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Ruth Butaumocho Gender Editor
Mrs Maud Chauke watched hopelessly as her mother, VaChireka, writhed in pain while lying under a mopane tree a few metres from the family kitchen.

She noticed her condition had worsened from the time she visited the nearest clinic for medication.

Her recent visit to the clinic had yielded nothing.

The nurse who attended to her advised the family to take her for cervical cancer screening at one of Chipinge’s district hospitals near Chibuwe, which is more than 100 kilometres away.

Mrs Chauke knew the journey to Chibuwe would never materialise.

Transport costs alone would chew into the family’s meagre savings of $30.

“One trip alone to the district hospital costs $6. Because her condition is very delicate, someone will have to accompany her for the testing.

“If you factor in the costs of food, the whole journey becomes too expensive although the screening would be for free,” lamented Mrs Chauke, while intermittently glancing at VaChireka who lay sprawled helplessly under the tree.

Although VaChireka was yet to get proper medication from the time she fell sick, she had clear clinical symptoms of cervical cancer.

The condition did not only present a major physical battle, but also an ultimate emotional battle which was further worsened by her failure to access the free cervical cancer services and the treatment itself.

She is among thousands of Zimbabwean women who are battling with the condition that is killing hundreds against a backdrop of inadequate but vital cancer services.

Cancer is now acknowledged as a major cause of morbidity and mortality in Zimbabwe with over 7 000 new cancers and over 1 000 deaths being recorded each year.

It has become one of the biggest killers of humankind the world over, killing more people than HIV, malaria and tuberculosis combined.

With different types of cancers emerging each day, latest statistics reveal that more people than before are likely to succumb to cancer than to any other disease.

Women have also been severely affected by this condition, with cervical cancer topping the list of types of cancers affecting them across social strata.

In fact, cervical cancer is the second most prevalent cancer in women and worldwide and one of the leading causes of their death in developing countries, Zimbabwe included.

According to the Zimbabwe National Cancer Registry about 3,96 million women over 15 years of age in Zimbabwe are at risk of developing cervical cancer.

On the global scale, 493 000 new cases of cervical cancer occur annually and 274 000 women die of the disease every year.

For Zimbabwean women the trials and tribulations of dealing with cancer were supposed to end with the commissioning of free cancer screening machines in most district and provincial hospitals in the country nearly two years ago.

The “see and treat” method – Visual Inspection with Acetic Acid and Cerviography or VIAC, as it commonly known – uses digital camera to take pictures of the cervix, and the results come out within minutes.

The nation had been pinning its hopes on Viac – popularised by a Zimbabwe professor, Mike Chirenje – a method which was expected to benefit thousands of women in the country, reducing the burden of cancer on patients and the country’s health delivery system.

Unfortunately, despite the tremendous promise and the impact of the project, it has been riddled with several challenges, among them inaccessibility of the centres that provide the service free as well as inadequate trained health personnel.

Some of the health staff trained to use the machines have since left in search of greener pastures in neighbouring countries, leaving behind inexperienced personnel to man the machines.

“I hear there is a free cancer screening service in Checheche, but it is too far and none of the villagers have been there. You will need more than $20 for transport alone to get there, and not many of us can afford that,” said Mrs Chauke.

The service is not yet available in most districts around Zimbabwe, save for a few provincial hospitals, mainly in major cities.

A number of public institutions in Zimbabwe, among them Parirenyatwa, the country’s largest referral hospital, with the support of the United Nations Population Fund, have been running free cervical cancer tests, servicing patients from Harare and surrounding areas.

Other centres that offer free cancer screening services include United Bulawayo Hospitals, Newlands Clinic, Edith Opperman Clinic in Mbare, Warren Park Polyclinic, Highfield Polyclinic, Masvingo Provincial Hospital and Cancer Association of Zimbabwe.

While the method is faster and cheaper than the traditional pap smears, the machines at some of the centres are not enough to service the large number of people in need of the service, with some women having to wait for up to two months to be screened.

“I registered for free cervical cancer screening in December last year at Parirenyatwa and I was told to come back on January 28.

“My dates are somehow okay, because two of my friends have been on the waiting list since June last year,” said 36-year-old Mavis Rudawo from Mufakose.

Although she is not showing any signs of sickness, Ms Rudawo said she wants to be screened for the disease before the facilities become oversubscribed.

She knows there are many women out there who badly need the service, but have no access.

Women Aids Support Network, an organisation that deals with women’s issues in the areas of HIV, through advocacy, support and networking concurred on the inaccessibility of the screening service for women.

“Areas that we are working in like Chirumhanzi have access, but the service is not widely accessible to other districts, making it difficult for the majority of women, particularly those in the rural areas, to access the service,” said WASN information officer, Ms Evince Mugumbate.

With the symbiotic relationship that exists between HIV and cancer, Ms Mugumbate called for the decentralization of services for the majority of Zimbabweans.

“Information should be made available to women throughout the country on the importance of early cancer screening,” she said.

However, the National Cancer Alliance of Zimbabwe said notable progress has been recorded in free cervical cancer, although its uptake was still low because of a number of teething problems.

NCAZ executive director Dr Nelson Ngwaru said with only a year after being launched VIAC, was yet to be decentralised.

“There is no way people can expect the service to be available throughout the country, having started only a year ago. The programme needs funding for it to spread across.

“Training of all health workers is also a critical component that needs to be factored in, so that they will not be margins of error, once the health staff starts working

“Once training has been completed, implementation will still be done in stages to ensure that all the critical areas have been covered,” he said.

Dr Ngwaru said despite logistical challenges being faced in the implementation and effective running of the programme, the progress was encouraging.

He called on women to be proactive and go for screening before they experienced any cancer-related symptoms.

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