• Sat. Oct 29th, 2022

Visual Inspection with Acidic Acid (VIA) is the only form of cervical cancer screening in Malawi

Jun 10, 2021

ONE in four women in the southern region of Malawi is treated for cervical cancer, using a quick and easy screening and treatment process that includes the use of vinegar.
Visual Inspection with Acidic Acid (VIA) is the only form of cervical cancer screening in Malawi. While there is the option of pap smear testing at private hospitals, the costs are too high for the average woman in the poverty-stricken country.
In the screening process, medical practitioners use vinegar to identify precancerous lesions in the cervix.
A piece of cotton soaked in vinegar is dab on the cervix. If the lesions become whitish, that is an indication of precancerous cells. Those cells are treated using cold coagulation treatment.
The screening and treatment are painless and can be done in a few minutes. It is also a relatively inexpensive method for the struggling country.
Video: Zodidi Dano/IOL
In South Africa, free pap smears are available at public health-care facilities. The average cost of a pap smear is around R400.
Doctors Without Borders Malawi head of mission Marion Pechayre said pap smear screening was more sensitive and 100% effective in detecting cancer than VIA.
“It is better than not doing anything,” she said.
While the screening may be quick and easy, Malawi faces a challenge of women coming in late for screenings when the cancer is advanced.
Cancer is the leading cause of death in Malawi, at around 35%. Cervical cancer accounts for 10% of the deaths.
Picture: Zodidi Dano
Every year, about 4 163 women are screened for cancer. Of those, 2 879 die of cervical cancer.
MSF in Malawi cervical cancer project co-ordinator Sylvie Goossens said Malawi did not have enough medical or human resources to tackle cervical cancer.
Sacha Curry who heads the medical front point for MSF at one of the country’s teaching hospital, Queen Elizabeth Hospital in Blantyre, said in the Southern region alone there was only one histopathologist. A histopathologist looks at the biopsy and can tell which type of cancer a patient has and at what stage it is at.
Queens Elizabeth Hospital is one of the only two biggest hospitals in the country and has 1 300 beds.
Picture: Zodidi Dano
Goossens said that if more people were screened at an early stage, from 25 years old, Malawi’s battle against cervical cancer would not be so challenging.
“Our target is screening women between 25 and 49 years old. The older you are, the more at risk you are.
“At 15 years, the HPV in a woman’s body is on an upward trajectory and then dies down by the age of 25. From 25 to 35 years old you can start seeing the pre-cancer after HPV. If not treated, then real cancer develops,” Goossens said.
Picture: Zodidi Dano
She said most women come for screening once they have developed symptoms such as bleeding, vaginal discharge and pain.
Goossens said that with the high HIV rate in the country, it was difficult for women with the virus to overcome cervical cancer in the late stages.
She said an HIV positive person’s immune system decreased, allowing for the HPV that causes cancer to be more active in the body.
Treatment options following VIA
If the cancer is advanced, women are referred to the hospital where they may have the options of surgery and or chemotherapy. Radiation is not available in Malawi. There is no equipment for it.
If it’s too late, then palliative care is also given.
Pechayre said MSF budgets more than R49 million annually towards Malawi projects. She said the organisation has a five-year contract, signed in 2019, with the Malawi Health Ministry.
“I doubt we will leave the mission soon, our goal is that we empower the ministry to a point that they can sustain the programme themselves,” she said.