Published on 18th September 2017
Cervical cancer is one of the leading causes of cancer death among I-Kiribati women.
The thing about cervical cancer, Holly Coulter says, “is it’s one of the most preventable cancers there are. Ninety percent of deaths could be prevented – there shouldn’t still be women dying of it.”
Worldwide, 80% of cervical cancer cases occur in developing countries, where barriers to healthcare in terms of money, time and knowledge can be huge. During Holly’s nine-month assignment as a Cervical Screening Programme Adviser with KFHA, she’s working alongside the experienced Non-governmental organization (NGO) to address those barriers in Kiribati. KFHA’s reporting found that in 2013 the number of women tested for cervical cancer was 554, of whom 49 were confirmed to have cervical cancer. That number increased in 2014, when 532 were tested and 60 cased confirmed. Pap smears are available for free in Kiribati, provided by KFHA and the Ministry of Health, and Holly says “precancerous changes can be treated locally with a minor, effective procedure.”
With free pap smears and early treatment available, Holly says one of the major barriers is that “most people in the community know nothing about cervical cancer – most said they’d only come for a pap smear if they have symptoms, and by the time you have symptoms it’s usually a little bit late.”
In the first few months of her assignment, Holly completed a research report with the aim of creating better coordinated services, with an eventual goal of a national policy: “Although cervical screening has been available in Kiribati since 1999, there is currently no centrally organised programme, and screening is primarily conducted on an opportunistic basis.” Only 10% of eligible women visited health clinics for a smear in 2016, so there is still a long way to go.
In the meantime, Holly is working with KFHA to spread the word about the importance of early detection to I-Kiribati women. “I worked with our youth officer here, who’s in charge of 20 youth volunteers who do peer-to-peer education in the community. They’ve been trying to find a way to communicate that cervical cancer is something transferred through sexual activity, without getting to the point where people see cervical cancer as some kind of STD (VSA: Sexually Transmitted Diseases), because there’s a lot of stigma. So they talk about it like getting the flu, so that gets the idea in people’s heads that everyone needs to come for pap smears, no matter what their lifestyle is.”
Holly’s highlight so far has been a workshop she gave for young people in leadership roles at tertiary institutions. “To share the information with them, then have them go out and share it with their communities – doing health promotion helps, but helping other people to do it, that’s awesome.”
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