Report on the spot: Eldoret, Kenya

Cervical Cancer Prevention in Kenya: our team in Eldoret

I love it when my stay with one of the Save my Mother teams starts with a hands-on outreach. Arriving in Eldoret on Tuesday morning 8.00 am, I have a quick acquaintance with the team before we leave to Baharini.

Baharini is far. Since the Eldoret team has started their phase II of the SmM program, they are going deeper into the communities. We arrive at a new dispensary which has not even opened yet to the community, which requires some improvisation. The local community feels blessed to be visit by this team. However, the male visitors feel left out and request to be screened for prostate cancer.

Being a medical doctor, it is beautiful for me to see how some universal values are applied in different cultures around Africa. The screening nurse, Martha, approaches the clients with a lot of patience and a lot of respect. The clients are being comforted, given their privacy and their time to ask some questions.

The rest of the week is used for the evaluation of phase I with the clients, the team and the key stakeholders. The program coordinator and I visit a health centre in the adjacent sub-county. We have an interview with the two nurses most involved with the See & Treat program, which leaves me optimistic ànd pessimistic on the future of the cervical prevention program in Kenya.

On one side, these nurses seem very passionate on the subject. They seem to have a very clear understanding of the program, are motivated to learn more on the See & Treat method (they are taught how to screen, but not how to treat yet) and ask me all kinds of questions, e.g. on HPV vaccination.

On the other site, they don’t feel cervical cancer screening is in the priority list of county’s Reproductive Health Director. In contrast to diseases like HIV, malaria and tuberculosis, (cervical) cancer is not included in the reporting system used by nurses throughout the country. This specific health centre possesses only five speculums, which are intended for the Maternity ward. They could buy the acetic acid, but they can’t offer any cryotherapy and when referred, the clients are probable to be lost in follow-up.

I ask one of the nurses about the costs of the treatment of the other common diseases, the ones they are obliged to report on in their national reporting system. “It’s all for free”, she says. I am surprised and start thinking that if they could get cervical cancer on the national agenda of Kenya, the prospectives for Kenyan women would increase significantly by offering the treatment for free in these facilities. But I shouldn’t rejoice too quickly, I discover while the nurse finishes her sentence: “If there are any medicines”.