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A Journey of Hope in Zimbabwe

Zimbabwe Association of Church-Related Hospitals , with support from PEPFAR as part of the Go Further partnership, began offering Visual Inspection with Acetic Acid services in October 2018 to screen women living with HIV for cervical cancer. Sarudzai Ndlovu shares her journey.

Article by Shamiso Yikoniko, ZACH Technical Advisor, Advocacy and Communications January 28, 2021 //   5 minute read
Ms. Sarudzai Ndlovu, a beneficiary of VIAC services from Makonde District in Zimbabwe.

Zimbabwe Association of Church-Related Hospitals (ZACH), with support from PEPFAR as part of the Go Further partnership , began offering Visual Inspection with Acetic Acid (VIAC) services in October 2018 to screen women living with HIV for cervical cancer. ZACH started with 11 sites and has expanded to 17 static and 58 outreach sites.

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ZACH uses the ‘see’ and ‘treat’ approach. Clients are screened and offered treatment for eligible precancerous lesions on the same day if any are found. Clients with lesions suspicious for cancer are referred to the next level of care for biopsies.

Ms. Sarudzai Ndlovu, from Makonde district in Zimbabwe, shares her cervical cancer screening journey.

This interview has been translated and edited for length and clarity.

Tell us about your life and what’s important to you?

Sarudzai Ndlovu: I am a 40-year-old woman, married and a mother to three children. I am living openly with HIV. As a source of living, I’m into buying and selling goods so that I assist my husband to raise our children and give them a comfortable life.

The most important thing for me is to have a prolonged healthy life so that I see my children grow up to be responsible citizens. I also hope to see my grandchildren.

Tell us about your journey with cervical cancer screening or treatment.

SN: Being screened for pre-cervical cancer lesions was out of question for me, I was afraid of the procedure. My peers would describe it as a horrendous procedure where one’s uterus will be removed and placed in a tray then it’s checked for any cancer cells and later replaced back. So just thinking of that experience gave me chills.

When I eventually agreed to get screened, it took me less than 30 minutes and it was painless. The healthcare worker was friendly and first explained how the procedure is done. I’m excited that I finally did it and I’m elated that I don’t have cervical cancer.

What was your experience at the clinic?

SN: The very first time I went to the hospital with the intention of getting screened, I developed cold feet and returned home. The second time I was going to the facility for my ART [antiretroviral therapy] refill and the VIAC nurse held a health talk explaining about VIAC and its advantages and encouraged all women to get screened. I then lied saying I had been screened before. After listening to more teachings on VIAC, I then agreed to get tested.

I tested negative for pre-cervical cancer lesions and I thank God for it all. The nurse went on to explain the ways I could reduce my risk of developing cervical cancer and that I should come back again after two years to be screened.

Who were the people along the way who supported you?

SN: My husband, kids, the community peer mentor and the VIAC nurse walked with me through the journey so that I overcome the fear of being screened. I am grateful to all of them. I’m now a self-proclaimed VIAC ambassador in my community as any opportunity I get, I share my experience with pre-cervical cancer lesions screening and encourage all women to get screened early.

What are your dreams in life?

SN: I dream of living a healthy and normal life. When I tested positive for HIV, I made a vow not to limit myself because of my condition. Even if I had tested positive for pre-cervical cancer lesions, I still would have carried on with life. My consolation about cervical cancer is it’s preventable, so I have nothing to fear. I also dream of growing my business, but I am currently limited by lack of capital.

What messages do you have about cervical cancer or cervical cancer screening?

SN: Every sexually active woman should be screened for pre-cervical cancer lesions as one would get to know where they stand and get treatment early. 

Due to the association between HIV/AIDS and cervical cancer, stigma and discrimination is a prohibitive factor to some women in accessing VIAC services.

The health facilities offering VIAC services are making efforts to increase VIAC uptake through awareness campaigns by the community peer mentors and educating women as they visit health facilities for other services (e.g. postnatal care, outpatient visits, and HIV clinics) as a way to fight HIV-related stigma and discrimination.