IT is a chilly Thursday morning, and 54-year-old Rebecca Gwanzura stands patiently in a winding queue at Parirenyatwa Hospital in Harare, waiting for her review.
Elderly women, with crying babies on their backs, chat about their ordeals, which have brought them to the capital.
Gwanzura, who lives in Kwekwe, about 200 kilometres from Harare, discovered she had cervical cancer three months ago. Like many others, she cannot afford the steep costs of treatment.
“Cancer treatment costs are steep,” Gwanzura says. “The hospital does not have medication, so we must purchase chemotherapy drugs from a pharmacy for US$180 every three weeks. The consultation charge is US$30.”
Her story reflects the state of Zimbabwe’s struggling healthcare system, marked by shortages, dilapidated infrastructure, poorly equipped hospitals, and the exodus of healthcare professionals due to ongoing economic challenges.
For Gwanzura and others like her, Parirenyatwa is the only facility offering cancer treatment services in the country. Yet even here, affordability remains a barrier.
Tariro Chikwanha, 63, another cervical cancer patient, highlights the critical need for accessible treatment.
“Decentralisation of chemotherapy and radiotherapy is needed since cervical cancer is spreading very fast,” she says.
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Chikwanha, who has faced multiple health challenges, including HIV-infection, leprosy, and tuberculosis, has become a beacon of hope for others.
She emphasises the importance of early diagnosis and treatment.
“I urge my friends who are victims of cancer to remove fear. One tends to think that it is a death sentence, but that is not the case. Early treatment and diagnosis are the best approach,” she says.
Her advice to women is simple but profound: “I encourage all women to be screened for cervical cancer. Early detection saves lives.”
She also underscores the importance of dietary changes during recovery and acknowledges the support she received from Ondine Francis, which helped her navigate the financial and emotional challenges of chemotherapy.
Cervical cancer is the leading cause of cancer deaths among women in Africa. Zimbabwe is one of the top five countries most affected, with approximately 3 000 new cases diagnosed annually and over 2 000 deaths reported each year — a mortality rate exceeding 60%.
Many women across Africa, including Zimbabwe, are diagnosed at advanced stages due to limited access to screening programmes, diagnostic facilities, and prevalent myths surrounding cervical cancer.
Additionally, the high prevalence of HIV in Zimbabwe increases the risk of cervical cancer sixfold, compounding the crisis.
The financial burden of treatment remains a significant barrier. Patients must pay out of pocket for cancer therapies, with costs well beyond the reach of most.
The lack of adequate care services across the spectrum of cancer treatment has further hampered the national response to this growing health challenge.
Cervical cancer is largely preventable, with more than 95% of cases caused by the human papillomavirus (HPV), a sexually transmitted infection.
In 2014, Zimbabwe piloted an HPV vaccination programme in two districts before rolling it out nationally in 2018 for girls aged 10 to 14. With an 86% vaccination coverage rate, Zimbabwe has one of the highest rates in the region.
“Infection-related cancers such as those caused by HIV, HPV, Hepatitis B, and bilharzia are the most common,” says Itai Rusike, executive director of the Community Working Group on Health (CWGH).
“Cervical cancer can be prevented in 85% of cases by avoiding HPV infection. Delaying sexual debut, comprehensive education, and vaccination are effective strategies.”
Rusike stresses the need for improved access to treatment, particularly for older women.
“Innovative strategies, including surgery, chemotherapy, radiotherapy, and palliative care for advanced cancer, are essential,” he says.
However, with only two centres in the country offering chemotherapy and radiotherapy, the national capacity for early diagnosis and intervention remains weak, leading to poor-quality care and alarming statistics.
The World Health Organisation recommends that all girls aged nine to 14 receive the HPV vaccine before sexual debut to minimise cervical cancer cases.
Some innovations offer hope. New Zealand’s TruScreen Group Limited has developed an AI-enabled device that detects precancerous and cancerous cervical changes in real time using optical and electrical measurements of cervical tissue.
In Masvingo, the TruScreen programme has already screened over 14 000 women for cervical cancer as of September 2024.
As Zimbabwe grapples with the rising burden of cervical cancer, there is a growing need for comprehensive reforms in healthcare service delivery.
For women like Gwanzura and Chikwanha, early detection, treatment, and support remain critical lifelines in a system desperately in need of transformation.
