Falesi Wajomba, sounded heartbroken when asked about her long walks to ensure no woman dies of the common condition. At 43, the 48-year-old woman, living at Dyeratu in Chikwawa, was diagnosed with the disease that kills at least four Malawian women every day.
For five years, she has been going door-todoor, encouraging women to go for checkup because the chronic disease caused by human papilloma virus (HPV) can be cured if detected early.
However, it was too late when Wajomba met her latest client.
In an interview, she unpacked the heartbreak, saying: “Recently, I got a call from a woman in Madiya, asking me to assist her access cervical cancer testing. When I went there three days ago, she was in pain. We rushed her to Chikwawa District Hospital, but she was referred to Queen Elizabeth Central Hospital, where they told her that there wasn’t much they could do to treat the condition.”
According to Wajomba, the 74-year-old patient returned to her remote locality “weeping like a child when she was told her condition is incurable”.
“She is just waiting to for the hour to die,” she says.
Such encounters have become a familiar part of Wajomba’s work with Tikondane Women Group, which she founded to ensure no woman dies of the disease she was diagnosed with on July 12 2013.
The cancer of the lowermost part of the uterus constitutes a silent public health crisis because Malawi has the highest rates globally.
According to the Ministry of Health, about 2 300 women develop cancer in the country and nearly 1 600 die.
It remains the most prevalent form of cancer, accounting for about 45 of all cancers among women.
Sadly, most of them go undetected and unreported due to low cancer awareness among both patients and community health workers.
The shortage of skilled staff and necessary equipment worsens the situation.
Ministry of Health spokesperson Joshua Malango commends Wajomba and her group for bringing cancer awareness and screening closer to those who need it most.
He states: “The strides taken by those women can help, though minimally. Since it is one-to-one, they might not be able to reach many people, but they are commended.
“It’s a good initiative as long as the information passed on is correct. Everybody is a neighbour’s keeper. We are all supposed to pass on information to the next person when there is need.”
Wajomba counts herself lucky that she knows her status. According to community nurse Mercy Kapingasa, many women are “suffering in silence”, unaware of “what is killing them”.
Wajomba personifies the hardship of the population at risk.
Looking back, she states: “I don’t know how long the tumor had developed, by it was in 2012 when I started feeling pain, bleeding and releasing pus in my private parts. I had no chance to go for screening. I didn’t know what to do. I couldn’t enjoy sex anymore. Every time I tried to have sex, I was bleeding on bed.
“When a doctor at Chikwawa District Hospital screened me, it was never easy for the woman to accept the results. I have one child. It was difficult to have my womb removed because of the condition.”
Her community-based organisation, comprising 20 volunteers living with cervical cancer, is opening pathways to life-saving service, including screening and treatment. The women meet once every week to share experiences and ways of beating their shared challenges.
They also walk long distances to rally women to go for screening as the curable viral disease can have deadly and demeaning consequences on women if not treated early.
“The group started with four women. Ever since, many people living with cancer of the cervix have come in the open, but we constantly make door-to-door visits to meet women and explain the important of screening because it is hard for some to open up due to stigma.
Cervical cancer exposes women to exclusion. Some are expelled from marriage while others endure insults wherever they go,” Wajomba explains.
Interestingly, her husband, Benjamin Wajomba, has stuck by her side.
The retired pastor of the Seventh Day Adventist church says he was shocked to learn that his wife would never have another child, but cancer was “no good reason to break the marriage vow”.
“Till death do us part,” he says. “My wife is in pain. She needs all my support. This is why I told her to stop farming and walking long distances to fetch water and firewood. However, I cannot stop her from visiting her fellow women in need because we believe it is a good cause. Many women are dying of this cancer, leaving children orphaned.”
The volunteers meet women in homes, markets and water points to encourage them to go for screening.
“We are but a mere bridge between the healthcare system and patients who would be languishing in pain if not reached. If a woman suspects she has cancer, she follows us and we link her with health workers for screening,” she explains.
However, they are worried that some women eager to undergo checkups are sometimes sent back without screening due to shortage of health workers and testing supplies.
“When they go to hospital, women are told to come back later, but they don’t get screened when they return. The health workers keep changing dates and some clients get discouraged in the process,” Wajomba bemoans.
We linked up with the women group through the long-serving community nurse, who gave a glimpse of a testing session in which almost 19 out of 25 women brought by Falesi and her colleagues were diagnosed with cancer of the cervix.
Stated Kapingasa: “Cervical cancer poses a threat to the life, productivity and dignity of a woman. The saddest thing is that many people are at risk because they don’t know if they have it. These women are doing a commendable job to increase awareness and access to screening and treatment although they are in pain. Surely, they need a better mode of transport to ease their mobility.”
The women, who also put together their saving and lend each other low-interest loans for running small businesses, requested capital to grow their enterprises because “they cannot farm or do other hard labour.”
Wajomba sells fritters and doughnuts, thanks to borrowings from the savings group where she deposits K1 000 a month and get life-saving tips while discussing shared realities with her friends.
Together, they have reached out to 18 women in Madiya, 10 women in Ngabu and 50 in Chikwawa to go for testing.
In so doing, they are saving lives a visit at a time.
“There is no treatment for cancer if you are diagnosed late. The earlier one is screened, the higher the chance of getting cured,” she says.
The Ministry of Health targets to ensure four in every five women know whether they have cervical cancer, but just about half of the target have been screened.
And the screening is so simple that over 20 women would have known their status by the time a referee blows the final whistle ending a football match.
Hawa Mamary Sangare, the national coordinator for Cervical Cancer at National Dream Centre, is quoted in the press saying it takes just five minutes to complete the test and then the women are told the results. Cancer surgeon Leo Masamba, from QECH, is worried that about 16 000 die because they get screened too late.
This is the story of the woman languishing in Madiya whom Falesi escorted to the referral hospital rather too late for a healing. The area, where refugees fleeing civil war in Mozambique lived for over a decade, offers no hope for the patient.
“The woman waiting for her final day could be your sister, your mother, your aunt. This is the reason every woman must know her status,” warns Wajomba.