Last week, after having many weeks of administrative work for the VIA (cervical cancer prevention through Visual Inspection with Acetic Acid) program, I was feeling discouraged about my role. It seemed like it was difficult to get many women to come to the VIA clinic and there were many barriers to integrating this program into the HIV clinic as part of their standard care. But then two women came in and reminded me of the need for this program.

Last week, “Patience,” a 30-year-old woman, came to show me her health book. In April, we had referred her to the Central Hospital due to a lesion suspicious of cancer. She had gone to the hospital twice, but had been turned away because there were too many women needing care and they only had time to see the women who had come from far away. She returned to us in October. We checked again, but came to the same conclusion: a lesion suspicious for cancer. This time, I took her to the hospital and made the appointment with the gynecologist. As I looked in her book last week, I saw the pathology report showed a lesion with an early cancer, one that can be treated; she will be receiving a hysterectomy soon. I was so thankful we caught it early.

The next day, Chisomo, a 51-year-old woman, noticed me in passing and started chatting with me about her results. We had referred her to the Central Hospital for a large lesion we could not treat with cryotherapy. It turns out the lesion contained an early cancer and she also was scheduled for a hysterectomy to remove this cancer. She was so happy we found this at an early stage.

As of the end of October, we have provided initial screening for 297 women at the VIA clinic  at Partners in Hope (PIH). Of these women, 23 have needed cryotherapy and 40 have been referred to the Central Hospital because of large lesions or lesions suspicious of cancer. So about 20% of the woman we see in the HIV clinic require further treatment. We are excited about this program because with VIA we can detect these lesions early so the women can be treated rather than die an excruciatingly painful death due to cervical cancer; most Malawian women diagnosed with cervical cancer have been diagnosed at such a late stage that palliative care is the only treatment option available and pain medicine is in short supply.