-All cervical cancer screening and treatment services are integrated into
pre-existing government public health clinics and are free of charge.

-Zambian nurses undergo a highly rigorous training program that
permits them to screen and treat patients for cervical precancers during the same visit.

-Women who undergo screening are also examined for sexually transmitted infections and offered counseling and testing for HIV if desired.

It is a long way from the US to Zambia, but an African-American doctor has come closer than most to eradicating a killer disease.

Tej Rae reports

The sprawl of low buildings, grassy spaces, flowering trees and outdoor walkways could be mistaken for a college campus. Then the siren of a baby’s cry from an open window punctuates the peace. Nearby elderly women, known as professional mourners, wait to be hired to wail at funerals while family members take a break from caring for their loved ones. This is the University Teaching Hospital in Lusaka, Zambia’s only comprehensive public hospital, and at once a place of hope and despair. Indeed, it is not unheard of for patients to die waiting for medical attention.

On a bright morning, Febby Chapota, a slim 25-year-old with long braids and a voice
choked by tears, waits to be seen by a doctor. She has recently undergone a procedure that removed a pre-cancerous lesion from her cervix.

Chapota’s appointment will take place in a tall pink building, recently constructed to house the Cervical Cancer Prevention Programme in Zambia (CCPPZ). Cofounded in 2005 by Dr Groesbeck Parham, an African-American gynaecologic oncologist, and his Zambian counterpart Dr. Mulindi Mwanahamuntu, the programme offers inexpensive, low-tech screening and treatment with a particular focus on HIVpositive women.

The two had initially run a study on 150 HIV-positive women in 2004 and were shocked to discover that 95 per cent of the participants had some form of cervical cancer. As the country with the second highest cervical cancer rates in the world, the programme could not have arrived in Zambia sooner.
Dr Parham, whose speech is peppered with curses and ‘southernisms’, hails from Birmingham, Alabama in the south of the United States. He reassures Chapota that everything is healing well. Clearly she is one of the lucky ones. Although most cervical cancer cases are preventable if diagnosed early, sub-Saharan Africa along with Latin America and South Asia have the highest mortality rates in the world.

Around 83 per cent of all new cases each year – and 85 per cent of all deaths from the disease – occur in developing countries according to the World Health Organization. That amounts to 600 female deaths daily. In sub-Saharan Africa, cervical cancer is the most common female cancer and the number one cause of cancer-related death in women. The risk of contracting the disease is further compounded by poor nutrition and sanitation, a lack of education, early sexual activity, multiple partners and inadequate preventative care. Women like Chapota who are on low incomes – she earns just $15 a month – are most vulnerable.

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