Uganda: Cervical cancer: Little-known but deadly (IRIN)

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In the obstetrics and gynecology ward of St. Mary’s Hospital Lacor in northern Uganda’s Gulu District, Apilli Kilara lies on the floor under a blood-stained sheet, staring at the ceiling.

The 43-year-old mother of seven is in the advanced stages of cervical cancer.

She noticed an unusual itching after her fifth delivery in 2007. Then in 2011, after her seventh child, she had sharp pains in her pelvis and irregular bleeding. She remembers, “The pain and bleeding didn’t stop. That’s when I started imagining something was wrong with me.”

Mrs. Kilara could have been treated successfully if the disease was caught early, but she knew nothing of cervical cancer at the time. Now, doctors fear she may not live much longer.

Lying next to her is another patient diagnosed with cervical cancer. Akello (not her real name) is 39. When her symptoms began, Akello thought witchcraft was responsible, and sought treatment from a local healer.

She says, “I had been visiting a traditional herbalist for treatment in vain; that is what women suffering similar ailments in my village do.”

Cervical cancer is the most common form of cancer affecting Ugandan women. Every year, over 3,500 women are diagnosed with cervical cancer, and nearly 2,500 die. In comparison, 1,100 women die of breast cancer every year.

It is estimated that about a third of Ugandan women harbour cervical human papillomavirus − the main cause of cervical cancer − at any given time.

A study from the University of Washington in the US found that three-quarters of all reported cases of cervical cancer now occur in developing countries. Almost half are in women under 50.

Pontius Bayo is head of obstetrics and gynaecology at St. Mary’s Hospital Lacor. He says the hospital has a limited ability to treat women with cervical cancer. Eleven per cent of deaths in the maternity ward result from the disease.

Health workers worry that, due to lack of knowledge, cervical cancer will continue to go undiagnosed and untreated. Mr. Bayo adds, “It’s a concern in a situation where there is no adequate outreach program for screening and treating the disease in its early stages.” In addition, many women diagnosed with cervical cancer cannot afford treatment. Many cannot even afford the fare to the hospital.

The Ugandan Women’s Health Initiative, or UWHI, is a collaborative effort between universities and hospitals to address women’s health issues. UWHI, which conducts cervical cancer screening around Uganda, says even major referral hospitals do not offer regular screening. UWHI’s Tom Otim says, “There is very high need for women and their husbands to be sensitized so that they know the symptoms of cervical cancer.” He emphasizes, “It’s a neglected area that requires attention.”