Cervical Cancer in Rural Bolivia

15 May, 2016 | Karina Guzman

Health & Science and Social issues

Almost Entirely Preventable, the Disease Still Takes Its Toll

Photo: William Wroblewski


Nicolasa, an 84-year-old widow, says that she moved to Pucarani – a community 55 kilometres from La Paz – after getting married. The passing of time would see her witness all of her children leaving in the search of better opportunities, as well as the death of her husband, leaving her all alone to tackle the duties of working the fields and raising the cattle in her rural dwelling. One day, the pain she felt grew unbearable. Nevertheless, the posta de salud of her village was neither able to diagnose the affliction nor heal her. Luckily, being over 60 entitled her to free medical treatment, so when referred to a clinic in La Paz, the only barriers she needed to overcome were the costs of travelling to the city and waiting for a hospital bed to become available. When she finally saw a doctor, the diagnosis was made: Nicolasa had cervical cancer.

According to the the Bolivian government Health Ministry, by 2010 almost five Bolivian women were dying everyday because of cervical cancer. This staggering figure did drop slightly in 2013, according to the Pan-American Health Organisation, to two women per day. But these deaths are almost all preventable, as cervical cancer is usually caused by the human papillomavirus (HPV). HPV is transmitted sexually and presents no symptoms – except for certain strains that cause genital warts. Like many other countries, Bolivia has a vaccination program that combats the infection and spread of four different strains of HPV – between 2009 and 2011, an average of 28.000 Bolivian girls were vaccinated every year. But there has been no free, state-sponsored vaccination campaign since. (Currently, the HPV vaccine can be bought privately for around US$300 – more than the national monthly minimum wage.) However, HPV and cervical cancer can be treated when detected early by Pap tests, which are provided for free in public health centres. Nevertheless, only 14 percent of Bolivian women that took the test in 2010.

After Nicolasa was diagnosed, she was placed in the hospital’s 14-bed room. Chemotherapy, blood transfusions and several other tests and medications quickly followed. Her son did not stay for long, and she was left alone in the hospital bed, waiting for the treatment to end. Unfortunately, Nicolasa’s plight isn’t unusual, one of the main reasons being that cervical cancer is rarely caught in its early stages, when less invasive and more efficacious treatment is possible. In most rural communities in Bolivia, postas sanitarias are the only medical resources, and Pap tests are not regularly included in routine checkups. Furthermore, conservative rural communities frequently shun discussions of female sexuality and sexual health. Some doctors report that husbands forbid their wives from seeing medical professionals. The combination of shame, fear and ignorance contribute to HPV’s deadly toll.

Making matters worse, Bolivia has only three public hospitals to treat cancer, according to Ana Carola Torres of the Association of Volunteers Against Child Cancer, all of them located in the central axis of the country: Hospital de Clínicas in La Paz, Hospital Viedma in Cochabamba and Hospital Oncológico in Santa Cruz. Additionally, Torres says that these medical centres often lack of the proper equipment and infrastructure for treatment. For example, cobalt radiotherapy machines – an outdated technology from 50 years ago – are still in service. These conditions would prove daunting to a relatively sophisticated cosmopolite from La Paz, let alone a poor, uneducated woman from the countryside.

However trying Nicolasa’s story is, the scenario gets worse for women who live in even more remote communities, where logistics prevent any commute to one of the three public hospitals in the far-flung metropolis. And, with no free national medical insurance for women younger than 60, a bed, blood transfusions and chemotherapy can easily cost tens of thousands of dollars.

Nicolasa’s story is but one of many, her plight highlighting the challenges that cervical cancer poses to many in rural Bolivia. But Nicolasa, as difficult as her story is, is one of the fortunate ones. Cervical cancer has proven itself to be a silent and deadly killer amongst many other women from the Bolivian countryside – one that is treatable and preventable. There is room for improvement, but Bolivia faces an uphill struggle. The public healthcare system is not properly equipped to provide timely diagnosis and treatment, which can prevent or ameliorate the deadly effects of cervical cancer. Women need to be informed, empowered and encouraged to demand their rights and own their bodies. And the state needs to respond to these demands and provide rural women the healthcare and medical infrastructure they deserve.

Comments

avamys
08 Jul, 2019 | 17:24
Chronic allergic rhinitis may also be called persistent or perennial allergic rhinitis. The problem may be further classified in line with the severity of the symptoms of allergic rhinitis.
Private label supplements USA
02 Jul, 2019 | 09:47
Professional listed multi-vitamins really are multi-vitamins and additionally pills pre-manufactured just by a supplier, still name brand and additionally advertised just by an alternative. They are simply characteristically usual vitamin supplement preparations who are stated in considerable keeps going thereafter advertised to make sure you many different vendors for reduced lots that should be allotted using ones own trademark.
Eye hospital on pune
27 Jun, 2019 | 07:34
It is really a strange proven fact that the attention is the main sense for every one of us, but whenever we mention our health, most of us mean the health of our body, but without enough attention to the eye health. Let's just imagine how the planet or our life is going to be when we do not need healthy eyes.
hair replacement in india
20 Jun, 2019 | 03:02
I’m definitely still learning and have SO much still to learn in the dairy-free arena, which is why I appreciate blogs like yours with an arsenal of helpful recipes and tips! You know me: I love to throw fun events :) Let me know what you have in mind for a dairy-free event sometime!
Hary
20 Jun, 2019 | 03:01
I came across this on Google, and I am stoked that I did. I will definitely be coming back here more often. Wish I could add to the conversation and bring a bit more to the table, but am just taking in as much info as I can at the moment. Thanks for sharing. <a href="https://www.infinitihairclub.com/services/hair-replacement-in-mumbai/">hair replacement in india</a>
Kamagra oral jelly 100mg
18 Jun, 2019 | 03:19
If the rural areas such as rural Bolivia had access to herbal medicines then this would be diagnosed early on. As such almost entriy preventable diseases are overlooked due to their medicines cost. But have no fear as Kamagra oral jelly 100mg is the best new drug reliably cost efficient. Which in future might be developed in rural areas to lead to no such problems being caused further on.
Kamagra oral jelly Australia
17 Jun, 2019 | 06:06
Cervical cancer is a serious issue, and a cure for this cancer needs to come out soon. I know that Kamagra oral jelly Australia will help you with this cancer, but there needs to be a proper solution for this cancer soon.
vrbaski
04 Jun, 2019 | 05:31
Veoma znacajna i velika priznanja Srpske pravoslavne crkve dobilia su dva Vrbašana. Orden Svetog Save drugog reda dobio je Vladimir Vrbaški, dok je priznanje gramata dobio Ratko Vujadinovic.
Medical Answering Service
02 Jun, 2019 | 08:57
Nicolasa is a brave woman who gets a hard life. Now the cancer medicine common available in the market. The GOV should release some funds to live.
www.imedix.com
04 May, 2019 | 04:32
How can I not know anything about this cancer? I think that these doctors are trying to hide it as much as they can and this is not right. They need to tell this to everyone about it and then we all can work on it.
GARY C Jackson MD
10 Nov, 2017 | 15:47
Bolivia needs to immediately begin free screening of ALL women over 30 yrs old using Visual Inspection with Acetic Acid, NOT the PAP smear. The infrastructure for PAP smear use is ineffective. Cryotherapy can be provided at the same appointment where cervical dysplasia is detected. Further, vaccination of girls (and boys) must be provided universally.

Make a comment