Thank you so much for all your past support. This will be the final report for IMA World Health’s Combating Cervical Cancer in Tanzania project on Global Giving. IMA will continue this program and continue to raise funds for our cervical cancer prevention and treatment program through our website. IMA World Health has been implementing cervical cancer prevention and control programs in the Mara Region of northwestern Tanzania since 2011. IMA has screened nearly 5,000 women between 30-40 years of age and treated over 300 women.The main cause of cervical cancer is the human papillomavirus (HPV), a common virus that can be passed from one person to another during sexual intercourse. It can be prevented by either primary prevention, through abstinence and HPV vaccination, or secondary prevention by way of screening and treating pre-cancerous lesions. This problem is compounded by the HIV/AIDS epidemic in Tanzania. Being HIV positive increases the risk of developing cervical cancer by at least 50%, as well as contributes to an earlier onset of the disease by 10 years (1).Tanzania has one of the highest cervical cancer burdens in the world, with incidence of 50.9 cases per 100,000 women (2). This burden is 50% higher than the East African average and nine times higher than Europe and North America. However, if pre-cancerous lesions are detected and treated early, cervical cancer is almost 100% curable. IMA selected implementation for the Cervical Cancer Prevention and Control program in the Mara Region of Tanzania because it is among regions where HIV prevalence has increased from 3.5% in 2003/04 to 7.7% in 2007/08 (3). IMA has been working in the Mara region for the last 10 years and has a strong working relationship with the health leadership. To overcome the access barrier IMA has engaged in outreach activities providing cervical cancer screening and treatment at the community level in the Tarime, Rorya and Musoma districts. IMA also collaborates with the Ministry of Health and Social Welfare (MOHSW) in the development of national IEC materials to raise community awareness of the importance of cervical cancer screenings and early treatment. In addition, IMA has increased capacity building efforts to include training of health care workers (21) and procurement of necessary equipment for screening and treatment. IMA has also developed a cancer database to capture data of all women screened and treated for cervical cancer at the health facilities. IMA is implementing the Cervical Cancer Prevention and Control program by providing appropriate and quality cervical cancer care and treatment services to include screening and treating pre-cancerous lesions. In addition, IMA is working with hospitals to build community awareness of cervical cancer risks and successes in treatment to promote screening and treatment uptake and demand for these services. Thank you for all your past support. We could not provide the services we have provided over the past few years without your support. You have truly made a difference in the lives of women in need of cervical cancer screening and treatment. If you would like to continue to follow or support our work on cervical cancer please visit our website and our Facebook page (links found below). If you would like to continue to support an IMA World Health project through Global Giving please check out our Safe Motherhood Kit project. Again, thank you for all your past support!
1 Kehesa C, Mwaiselage J, Wabinga HR, et al 2008. “Association between cancer of the cervix and HIV-1 infection in Tanzania: the need for dual screening” BMC Public Health, 8:262 2 World Health Organization. Tanzania: Human Papillomavirus and Related Cancers, Fact Sheet 2010. http://apps.who.int/hpvcentre/statistics 3 Tanzania HIV/AIDS and Malaria Indicator Survey. Government of Tanzania. 2007-08
Thirty-one year old, Happiness, who lives in Nyamongo in Tanzania traveled 31 miles from her home to Tarime District Hospital because she was in desperate need of HIV testing and cervical cancer screening. Unfortunately, the Sungausungu Health Centre that is closest to where she lives has limited medical capacity.
After being screened Happiness said, “I enjoyed the screening because I wanted to know my status for HIV and cervical cancer and I trust in the procedure by the way I was examined thoroughly.” Happiness also stated, “The staff explained the procedure to me and eased my fears.” Happiness concluded by saying, “I encourage women to be screened for cervical cancer because I thought it would be painful but it wasn’t painful at all.”
Happiness learned of the screening through her church. She brought four other women along with her and has since motivated many others to make the trip for cervical cancer screenings.
Happiness and the four women she brought with her are just a few of the many women who have greatly benefited from the cervical cancer screening and treatment available at the Tarime District Hospital. Your support helps screen more women in need of this life-saving screening.
IMA currently implements cervical cancer programs at established health facilities, Shirati Hospital and Musoma Regional Hospital, both in the Mara region. Due to the growing need for cervical cancer screening and treatment services in the rural areas surrounding these two health facilities, IMA also engages in outreach activities providing cervical cancer screening and treatment at the community level. On June 6th, IMA provided an outreach screening where HIV testing as well as cervical cancer screening and treatment were provide at Tarime District Hospital, also located in the Mara Region but near the Kenyan border. Originally scheduled for two days for 150 women, but the turnout exceeded expectations so the event was extended to three days where 560 women were screened for cervical cancer. Of those screened, 15 were diagnosed with precancerous lesions and received cryotherapy treatment the same day.
Nyafuru Masoya Matiku, a participant at the cervical cancer screening at Tarime District Hospital, is a 31 year old woman with four children, three boys and one girl. When asked would you vaccinate your daughter she stated, “yes, that is the preferred prevention method for my child to be protected from cervical cancer.” Nyafuru is from Nyamongo, a town in northern Tarime, approximately 316 km from Arusha and an hour from Musoma Regional Hospital. Nyafuru paid 5,000 TSH (approximately $3.00) to get to the screening at Tarime District Hospital, which shows her determination because the majority of people prefer to go to health facilities that are walking distance from their home. Nyafuru heard about the screening while at the hair salon, there women were talking about the screening and which day they planned to attend.
