Cervical Cancer History

As we wind our way deeper into Kisenyi II past the pungent aroma of fermenting millet, down a steep alley, through a door that opens onto a dirt courtyard of children playing and women washing clothes, around the corner of a block of latrines you can see how a child could get washed away in a downpour. We edge along narrow ledges between houses, the drop-off off to deep open sewers inches from my toes. I duck my head to follow Veronica into a house, a sheer piece of cloth is the door. We are welcomed and a colouful woven mat is layed on the floor where I sit, legs bend beneath me next to Hadija, a wide-eyed 2-year old chewing on her breakfast chapatti. The morning sun glows through the curtain as Veronica explains what we're doing and asks if the woman would like to participate. She's keen to get tested only after she is reassured that she won't have to 'open her legs for an exam like they do at the hospital' unless the test is positive.

Although I am obviously deeply invested in the project and passionate about working towards preventing women dying of something so incredibly preventable it still boggles my mind that women are so open to collecting their own samples and being screened for HPV. On our first day of testing, one of the teachers at the primary school heard we were testing for cervical cancer and ran over to find us during recess so she could get tested. They take the swabs, go behind a curtain or to the latrine, and come back with the specimens for the research assistants to label then ferry to the lab for analysis. To be honest, if someone showed up at my door with a cooler full of swabs and asked if I wanted 'do-it-yourself' cervical cancer screening I might just shut the door. Although the logistics of a truly community-based screening program can seem intimidating, I can't help but be encouraged by how eager women are to be involved.

I remember an impassioned speech by Stephen Lewis at a huge HPV conference in Montreal last year. His usual topic is HIV but he spoke about cervical cancer that night, and the tragedy of something that is completely preventable, not only with screening, but with an effective and safe vaccine that is responsible for the death hundreds of thousands of women across the world. Over 85% of those deaths occur in the developing world where there is no infrastructure for effective screening programs.

I heard Stephen Lewis again more recently, on a CBC podcast interrupted by haltering internet when he spoke at the funeral of Jack Layton, previous leader of the opposition. The quote of Jack Layton's that stuck with me was 'Always have a dream that's longer than your lifetime'. Today, my dream is to make cervical cancer a historic disease, this disease that is often called a case study in health equity has no right to take the lives of young women, regardless of where they are on the planet. Check in with me in a decade to see how we're doing.