Agnes Musonda meets with members of the Chief Mphamba Village community
Pink Ribbon Red Ribbon began supporting cervical cancer control programs in 2011, when President George W. Bush announced Zambia as Pink Ribbon Red Ribbon’s first partner country. Nine out of 10 cervical cancer deaths occur in less developed regions and in Zambia, cervical cancer kills more women than any other cancer. At the launch of PRRR in Zambia,the team traveled to the George Urban Health Center and Cancer Diseases Hospital in 2011, where we met with myriad cancer survivors – many of whom were HIV-positive. Their stories taught us that working with local governments, engaging with the private sector, and leveraging existing health systems can create positive outcomes for women. Seven years later, we still look to Zambia for stories that confirm the successes of our partnership model.
Agnes Musonda, the Health Promotion Manager at the Ministry of Health/ Center for Infectious Disease Research in Zambia (CIDRZ), met with a woman named Jane* to tell her story. Jane is one of the headwomen of Chief Mphamba Village in rural Lundazi District in the Eastern Province of Zambia. She is respected in her community and participates actively in important village matters. Jane has lost friends and family in the village to cervical cancer, including her mother-in-law – Diana*.
Jane explained that when Diana first noticed her symptoms, she sought help from various traditional healers, who administered medicines ranging from roots and leaves to herbal liquids. Nonetheless, her health deteriorated, and she eventually became so weak and lethargic that she was taken to the Lundazi District Hospital. Sadly, by the time she reached the hospital, her cervical cancer had advanced to a late stage. The best her nurses could do was administer painkillers and antibiotics to manage the various other infections she had acquired. After some time in the hospital, Diana lost her battle with cervical cancer, like many other women in her position.
Since losing her mother-in-law, Jane has made a conscious effort to encourage other women in the village to go for cervical cancer screenings. Even more importantly, Jane hopes to direct her efforts to creating awareness about cervical cancer amongst young girls – especially those who are still in school and can be vaccinated against the human papillomavirus (HPV), the virus that causes most cervical cancer cases. The PRRR partnership supports immunization for girls ages 9 to 13, as it is unlikely that girls in this age group have reached their sexual debut and therefore can be protected by the vaccine. The HPV vaccine is both safe and effective; in fact, the vaccine has been proven to prevent against close to 100% of HPV-16 and HPV-18 strains– the strains that cause cervical cancer.
It is important to take heed of stories of women like Jane, who have witnessed the realities of cervical cancer in a country with such a high incidence rate. Jane’s story shows us that our work in ending cervical cancer is far from over. In Zambia, the incidence of cervical cancer is 58 per 100,000 women, 9 times that of the rate in the United States. 40% of women who present with advanced-stage cancer are under the age of 35. At this age, many of these women are in their prime: they’re contributing to their communities, they’re raising children, and they’re caring for their families. Like Diana, many women who seek care for cervical cancer are already at an advanced stage, especially in areas without cervical cancer screening programs. It is also important to note that according to UNAIDS, there are over 640,000 Zambian women living with HIV/AIDS, which puts them at a higher risk for cervical cancer. Women living with HIV are four to five times more likely to develop invasive cervical cancer due to their compromised immune systems.
Pink Ribbon Red Ribbon’s nationwide programs in Zambia have helped vaccinate over 48,000 girls against HPV and screen over 278,000 women in for cervical cancer, and supported the Government of the Republic of Zambia in launching their National Cancer Control Strategic Plan. Through our partnerships, we have also helped educate countless girls, women, and men about the risks of cervical cancer, and how to avoid these preventable deaths.
Looking forward, PRRR aims to continue to reduce deaths from cervical cancer, particularly among HIV-positive women, who are at a higher risk. We aim to continue to screen and treat in our partner countries, increase awareness of cervical cancer, and promote early detection. With our partners, PRRR will continue creating and testing innovative approaches to sustainability, financing, and service-delivery that can be scaled up and used widely.
*Names have been changed to protect the identities of the women
Photos by Agnes Musonda, Program Manager for Breast and Cervical Cancer Health Promotion, Ministry of Health/CIDRZ