Nyafuru brought two women from her village with her to the screening event so they too could be screened for cervical cancer. In addition to cervical cancer screening, Nyafuru was also offered and agreed to be tested for HIV. When asked her thoughts on the screenings being offered in Tarime she remarked, “please keep coming to help us because we need this service here in Tarime.”
Your support can help screen more and more women in need of this valuable and life-saving screening.
In efforts to prevent and control cervical cancer, IMA World Health, in collaboration with the Ministry of Health and Social Welfare (MOHSW) has established cervical cancer screening sites in two districts of the Mara Region located in northwestern Tanzania. IMA is implementing the Cervical Cancer Prevention and Control Program by providing appropriate and quality cervical cancer care and treatment services to include screening and treating pre-cancerous lesions on the cervix according to the national guidelines. In addition, IMA is working with hospitals to build community awareness of cervical cancer risks and successes in treatment to promote screening and treatment uptake and demand for these services. IMA’s cervical cancer prevention program has been in operation since 2011 and to date nearly 5,000 women have been screened and treated.
IMA’s cervical cancer screening and treatment techniques use the visual inspection with acetic acid (VIA) approach as well as the Single Visit Approach (SVA) as outlined in the MOHSW’s Tanzania Service Delivery Guidelines for Cervical Cancer Prevention and Control. Screenings are offered daily, and if diagnosed positive with pre-cancerous cells, the woman is treated with cryotherapy. SVA allows women to be screened and treated on the same day so they do not have to come back for treatment should they be diagnosed with pre-cancerous cervical cancer cells. This approach is beneficial to the women screened, as health facilities are sometimes very far from their home and having to make multiple trips after diagnosis may result in the women not returning for treatment. This is very unfortunate as cervical cancer is highly curable if diagnosed and treated early.
Due to the growing need for cervical cancer screening and treatment in the rural areas surrounding the health facilities IMA engages in outreach activities providing cervical cancer screening and treatment at the community level. On June 6th, IMA provided an outreach screening where they provided HIV testing as well as cervical cancer screening and treatment at the Tarime District Hospital, located in the Mara Region near the Kenyan border. Originally it was scheduled for two (2) days and 150 women but the turnout was so great, the event was extended to three (3) days and 560 women were screened. Of the 560 women screened, 23 were HIV positive (4%) and 15 were VIA+ (3%), of the 15 that were VIA+, 4 were HIV+ (27%).
Through the years, treatments have been developed for infectious diseases such as HIV/AIDS and malaria. These diseases impact the lives of all people especially women in developing countries but in recent years non-communicable diseases such as diabetes and cancer are also being diagnosed. It is so unfortunate that we can save a woman from dying of HIV/AIDS only for her to be diagnosed and die from such a treatable disease as cervical cancer. Through continued support, IMA can maintain the cervical cancer screening and treatment program to save the lives of women in Tanzania.
IMA World Health first met Nyangeta, 29, at an HIV/AIDS careand treatment center (CTC) in Tanzania through our work with Project LEAD.
She was diagnosed with HIV a year ago. Having depended on her aunts andolder brothers and sisters for survival since she was orphaned at 15, Nyangeta wasnervous about how her family would react to the news.
She explained, “I was so much disturbed by these results, it was verydifficult for me to disclose to my brothers and sisters. However, when I joinedthe Groups for People Living with HIV/AIDS, through sharing, I was empoweredand disclosure was somehow easy. I am now living positively, and sometimes I goto work at the care and treatment center to encourage the newly diagnosedclients.”
Because of the medical treatment and emotional support she receives throughthis program, Nyangeta has been able to continue working on her brother’ssubsistence farm, where she lives with her eight-year-old child.
Recently, during Nyangeta’s routine checkup at the CTC, a nurse educated her on thedangers of developing cervical cancer, especially when one is HIV positive. Accordingto recent studies, a weakened immune system due to HIV significantly increasesa woman's chance of developing cervical cancer. Nyangeta also learned aboutthe Cervical Cancer Prevention and Control program that IMA World Health and partners beganoffering at Musoma Regional Hospital last fall, and she started talking with otherwomen who had already undergone screening. They encouraged her to go for theprocedure.
After her screening, Nyangeta told us, “I was so much impressed by the screeningteam. They are conducting a group as well as one-to-one talk, explaining theprocedure, what is expected, the meaning of positive and negative results and thetype of treatment given when the results are positive. We were allowed to askquestions and got clarification. We miss this in most of our other clinics,probably because of time, but more so I think because of lack of commitment ofsome of the health care providers.”
Nyangeta tested positive using the visual inspection with acetic acid approach (VIA).Since the project utilizes a “Single Visit Approach,” she received cryotherapytreatment that very day. She was thankful for early detection andimmediate treatment.
“I thank God for this opportunity,” Nyangeta said. “I would have reported with advanced cancer [if Iwould not have gotten my cervical cancer screening when I did]. This is myfirst time to have a screening done on me since I was born. I have already informedmy friends through their mobiles. They are on their way, coming for this examination.”
Thanks to the caring support of our generous donors – including Week of Compassion and the AmericanBaptist Churches (USA) – as well as the commitment of the health workers atMusoma Hospital, Nyangeta’s story has a happy ending, and she is spreading theword so other at-risk women can get the screenings and treatments that can savetheir lives too.
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Combined with other sources of funding, this project raised enough money to fund the outlined activities and is no longer accepting donations.
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