solve all of the problems during the training. And there were plenty of them!

The training proceeded with over 150 women receiving VIA examinations at two venues. Six women (all HIV +) at PIH were found to have precancerous lesions; one was treated with cryotherapy at PIH (I was able to assist with this cryotherapy and got hands-on experience with this instrument). The other women’s lesions were too large and they, in addition to a woman who had lesions suspicious for cervical cancer, were referred to a nearby gynecologist for treatment. Here were 7 women who now were going for treatment who would not have known there was a problem except for the VIA examinations we completed.

In four days, we found 7 women who needed further treatment to prevent cancer or to treat it in its early stages. Can you imagine what an impact this program will have on the women at PIH and in Malawi over a year, two years, 10 years?