Medicine student Yaël Stroeken wrote about her research in Uganda on the views and roles of husbands and men with the goal of reaching more women for screening:

- A woman without a uterus, is no longer a woman -

After months of preparing for the research and my trip, the time has come; Kagadi will be my new home for 5 months. I am conducting research here as part of my science internship for my medical studies, on men's perceptions about cervical cancer screening and vaccinations. I am proud to contribute on behalf of the Female Cancer Foundation and together with a motivated team in Kagadi to help eliminate cervical cancer from the world.

I can hear you thinking, 'Why research the perceptions of men and not women? '
Much research has been done on women's reasons for coming or not coming to screening, and one of the common reasons is that the husband does not give consent: "My husband does not want me to go." Uganda, like many African countries, is a country where the husband is the head of the family, making decisions for the family members and managing the money. Therefore, with this study we hope to learn more about men's knowledge and perceptions and in this way get more support for women to go to screening and vaccinate their daughters against human papilloma virus (HPV).

We have now had a number of group discussions in different villages and are already seeing some opportunities to incorporate the "Tell" of the "Tell-See and Treat" project for men as well. The participants are enthusiastic and happy to participate in the study. Everyone shares their experiences and there appear to be many misunderstandings about the origin of the disease.

During the interview, an explanation of the clinical picture and how to screen and treat is given.

In addition, the importance of screening becomes painfully clear in discussions with men.

"I have heard on the radio about cervical cancer screening and I asked my wife if she had ever gone for screening. She said, 'no, but I don't have cervical cancer.' So I asked her: 'How do you know?' And she told me: 'If she had it, she would feel it'. "

"I heard on the radio about cervical cancer and I asked my wife if she had ever been screened. She said, 'no, but I don't have cervical cancer.' So then I asked her, 'How do you know?' And she said, 'If I had it, I would have felt it'."

Cervical cancer is a "silent killer" that causes few symptoms in the early stages and is often not detected until it is already too late. It is therefore vital that we reach as many people as possible and explain why prevention in the form of screening and vaccinations is so important.

Besides the physical symptoms, anxiety and stress that cervical cancer brings, there is also a lot of shame and discrimination regarding this issue. Female fertility is very important in this culture.

"She knows she will lose her family and that is the end of marriage. A man cannot stay with her when she has had her uterus removed because of cancer. A woman without uterus is no longer a woman."

"She knows she will lose her family and that means the end of her marriage. A man cannot stay with his wife if her uterus is removed because of cancer. A woman without a uterus, is no longer a woman."

So there is still much to achieve. With this research, I hope to take a step toward a Uganda where women are supported to go to screening and do not have to suffer through the effects of cervical cancer.

Yaël Stroeken - Student of Medicine, Leiden

Supervision doctor Marlieke de Fouw was in Ethiopia and visited the project there, read her blog here :

"I wish I am the final one" - "I wish I am the final one" -

In an open field under the trees, more than a thousand men and women have gathered. Silently they sat together. On the way here, we met many men and women, walking, their heads covered with black or white veils. I am in Ethiopia at the funeral of a woman who died of cervical cancer and the community has come to say goodbye.

A 45-year-old woman, mother of 5 children under the age of 16, married to a man who has problems with alcohol abuse and therefore cannot provide for his family. During screening, cervical cancer was diagnosed at an advanced stage. Treatment was no longer possible. She and her family were supported through the palliative care program with visits from spiritual leaders, community workers and livelihood support. In her final weeks, she said she felt safe and supported by all the people around her and expressed her hope for the future; "I hope I'm the last one."

One of the religious leaders gives an impressive speech at the funeral. He tells his community that the signs of cervical cancer are not visible until it is too late. He urges women and their husbands not to fear screening because it makes your health better. And when the nurse tells you that you are sick, you are not alone; the community is there to stand by you.

A week earlier in Addis Ababa, a woman was visibly tense waiting in the clinic. She had been referred for treatment (cryotherapy) by another clinic, where abnormalities had been found during screening. When we had examined her again and told her that the screening results were normal, her face turned into one big smile. She had not slept for three nights from worry. She had not known how to tell her children that their mother was seriously ill and had cancer.

The effects of cervical cancer are visible and palpable here. Many people know a woman themselves or stories about women who died with blood loss and severe pain. Not everyone knows that this is called cervical cancer and that it is preventable. This is why proper education and access to screening for all women are so important.

The screening program in Ethiopia has now trained staff at 21 clinics in screening and treatment, and together they have already screened more than 15,000 women. A great step towards realizing the hopes of patients.

Marlieke de Fouw