Life is rough for women with cervical cancer in Kenya. Some of those attending the country's only public treatment facility sleep on benches and concrete floors outside the hospital to save money for their treatment. Others never make it to the capital for assistance because they cannot afford the bus journey. Now, a vaccination programme has been rolled out, offering hope for future generations.
"Cervical cancer vaccine now available for girls in primary school free of charge!" reads the turquoise poster outside the office of Christina Mavindu, senior nursing officer at the Kitui district hospital. Mavindu is two-thirds of the way through implementing Kenya's first public cervical cancer vaccination campaign in Kitui county. The third and final jabs will be administered in the next few weeks.
The campaign has been challenging. The number of children wanting the vaccine has exceeded the doses available and, at a cost of more than $50 (£30) per vaccine, many people have been unable to pay for it privately. "It should be for everybody," says Mavindu. Gavi (Global Alliance for Vaccines and Immunisation) supported the trial to enable Kenya to demonstrate that it has the necessary infrastructure and capacity to vaccinate nine- to 13-year-olds on a national scale.
Vaccination is needed urgently; cervical cancer is a growing cause of morbidity among women in Africa, and a rising concern. The disease is nearly six times more prevalent in Kenya than in western Europe, according to WHO data. It is also the cancer that kills most women in Kenya, whose neighbour Rwanda became the first low-income African country to achieve nationwide access to the vaccine.
The treatment for cervical cancer is inadequate: nearly half of the women who were being treated in Kenya "disappeared" from their programmes, according to the results of a recent survey published in the journal Plos One of patients at the only public cancer treatment centre. "Most likely they could not afford treatment," says Dr Ian Hampson, head of gynaecological oncology at the University of Manchester, who oversaw the research. Just 7% of women received "optimal treatment", while 41% dropped out.