From February 11-17, 2025, Ifakara Health Institute, in collaboration with St. Francis Regional Referral Hospital (SFRRH), the University Hospital Basel and Charité-Universitätsmedizin Berlin provided free counselling, screening and treatment of sexually transmitted infections (STIs) and Human Papillomavirus (HPV)-related cervical precancer, to local communities at Kilombero Hospital, located within the Kilombero Sugar Company. 

Cervical cancer remains a silent threat to women, especially in the Global South, where limited access to healthcare and low awareness contribute to late diagnoses and high mortality rates.

Recognizing the urgency of this challenge, these partners embarked on a mission to spotlight cervical cancer in Tanzania’s Kilombero area. The program was made possible through the support of its main sponsors, Swiss Medical Teams and Fondation Solidarite International.

The initiative was part of the 6th Colposcopy Course, which in part included a field-based practical training aimed at strengthening the expertise of medical professionals in cervical cancer screening and treatment. 40 medical professionals from across Tanzania participated in the course, gaining hands-on experience that will improve early detection and intervention efforts nationwide.

Breaking myths and changing mindsets
Despite widespread myths and low awareness surrounding cervical cancer, the response from women in Kilombero was overwhelmingly positive. Over 400 women showed up, eager to learn about the disease, undergo screening, and, for those diagnosed, receive treatment immediately. The high turnout underscored a growing willingness among women to prioritize their health and take proactive steps toward early detection and care.

Screening using advanced methods
Early detection is crucial in preventing cervical cancer. For this screening program, they used advanced screening methods like HPV testing, which identifies high-risk strains early, allowing for timely intervention. 
Integrating HPV testing into screening process helps detect high-risk strains early, enabling timely intervention, regular monitoring and follow-up colposcopy when needed. This approach reduces the risk of disease progression and improving overall survival rates.

Beyond HPV testing, other screening methods were used, including Visual Inspection with Acetic Acid (VIA) – a simple, cost-effective method that helps detect precancerous changes, making it highly suitable for low-resource settings. 

For women diagnosed with precancerous lesions, treatment was provided using thermoablation and LEEP-conization, both effective techniques for preventing the progression of cervical cancer.

Magreta’s testament on early detection
One inspiring testimony is that of Magreta Moherali, a 43-year-old woman who was among the first to participate in the free screening program. Having been advised during a prior hospital visit to get tested, she did not hesitate, understanding that her health must come first. 

When her results indicated precancerous lesions, Magreta showed remarkable resilience. Without a moment of hesitation, she sought treatment immediately. Her message to other women was clear: “Get tested. Do not be afraid. The earlier the disease is found, the sooner you can start treatment and avoid getting worse.”

Prevention is always better than cure
Dr. Andre Kind, Deputy Chief Physician of Gynecology and a facilitator of the 6th Colposcopy Course, stressed the importance of prevention, noting that without screening, many women are diagnosed at advanced stages when treatment is complex and expensive.

“ICC is the most frequent cause of cancer-associated death in Tanzanian women. The two most common causes of death among women of reproductive age in Tanzania are cervical cancer and maternal mortality. This is why the University Hospital Basel has been involved in both areas for over 10 years in Tanzania, including with training courses to achieve sustainability,” he explained. 

Together with Dr. Brigitte Frey, also an Obstetrician and Gynecologist in Switzerland, they have been facilitating colposcopy courses from the beginning in Tanzania and in the last 15 years in Switzerland, transferring their knowledge and experience to Tanzania, aiming for lasting impact.

“With these courses, we want to provide sustainable support in cervical cancer prevention. We hope participants will use the knowledge gained in their healthcare facilities to screen and treat women for cervical cancer,” Dr. Kind remarked.

Building capacity in cervical cancer prevention
Dr. Andreas Martin Kaufmann, a biologist specializing in HPV screening at Charité-Universitätsmedizin Berlin and a facilitator of the Colposcopy Course, underscores the importance of capacity-building initiatives in the fight against cervical cancer. Speaking at an Ifakara-organized talk on “Tackling Problems of Cervical Cancer Screening by HPV Testing in Countries of the Global South” ahead of the course, he underscored how strengthening local expertise is essential in tackling the disease effectively. 

Reinforcing this commitment, Ifakara and its partners have successfully conducted five Colposcopy courses since 2020, with the sixth course taking place this year, demonstrating sustained efforts in strengthening medical professionals' skills.

For her part, Dr. Sr. Nathalia Makunja, an obstetrician and gynecologist at SFRRH, who also served as an organizer and facilitator of the course, encourages medical professionals everywhere to participate in this vital training. 

“This course is a valuable opportunity for healthcare workers to expand their skills and bring life-saving services to their communities,” she said.

She emphasized that equipping more professionals with colposcopy skills can significantly improve early detection and treatment of cervical cancer. “By joining this program, medical professionals can play a key role in preventing and managing cervical cancer in their respective regions."

Insights from a practicing nurse
One participant of the course, a nurse from Kitete Regional Referral Hospital in Tabora, Tanzania, described the training as invaluable. She emphasized how it expanded her knowledge of cervical cancer diagnosis, particularly in colposcopy, a technique she was previously unfamiliar with.

"The skills I have acquired will greatly enhance my ability to screen and examine women for cervical cancer," she said. She encouraged fellow healthcare professionals to seize similar training opportunities, recognizing their role in early detection efforts.

She also urged women to prioritize their health by learning about cervical cancer, embracing screening programs, and, if diagnosed, seek treatment as early as possible.

A united front against cervical cancer
With increased education and improved screening efforts, more women can detect the disease early, receive timely treatment, and lead healthier lives. Ifakara and its partners remain committed to breaking barriers and ensuring that no woman is left behind in this fight.

As Dorcas Mnzava, a Research Scientist at Ifakara and organizer of the program, point out, four partners – Ifakara Health Institute, St. Francis Referral Hospital, University Hospital Basel, and Charité-Universitätsmedizin Berlin – have joined forces to make a lasting impact in Kilombero.

“This partnership is about more than just research and medical training – it’s about saving lives,” said Dorcas. “Through free screening, training programs, and advanced treatment methods, this partnership enhances early detection, improves treatment accessibility, and empowers local healthcare professionals.”

Dorcas also underscores the importance awareness, stating, “Cervical cancer is preventable and treatable when detected early. Women in Kilombero and beyond should take charge of their health by attending regular screenings, learning about HPV, and getting vaccinated where possible. Myths and fears about cervical cancer should not prevent women from seeking care – early detection can save lives.”

She points to the story of Magreta Moherali as a powerful example: taking action without hesitation can make all the difference. “Let’s work together to break the silence, spread awareness, and ensure that no woman is left behind in the fight against cervical cancer."

Celebrating success and looking ahead
The success of this initiative is evident in the numbers: more than 400 women were screened, and those diagnosed with precancerous lesions received outpatient surgical treatment. And while the field-based training concludes, screening services at Kilombero Hospital will continue, ensuring more women in the community receive essential care.

Meanwhile, for the newly graduated medical professionals of the 6th Colposcopy Course, this achievement represents a significant step towards strengthening Tanzania’s healthcare system. The journey continues, but with every woman screened and every healthcare worker trained, the fight against cervical cancer gains momentum.