MUTARE – Bridget’s inspiration to advocate for female health services bellies her decade long battle with chronic illness.
She is a 53 year old widow living in Dangamvura whose determination to promote healthy living among fellow women is inspired by her life story.
Since her husband passed on in 2008 Bridget has been battling recurrent opportunistic infections which impeded her ability to fend for herself.
After growing concern she braved a HIV testing and counselling session at Family Aids Caring Trust (FACT) New Life Centre where she tested positive.
This news, although it was a blow to her shattered hopes, taken to the grave by her husband, also brought a measure of relief.
“I was upset at hearing my results but also relieved that now I knew what was wrong and I could receive treatment,” said Bridget who immediately started Anti Retroviral Treatment.
However, persistent chronic back pains as well as regular vaginal discharge continued causing her further anxiety.
A chance meeting
Having no knowledge of cervical cancer until a fortuitous meeting with Margaret Nyakuhwa, a Family Aids Care Trust (FACT) Behaviour Change Facilitator (BCF), Bridget continued to wonder at her deteriorating health.
However meeting Nyakuhwa transformed her life, albeit leading through another familiar path.
Upon meting Bridget, Nyakuhwa explained the purpose of her visit, and using her home visit guide she initiated risk assessment. She learnt of Bridget’s chronic back pain and regular vaginal discharge suspecting cervical cancer, Nyakuhwa referred her for a free a screening session at FACT New Start Centre.
“At that time I overheard people from my church talking about cervical cancer screening but I did not take them seriously until Nyakuwha visited me.
“She explained that she was conducting home visits through the Integrated Support Programme to talk to families about issues like HIV, gender-based violence and sexual and reproductive health. She suggested I go for screening,” said Bridget.
Integrated support through Behaviour Change Facilitators Nyakuhwa is part of 624 FACT behaviour change facilitators, promoting cervical cancer screening under an Integrated Support Program (ISP), in 268 wards of seven Manicaland districts.
Program coordinator for FACT (BCF) Jennifer Mandoga told stakeholders at a provincial National Aids Council 2015 1st Quarterly stakeholder meeting that ISP aims to improve health access by addressing service gaps.
“The Integrated Support Program aims to improve availability of Sexual Reproductive Health products and services for the poor and vulnerable both through private (not for profit) sector and the public sector.
“Address demand side barriers to accessing SRH products and services as well as integrate broader SRH & GBV services into existing HIV specific services & HIV prevention services into existing RH care delivery,” she added, “We have a total of 624 behaviour change facilitators operating in all seven districts of Manicaland Province and in all 268 wards.”
“Despite challenges, this program has rolled out quite well as the BCFs managed to reach 13 606 household with a total of 54 600 people reached against a target of 11 232 households and people in the first quarter of 2015.”
The VIAC process
Bridget recalls the screening process; “I met with other women who had also come to seek the service. The friendly staff took us through a group demonstration exercise to help us understand what would be happening during the VIAC screening process,”
VIAC is used to examine symptoms of precancerous fusions to gauge risks of infection using a dual testing method explains Mandoga, programs coordinator FACT.
“Visual Inspection with Acetic Acid and Cervicography (VIAC) is conducted on women to screen for precancerous cells on the cervix.
“This method uses naked-eye visual inspection of the uterine cervix, after application of 3-5% acetic acid to detect pre-cancer lesions which resemble a fried egg white appearance or ivory white patches.
“Cervicography is where a digital picture of the cervix is taken by a camera mounted with a special lens.
“These methods are used to see if a woman is at risk of infection,” she said.
A community advocate
Fortunately for Bridget she tested negative for cervical cancer although an infection that was causing her backache and vaginal discharge was diagnosed.
She received free treatment with advice to return for annual follow up screenings due to her HIV status which she observes religiously.
In June 2014 Nyakuhwa visited Bridget and was surprised to see her performing household chores which she used to have trouble doing.
Bridget narrated to Nyakuhwa her positive experience at the New Start Centre and this visit inspired her to advocate for cervical cancer screening in her community.
“I am now encouraging other women to go for screening early. On the day I was screened I actually booked for a cousin who was at home because the process is so easy”.
She added: “I really appreciate the Integrated Support Programme because it rescued me and my fears that I could have cervical cancer were allayed. I will keep spreading the word of encouragement for Cervical Cancer Screening through VIAC.”
For Bridget, the most pressing challenge is to spread awareness to fellow women who might not be aware of risks of contracting this deadly disease.
“For me the challenge is to ensure that other women know about this disease because most of them are ignorant that they are at risk of contracting this cancer.
She added: “So whenever I meet other women I tell them of the free screening conducted by News Start and encourage them to take up this opportunity.”
A global threat to women
Cervical cancer accounts for approximately half a million new infections, with around 275,000 deaths annually, said Zvidzai Kwedza of Population Services International.
“Cervical cancer is the second most common cancer among women worldwide and new cases are over half a million while 275,000 women die every year because of it.
“In Zimbabwe as well as most developing countries the situation is worse as cervical cancer is the most common cancer among women accounting for 33.4% of all cancer cases among black women,” said Kwedza It is caused by persistent Infection with the Human Papilloma Virus (HPV), passed on through sexual contact, which has a cumulative risk explains Kwedza.
“Cervical cancer is passed on though infection from HPV which is passed through sexual intercourse. This means every woman who has had sex in her lifetime is at risk.
“Cumulatively this risk for women with only one sexual partner is 46%
(3 years after sexual encounter) and even high after first intercourse and continues throughout her lifetime “Up to 80% of women will acquire an HPV infection in their lifetime and once contracted it takes a woman 5-20years to develop cancer,” she said.
This subtle nature of the disease’s development means all sexually active women should go for annual checkup visits Kwedza said.
“Cervical cancer is slow in developing and can take up to 5-20 years to fully develop once it is contracted and this means every woman who is sexually active needs to go for screening every year,” she said.
Earlier symptoms include: abnormal vaginal bleeding; abnormal foul-smelling vaginal discharge; dyspareunia (discomfort or pain during intercourse) while late ones associated with late advanced disease include: lower abdominal pain, backache, urinary or renal symptoms.
