“Preventing and treating cervical cancer in a very low resource country like Ethiopia is not a dream. It is achievable”, says Doctor Biniyam Sirak. Together with Cordaid and the Female Cancer Foundation he is now actively training midwives in Ethiopia to screen and treat women in one single day, with low cost and maximum impact.
Cervical cancer, caused by the HPV virus, kills 266.000 women every year. 85% of women with cervical cancer live in developing countries. Among Ethiopian women cervical cancer is one of the leading causes of cancer mortality. 4732 Ethiopian women die every year because of the disease. By comparison, in the Netherlands mortality rates are 20 times lower.
“This training has opened my eyes.”
A cotton swab and vinegar
Yet unlike many cancers, it’s a preventable disease. This is why Cordaid, the Dutch Female Cancer Foundation and Beza for Generation en Mary Joy Development Association, two Ethiopian partner organizations, joined hands. With support from the Bristol Myers Squibb Foundation and Pink Ribbon Red Ribbon they are now promoting an innovative, low cost and easy to learn approach to prevent cervical cancer in one single visit.
Dr Anbessie, gynaecologist and certified See & Treat trainer, demonstrating the cryotherapy equipment to trainees (photo: Cordaid/FCF)
How? By screening for precancerous lesions with a cotton swab and acetic acid, also known as cheap table vinegar. Lesions can be seen with the naked eye and most can be treated immediately through freezing (cryotherapy). When identified at an early stage women can be screened and treated in one single visit. This avoids women having to come back to health centers for follow up visits.
See how vinegar can save millions of lives in professor Lex Peters’ (founder of FCF) TEDx talk.
Training midwives, important first step
This month the first 28 midwives, from health centers in Addis Ababa as well as in the rural area of Sidama, received a ten day training in the ‘single visit approach’. Fozia Yemam, one of the participating midwives: “My knowledge about the prevention and treatment of cervical cancer was so minimal. But this training has opened my eyes in two ways. It helped me understand the nature of the disease and to create awareness among women. And it has equipped me with the skills to treat precancerous lesions using cryotherapy equipment.”
Tekolla Tatek from Cordaid Ethiopia interviews Professor Lex Peters about the Screeen&Treat training:
Prevention is crucial
Doctor Biniyam Sirak, one of the Ethiopian gyno-oncologists who gave the training, explains the importance of this low cost way of preventing cervical cancer. “Especially in Ethiopia, prevention is crucial. We have only one hospital where women that have cancer can get radio-chemo therapy. Waiting lists may take six months. In the meantime the incidence rate is extremely high, but in terms of surgery or radio-chemo therapy there is hardly anything we can do.”
During the training 177 women were screened. 26 of them had precancerous lesions and were successfully treated.
Low cost, safe and immediate impact
According to Sirak the single visit approach, using vinegar and cryotherapy, could well be the best way to combat cervical cancer in his country. Western countries use the pap smear as a screening test for cervical cancer. But given the lack of medical manpower, of logistics and infrastructure, pap smear services would come with a high cost. “In my country people could not afford this kind of service.”
The best way forward, according to Sirak “is to make sure they are being found in the earliest stages of the precancerous lesions and to screen women and mothers with vinegar and treat them with simple cryotherapy. It is low cost, safe, has immediate impact and can be done with low level professionals with minimal training. And as we screen and treat in one single visit, there are no follow up losses. On top of that, this way of fighting cervical cancer can be easily integrated in other health care activities throughout the country.”