By Andrea Kirsten-Coleman In many parts of the world, the word “innovation” means shiny new technology, the latest gadget, or a scientific breakthrough. In the field of cervical and breast cancer, “innovation” means much more than that. Rather than a single innovation, an innovative, multi-pronged approach is key to saving the lives of as many women as possible. The work of Pink Ribbon Red Ribbon in Tanzania is a good example. In a country where breast and cervical cancer are responsible for more than half of all cancer deaths, we and our implementing partners have found that these innovative approaches can make a difference by helping to bring services to scale more rapidly, strengthen the health system, and save lives.
- A regional focus: To maximize the effectiveness of our partners’ investments and activities, Pink Ribbon Red Ribbon has adopted a regional approach in Tanzania. Our implementers are delivering services in Dar es Salaam, Iringa, the Lake Region (Mwanza and Mara), and Mbeya. This “hub-and-spoke” model allows women to undergo screening and basic treatment for cervical pre-cancer at satellite sites, and receive a referral to a regional hospital for more-advanced care, if needed.
- Single-visit approach: Most women in Tanzania have never undergone a pelvic or clinical breast examination in their lifetimes. The result? Eighty percent of women with invasive cancer show up at a hospital when their illness is at an advanced stage, for which doctors can often do very little. The single-visit approach is a low-cost method that uses simple vinegar to screen for cervical lesions, and offers immediate cryotherapy treatment to remove them, which saves women the time and expense of making another trip to the clinic. Clients can take care of their health and return to their household chores and businesses on the same day.
- Social mobilization: Working with a network of credible local community-based organizations has proven effective in mobilizing women to get screened. In 2014, with Pink Ribbon Red Ribbon support, five community-based organizations, Medical Women Association of Tanzania (MEWATA), T-MARC Tanzania, Wanawake Na Maendeleo Foundation (WAMA), Tanzania Youth Alliance (TAYOA) and Mbeya HIV/AIDS Network, collectively sensitized 48,939 women by using conventional community-communication approaches and SMS technology.
- Rapid scale-up: To reach larger numbers of women, mass screening campaigns at the regional level have proven more successful than waiting for women to appear at static clinics. In 2014, local Tanzanian partners (MEWATA, WAMA, T-MARC, TAYOA) and the national Ministry of Health and Social Welfare all joined under the patronage of Her Excellency First Lady Salma Kikwete to sponsor a mass screening of women in the Mwanza Region in northwestern Tanzania. Over the course of two days, nurses screened over 5,000 women for both breast and for cervical cancer.
- Strengthened referral services: One of the reasons many women fail to continue with further treatment is that they lack the financial resources for transportation. Through a grant from Pink Ribbon Red Ribbon partner Vodacom Foundation, women in three Regions of Tanzania can now travel for advanced cancer treatment to Ocean Road Cancer Institute (ORCI) in Dar es Salaam and, later in the year, to Bugando Medical Centre (BMC) in Mwanza. “Ambassadors” from our local partner Comprehensive Community-Based Rehabilitation in Tanzania (CCBRT) purchase bus tickets for the women by using Vodacom’s m-Pesa mobile-phone cash-transfer system, and assist them to start their journeys. T-MARC “Cervical Cancer Champions” greet the patients at the bus station in Dar es Salaam (and soon Mwanza), and guide them to the treatment center. This process reduces the barriers to care, helps women finish their cycles of radiotherapy, and helps them return home afterwards to continue productive lives.