Cryotherapy is a method used to destroy precancerous cells to keep them from turning into cancer later on. According to medical experts, early detection and treatment of cervical cancer has demonstrated to dramatically improve the chances of survival. This is good news, as cervical cancer remains the most prevalent form of cancer in women in many developing countries, Kenya included and worst more to HIV+ women who are more likely to suffer from this type of cancer due to compromised immunity.
There have been concerted efforts by both the Kenyan government and the private sector to raise awareness and scale up screening and treatment services across the country, which has led to a steady rise and improvement in treatment facilities.
The ability of a patient to attend a screening clinic and to return to clinic follow-up evaluation and possible treatment is an important component to the success of a screening program. Once she surpasses the myriad barriers she may face in understanding the need for follow-up, finding the time and finding/paying for transport, she may arrive to find a health facility that is not ready for her. In a study looking at integrating HPV testing into community health campaigns and referring clients for treatment at selected health facilities in Kisumu County, we are faced by varied health facility-based challenges.
Currently, the study team refers clients to the sub-county hospital in Migosi. Both the study healthcare provider and study team ensures that all equipment are available including supply of gas used for cryotherapy and clients scheduled appropriately as we anticipate to offer treatment to at least ten clients per visit. Unfortunately you only realize you do not solve all the challenges accordingly.
Migosi is lucky; there are two trained full time nurses to offer cryotherapy and the study nurse comes on specified days. As far as trained human resource, we are good! However, we’ve constantly been putting out fires: as the study nurse prepared for the days’ work, we realized the headlight is not available as it was stolen from the facility. With no replacement, the study team was forced to look for an alternative. Once that problem has been solved, we realize that the facility has only 4 sets of cryotherapy tips, limiting the number of clients who can be attended to per visit unless the nurse takes time to run the sterilizing equipment in the middle of the day.
At this point some clients have to be rescheduled. They leave the facility quite disappointed and we must redouble our efforts to make sure that they show up for treatment again. Hence, despite these efforts, our facilities still face daily challenges to combat cervical cancer. Insufficient resources, weak health systems, maintaining an adequate supply of materials remain barriers to the implementation for conducting large scale treatment.