Rutendo Chirume
For many women who would have reached menopause, life is presumably expected to be characterized by happy moments with achievements of their last children together with grandchildren, but for 52-year-old Liliosa Bunye of Gutu South life became a bitter pill to swallow when cervical cancer drew a dagger on her, ultimately taking her life only two years after the first symptoms.
With the month of January being Cervical Awarenes Month, Bunye’s family gathered at Mukweshe Village in Magombedze area, Gutu laying her down on her final resting place, a tragedy that pierced through many hearts.
It all started in 2020 with continuous bleeding and severe abdominal pains but due to Lilliosa’s religious conviction, she attributed her situation to witchcraft and generational curses since her older sister also died under the same worrisome condition a decade ago.
She therefore consulted different white garment churches and even shaved her long black hair and became a full convert and a devotee of the Johanne Masowe sect, all in hope that her predicament will get better.
Unfortunately such efforts hit a brick wall as her condition further deteriorated without any improvement.
When her siblings and family members realized that her condition was deteriorating despite the prayers and special rituals she received from prophets, they decided to try other options.
After six months of excruciating pain, Liliosa was taken from Mukweshe village to Parirenyatwa Group of Hospitals, where she got diagnosed with cervical cancer and told that it was on its third stage hence she should start chemotherapy as soon as possible even though it was a bit too late.
Being on the third stage meant the cancer cells had spread widely and at its advanced stage meaning the suggested medical treatment would only contribute a mere 20 percent chance of recovery.
Liliosa’s family however went ahead with the treatment and hoped that one day she would become a hero who would have survived cancer, but as the doctors had said, it was too late when they learnt she had cancer and along the way she succumbed to the deadly disease. Advanced cancer requires more expensive and toxic multimodality treatments, and Zimbabwe has struggled with radiotherapy machines, which are only found at the Oncology Unit in Harare.
Cervical cancer contributes to over 25 percent of deaths of women in Zimbabwe according to statistics released by the Cancer Association of Zimbabwe (CAZ) last updated in 2017.
CAZ monitoring and Evaluation Officer Lovemore Makurirofa raised concerns over the less attention given to cancer screening due to Covid-19 but said during this month of January ,they will be doing screening and going around doing surveys and teach women about cervical cancer especially in the remote areas.
“So far we have statistics for 2017. Due to Covid-19 the backlog is very long. We have not been able to collect data or do proper statistics. However, since it is a month of cervical cancer awareness, we will be doing screening and cervical cancer awareness campaigns especially in the rural areas where most women live and are ignorant to the disease. We will also wait for February 20, when we join the world to commemorate World Cancer Day and unveil our theme and plans for the year of 2022,” said Makurirofa.
In Zimbabwe, over 5000 new cancer diagnoses and over 1000 cancer-related deaths are recorded every year.
The estimated cervical cancer screening coverage among the 15 to 49 age group in 2015 was 13%. Urban – rural disparities still exist at 21 percent in urban as compared to 7 in rural areas
According to the Zimbabwe National Cancer Registry, cervical cancer leads among malignancies in women and constituted 33.2 percent but Anecdotal evidence constructed from Department of Obstetrics and Gynecology at University of Zimbabwe College of Health Sciences suggests that many women die of cervical cancer without histological confirmation or seeking appropriate treatment meaning they will not be entered into national Cancer register.
By province from the latest statics of 2017 , Bulawayo 15.3%, Harare City 35.2%, Manicaland 5.7%, Mashonaland Central 4.4%, Mashonaland East 13.5%, Mashonaland West 7.4%, Masvingo 5.2%, Midlands 6.1%, Matabeleland North 3.1% and Matabeleland South 2.9%. The origin of 87 cases (1.2%) could not be determined.
In an effort to preach prevention and treatment of cervical cancer the world comes together in the month of January to commemorate the cervical cancer awareness.
However, for a country whose majority lives in rural areas and most are women who are at high risk of being diagnosed with cancer, these awareness are not enough as the majority do not have a chance to learn more on the disease and some are ignorant to the symptoms.
In particular a 2019 study in Zimbabwe’s Mudzi District by Lovemore Makurirofa and others in a report titled BMC Public Health revealed that lack of knowledge and incorrect beliefs about the risk of developing cervical cancer is a major undoing.
The study showed that majority of respondents did not know about Human Papilloma Virus (HPV) screening, or visual inspection of the cervix using aceticacidor. Most people believed they were not at risk of developing cervical cancer and 81.7 % of the respondents had not undergone cervical cancer screening
The impact of Covid-19 has also reduced cervical cancer screening in Zimbabwe since financial and human resources are being channeled towards corona virus responses thus critical aspects of women’s healthy are being neglected.
Masvingo Provincial Medical Director (PMD), Dr Amadeous Shamhu encouraged women to go for screening frequently and said he does not have the recent statistics of cancer diagnosis for the province, but would check at the clinics.
“I do not have provincial cancer statistics and do not think we will be doing anything special to commemorate the cervical cancer awareness month. I will try to check with clinics if there is anything being offered there. However, I encourage women to do screening as adviced by the health department,” said Dr Shamhu.
Serina Chirume a general nurse at Parirenyatwa (though not at the oncology department) mentioned the common cervical cancer symptoms include pelvis pain, abnormal mensuration and groin pain.
“I am not working at the oncology, but as a nurse I encourage women to visit a hospital if they see symptoms like abdominal pain during sex, bleeding during and after sex, abnormality, heavy or irregular mensuration and groin pain which may include vagina abnormal discharge with a foul odor and lastly bleeding for post-menopause women is certainly a red flag,” said Serina.
Cervical cancer screening is highly recommended by the World Health Organization (WHO) to prevent invasive cervical cancer and as a result government of Zimbabwe’s screening guidelines recommend cervical cancer screenings for every three years for all women, and every year for HIV positive women.
Poor access to health services like screening has been cited as one of the major drivers behind these cancer-related deaths.
The three stages in cervical cancer intervention are primary (delaying sexual activities), secondary (screening) and tertiary involving treatment in form of chemotherapy, radio therapy as well as surgical operations.
