A letter from Sue Makin in Malawi
March 4, 2009
A week of cancer and preventing cancer: 22-28 February 2009
Friends,
In November, 2008, I shared the good news that a cervical cancer screening program was being started at Ntcheu District Hospital, a large government district hospital halfway between Blantyre and Lilongwe, the two largest cities in Malawi. Cancer of the cervix is the most common cancer in women in Malawi. The vast majority of women with cancer come for medical help in the late stages of the disease. Most of them have never even heard of the disease or that it can be prevented. It is a shocking and sad task to have to tell them that not only do they have cancer, but that we health professionals have no radiation or chemotherapy to try to help them fight this disease when it presents in its late stages.
On Monday of this week, as a practicing gynecologist, I had the sad job of informing three women in their fifties that they had incurable cervical cancer: a woman at Mulanje Mission Hospital in the morning, a woman at Mulanje District Hospital in the afternoon, and a woman at Malamulo Mission Hospital in the evening.
Dr. Illona Hale, Canadian volunteer doctor (third from right) and nurses at Ntcheu District Hospital in Malawi admiring new cryotherapy machine for preventing cervical cancer.
But all was not discouraging news this week. I have just come from Ntcheu Hospital where we have just performed our first cryotherapy procedure to prevent cancer in a woman 29 years old. It was no easy task to get all the elements together in order to achieve this first cryotherapy procedure in Ntcheu District.
First, money was gived by Presbyterians in the United States to purchase a cryotherapy machine from a company in the United States last year. The machine itself was hand-carried by a helpful visitor to Malawi. A carbon dioxide gas cylinder was purchased, also with gived funds, from a company in Blantyre. The medical-grade CO2 gas was transported to Malawi from South Africa. Then I took the cylinder and the cryotherapy machine to a helpful local engineering firm to see if they could find the right fittings to connect the cylinder to the machine, as the American side did not fit the South African side. The men at the engineering firm were able to find the right fittings in Mulanje, and I thought all was ready for the trip to Ntcheu.
After the three-hour trip to Ntcheu with the cylinder in the back of my Toyota Venture, I took the items into the Family Planning Clinic where we were planning to have our cryotherapy session. Alas, somehow the two parts would not fight together correctly and the gas was leaking into the air instead of going into the tubing. The friendly plumber at Ntcheu told me I needed “thread tape.” I didn’t know what “thread tape” was, but I took his word that that was what was needed. I took off in the Venture to downtown Ntcheu looking for hardware stores. Sure enough, the young lady at “H and H Hardware” did not even blink an eye when I asked for “thread tape.” She said, “That will be 40 Kwachas.” This is about 35 cents, so I said I would take two.
Back at the hospital the plumber was able to connect the machine to the cylinder correctly. The gauge on the cylinder showed that the gas was at the right pressure, and all was in readiness for performing cryotherapy. And so, as the nurses were watching I was able to do the 11-minute procedure that will definitively prevent our first patient from ever getting cancer. In the future, I hope to train the nurses themselves to be able to perform cryotherapy. These are the same nurses who already have been trained how to visually inspect the cervix with vinegar to look for pre-cancerous changes.
When I was in medical school and in training to become an obstetrician/gynecologist I had no idea that I would need “thread tape” and friendly plumbers to help me do my job. Thanks to an exciting job as a medical missionary in Africa, I have had my horizons broadened and expanded.
Sincerely,
Sue Makin
The 2009 Mission Yearbook for Prayer & Study, p. 44
