By Ng Ai Fern
UNDERPRIVILEGED women living in rural areas of Sarawak are the most affected by cervical cancer, the second most common cancer among women following breast cancer.
Although it is a preventable cancer, due to lack of awareness, various obstacles and barriers such as shyness and logistics, many women only seek medical assistance in the later stages, usually in stage III and stage IV, resulting in lower survival rates.
“In Sarawak, many women are shy to examine their private parts,” said Sarawak General Hospital Obstetrics and Gynaecology trainee doctor Dr Abigail Susil.
“Women generally put themselves last, they take care of their husband, children, parents first, they only come to see the doctor when they have nonstop bleeding or unbearable pain,” she pointed out.
What saddened Dr Abigail was that most of Sarawak’s underprivileged women living in rural areas lack access to potentially lifesaving health screenings, due to distance or other obstacles, or simply lack awareness of the cancer.
Lack of awareness is killing Sarawak women
Cervical cancer is caused by sexually acquired infection with high risk human papillomavirus (HPV). Although most infections with HPV resolve spontaneously and cause no symptoms, persistent infection can cause cervical cancer in women.
“Precancer infection has no symptoms and takes five to 10 years to develop cancer,” said Dr Abigail, stressing that taking the HPV vaccine, and carrying out health screenings can effectively prevent cervical cancer up to 90 per cent.
The HPV vaccine, which has been introduced for all 13-year-old girls in Malaysia, can prevent up to 70 per cent of cervical cancer cases.
After vaccination, there is still a 30 per cent chance and hence screening is important.
Pap smears & HPV Screening
Pap smears, a mandatory test for all women aged 25 years in Western countries, is also available for free in Malaysia’s government clinics. However, most women do not go for free screening, especially women living in rural areas.
Dr Abigail pointed out that pap smears were only 60 per cent effective in detecting cervical precancer, and it took time to examine the sample in lab, and needed repeat testing, which is inconvenient for rural women.
The self-sampling HPV kit, on the other hand, has been proven to remove obstacles and barriers to cervical cancer screening. It takes about 5 minutes, can be done at home, and the result is 90 per cent accurate. It is nevertheless not available at government clinic and costly to rural folks.
Speaking to DayakDaily recently, the 34-year-old doctor related how she started a non-profit organisation to break the barriers in cancer care and awareness.
The NGO is called Pink & Teal EmpowHer, led by Dr Abigail herself, and they had their first rural outreach program in June 2018.
Screening women in the kampungs
Instead of asking busy women to leave their homes and farms to come to the clinic, the NGO with volunteer doctors come to the kampungs with all the necessary equipment and mobile tent to provide free screenings.
Dr Abigail said they used the cheapest and most effective way, which is Acetic Acid, for immediate results.
They also had HPV test kits, sponsored by urban women through a campaign themed “SigekKitak, SigekKamek” (One for me, one for you) where every HPV test kit bought will buy another test kit for an underprivileged woman.
The volunteer doctors also screen for breast cancer, provide free dental check-ups and provide fun activities for young kids.
Among the team is Dr Cheng Siang Tan, Head of Centre for Tropical and Emerging Diseases from University Malaysia Sarawak (Unimas), who is collecting data on the types of HPV-causing cervical cancers among Sarawakian women.
So far, they have reached out to Padawan, Siburan, Tebakang, Dalat, Serian and screened up to 800 women with the help of about 80 volunteers.
Among the 800 women, 25 per cent of them have tested positive for cervical cancer, and have been sent to Sarawak General Hospital to receive treatment.
Last year, Sarawak General Hospital had received 120 new cases of cervical cancer. But this may not represent an accurate picture of the prevalence of cervical cancer in Sarawak as many women living in rural areas still have no access to screening yet.
Pink & Teal EmpowHer is also concentrating on an urban outreach programme by organising a marathon to create greater public awareness on breast and cervical cancers.
The first women’s marathon in Sarawak to feature a 400-metre high heel run, tutu run, 1KM family children’s stroll and a competitive women’s half marathon will be held on Oct 27, 2019.
To know more about the run, how to get a HPV Test, or how to help in this great cause, visit their Facebook Page here:https://www.facebook.com/pink.and.teal.empowher/ — DayakDaily