I was recently very lucky to travel to Nepal with the Australian Cervical Cancer Foundation (ACCF). We went as a team of staff and volunteers to mark the 5th Anniversary of our Vaccination and Screening Programs in Nepal which commenced in 2008.
Cervical cancer is the leading cancer killer for women in Nepal and in many other developing countries around the world. In fact, well over 250,000 women die from this cruel disease every year - this is what the World Health Organisation tells us but we know that this is probably a gross under-estimate. What we do know though is that 90% of these women are in developing countries like Nepal where women have usually no access to health services such as Pap tests like women in Australia have access to.
ACCF’s mission is to bring the Brisbane-invented cervical cancer vaccine for free to girls in countries like Nepal and to also work with local partners to provide cervical cancer screening camps for women. By vaccinating a girl we can reduce her risk of dying from cervical cancer by up to 80%. By screening a woman just once in a developing country, we reduce her risk by up to 40%.
On my first day, we visited a Screening Camp in the village of Banepa - about an hour outside of Kathmandu. These camps are held in various districts and by working with local organisations we are able to get to each village every 4- 5 years. At this camp, 157 women from Banepa have come to be screened. Wearing their bright and vibrant saris, some women walk up to half a day just to come and get checked so that they can have peace of mind for another few years.
Out of 157 women, one woman presented with serious abnormalities which could develop into cervical cancer. A biopsy was taken and sent away to a laboratory in Kathmandu for testing. She can be assured that even if the results confirm there is an abnormality, ACCF will be there to help her with treatment and follow-up. 56 women that day presented with some sort of infection like thrush that the nurses were able to treat there on the spot. Infections they have possibly been putting up with for years that, if left untreated, could lead to more serious health concerns.
It was unusual that at this camp we didn’t see a case of cervical cancer as we usually do. That is probably because these women have been screened and treated previously. For less than a couple of dollars, we can treat them on the spot and give them medication to take away with them. Simply mind-blowing for the group of us who probably have a GP surgery and a Chemist probably within a 5km radius of our homes that we can most likely drive to in our cars in less than 10 minutes.
The screening room is very basic. A big room divided by makeshift curtains and a bed for them to lie on with a bucket underneath them for waste. It is very very rudimentary, but it does the job and these women are so grateful to have the opportunity that they were beaming. Once the camp was finished for the day, we sat down and had a chat with a group of about 10 of these women.
One woman shared how a previous screening camp identified that her daughter-in-law had early stages of cervical cancer a couple of years ago. She was able to have a hysterectomy and is now well. Another shared how she herself was diagnosed as having a prolapsed uterus - probably caused after childbirth. ACCF was able to help for her to arrange surgery to repair it.
When I asked them, what it meant to them to have access to cervical cancer screening one woman replied “Women in our country are lagging behind in so many ways that to have this opportunity to be proactive about our health, we take it with two hands. We are so very very grateful. Thank you.” Another woman replied “My dream is that we could be screened every year rather than every 4-5 years. Just so we have more peace of mind about our health. If we are healthy then so are our families and our communities.”
I explained to these women that in Australia the current guidelines are that women are screened every 2 years. The women gasped and were very envious. I told them that 43% of women in Australia, even though they have this opportunity, don’t get screened whether it is through choice or because they simply forget. The women were shocked.
From their perspective they can’t believe that if women are given this opportunity, why wouldn’t they take it? It is a difficult one to answer. I find half my work is about encouraging women why they should be screened at all here in Australia and then on the flipside we have these women who are desperate to be screened more. We really don’t know how lucky we are to even have choices.
At about 5pm and we had a giggle with the women about how their husbands don’t like helping with housework duties too and as the nurses packed up the camp, I wonder what these women will go through healthwise during the next 4 years until the camp returns to their village. They smiled and were happy they have peace of mind at least for the meantime as they began their 3-4 hour walk home.
The Australian Cervical Cancer Foundation has been working closely with the Nepalese Ministry of Health to get cervical cancer at the forefront of their Health Agenda to make Screening a National Program that all Nepalese women will one day have access too. ACCF has also been talking with Australian Diplomatic officials in Nepal to help influence Australia’s AusAID Agenda of which health is a priority. Until then though, the generosity of Australian people and the AXIOS Gardasil Access Program has meant that ACCF has been able to vaccinate over 95,000 girls in developing countries like Nepal, Bhutan and Kiribati since 2008 as well as screening thousands of women who would otherwise not be screened.
For as little as $50, ACCF can fully vaccinate a girl in a developing country with donated vaccine and just $15 will screen and treat a woman for cervical cancer. ACCF’s mission is to help countries like Nepal to get started with Vaccination and Screening Programs so that eventually these are Programs that they will be able to run themselves. Our influence to date has encouraged the Nepalese Ministry of Health and Population to commit to screening at least 50% of the women in Nepal over the next 5 years. Do we realise how lucky we are when Australian women have the opportunity to be screened every 2 years but 43% of women aren’t taking the life-saving opportunity to be screened? Do we really realise how lucky we are?