Abidjan, Côte d’Ivoire—Cathérine could hardly hope for good news when she went to Abobo General Hospital for a consultation. After all, she had gotten used to bad news. Her husband died in 2002 of an HIV-related illness and about a year ago, Cathérine learned that she is HIV-positive.
Last year, Cathérine also tested positive for precancerous lesions of the cervix through a visual screening (visual inspection with acetic acid [VIA], or vinegar) and then received immediate cryotherapy—in accordance with the single visit approach (SVA) that Jhpiego advocates. Cathérine, 44, is a community advisor at Abobo-North Hospital, where she spends the majority of her time encouraging others living with HIV to take advantage of support groups.
When she returns for her one-year follow-up after treatment, the worry is visible on her face. During Cathérine’s last visit, the health provider had explained that cervical cancer in Côte d’Ivoire is most common among HIV-positive women. Fearing the worst, she wondered what living with cervical cancer would mean—the effort it would take to stay healthy, the impact it would make on her work, how she would care for her children.
The doctor performs Cathérine’s follow-up VIA screening and the result is negative. The cryotherapy treatment she received a year ago was effective! As relief washes over Cathérine, she smiles. “I feel free,” she murmurs between two deep breaths.
Thanks to Jhpiego’s work under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), cervical cancer prevention (CECAP) is a reality in Côte d’Ivoire. Today, 12 sites offer CECAP services and more than 54 providers have been trained to deliver them. The success of the project is the result of a close collaboration with the Ministry of Health and National Program for HIV Care and Treatment (PNPEC). Jhpiego has also benefited from the support of partners such as the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), the International Center for AIDS Care and Treatment Programs (ICAP), and a local organization called ACONDA.
Jhpiego’s work in Côte d’Ivoire is part of its ongoing efforts to partner with countries in building the capacity of health care workers and strengthening health systems to prevent the needless deaths of women and families. The organization develops innovative, low-cost technologies—such as SVA—to address today’s global health challenges and works with communities to increase frontline health workers’ ability to deliver lifesaving care.
Jhpiego’s CECAP partnerships in the country have produced measurable results under difficult circumstances. A series of political crises began toward the end of 2010 and continued through the first quarter of 2011—Jhpiego’s work was interrupted. And despite the challenges, a total of 5,400 women were screened between October 2009 and September 2011. Of the 5,400 women screened, 8 percent (404) were found to have abnormal results. Luckily, 77 percent (193/251) of the women who were eligible for immediate treatment received it on the same day as their screening.
After a year of uncertainty, Cathérine finally has some hope and is rid of her “cursed” precancerous lesions. “I am living proof that this approach works because I was at risk of cancer and I am healed,” she says. With this, Cathérine promises to raise awareness about the importance of cervical cancer screening among all of the women in her support group and neighborhood.