Most people in the United States are shocked to hear that cancer of the cervix is the most common cancer killer in women in Malawi. The reason for this is that there is no effective screening program coupled to early treatment in this country. Literally thousands of women around the world have been saved from this cancer through screening with the Pap smear, which has been available since the 50’s in the USA. Unfortunately, the infrastructure and the interest have not been available for screening and early treatment in Malawi where I am working.
The good news is that a movement is afoot to stop cancer of the cervix in Malawi. The method is called “visual inspection of the cervix” and is referred to as “VIA” or the vinegar test for short. This cancer of the cervix starts with abnormal changes in cells on the surface of the cervix. The Pap smear is based on taking a small sample of cells from the cervix, smearing them on a glass slide, staining them with the Pap stain, and reading the slide under the microscope. Visual inspection is based on a naked eye inspection of the cervix after applying household vinegar. Vinegar is a weak acid and reacts with abnormally rapidly growing cells causing them to turn into a white patch. This patch can be recognized by a trained service provider, and treatment to remove this patch can be offered at the same visit for the client.
Treatment options for a woman who has been found to have a patch include simply freezing that area of the cervix or removing that area with a cautery or electrical procedure. Freezing is usually 100% effective, but larger patches should be removed with the cautery procedure.
I am actively in the process of training nurses, clinical officers, and doctors in the method of VIA and also teaching how to perform cryotherapy. The methods and materials are appropriate technology for a resource-limited country like Malawi.
Africa MEF 