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Cervical Cancer Crisis Card: A Gift Of Health And Safety On Mother’s Day

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India has highest number of women dying from cervical cancer. Australia provides a global model for dramatically preventing cervical cancer.

More women die of cervical cancer in India than anywhere in the world. India along with China, Brazil, Bangladesh and Nigeria represent over 50% of the global burden of cervical cancer deaths.

However, African countries are struggling to deal with cervical cancer too according to the new Cervical Cancer Crisis Card, which ranks countries from across the world based on the number of deaths from cervical cancer and the mortality rate from this preventable disease. The Crisis Card is available on the Cervical Cancer Free Coalition website and is being launched globally to mark International Mother’s Day on Sunday 12th May.

cervical cancerCervical cancer kills an estimated 275,000 women every year and 500,000 new cases are reported worldwide. This entirely preventable disease is the second largest cancer killer of women in low and middle-income countries. In India, cervical cancer kills a staggering 72,000 women every year.
“Despite the great burden of this disease there are exciting opportunities for prevention with breakthroughs in available options for cervical screening in low resource settings” said Dr. Usha Rani Poli Associate Professor of Gynaec Oncology at the MNJ Institute of Oncology & Regional cancer Center in Hyderabad. “Still major barriers need to be addressed, community mobilization is critical to educate the public on the importance of screening and to break down cultural barriers about discussing sexual issues.

According to the Crisis Card, Australia has the lowest cervical cancer mortality rate, which is due to the successful rollout of a comprehensive package of HPV vaccines, treatment and prevention. According to the Government of Australia, there has also been a decline in genital warts and cervical abnormalities among young women since the introduction of the HPV vaccine in Australia.

Dr Jennifer Smith, Executive Director of the Cervical Cancer Free Coalition said: “Cervical cancer is a preventable cancer, yet we are still seeing so many deaths around the world. At Cervical Cancer Free Coalition we are working towards building networks across the globe to help support our common goal of a world free of cervical cancer. Together we can dramatically reduce this disease through vaccination, screening and education.”

The startling disparities between women in the developed and developing world are personified by cervical cancer. A woman in Zambia is 25 time more likely to die from cervical cancer than a woman in Australia and India has 750 times more deaths than Norway. This level of inequity is also reflected across gender indicators with girls less likely to attend school but more likely to be malnourished and married as a child.

Coming in the same month as the global Women Deliver 2013 conference that will have a focus on gender and health equity in terms of the post-2015 framework (the follow-up framework to the Millennium Development Goals), the report is a timely reminder of the challenges facing women, especially in the low and middle-income countries. By prioritising women’s health in the next developmental framework, world leaders would show that they’re serious about challenging inequity and building sustainable societies where universal rights are guaranteed for all.

Yuvraj Singh, former India Vice Cricket Captain and cancer survivor who is attending Women Deliver 2013 said, “If there is something that I have learnt in my battle with cancer, it is, to use a clichéd term, Prevention is better than cure. This Mother’s Day, let’s pledge to keep our mothers safe. Let’s protect the women in our families. It’s time we showed that we care”

Cervical cancer is a taboo issue in many places as it is linked to sexual reproduction and cancer. Unless women’s groups and civil society join together to lead movements that break through stigma, patriarchy and other societal barriers, we will continue to see large numbers of deaths and high mortality rates. Projections show that by 2030, almost half a million women will die of cervical cancer, with over 98% of these deaths expected to occur in low and middle-income countries. The time to act is now.

The crisis card also calls for:

– The rollout of a comprehensive approach to cervical cancer that includes the aggressive rollout of HPV vaccines that prevent disease and for the scaling up of screening and treatment options.
– Women to be encouraged to visit their health provider for early screening of precancers using either the pap smear (colposcopy), visual inspection with acetic acid (VIA) and HPV testing to help diagnose precancerous cells.
– Treatment of precancers is advancing, which provides hope to the hundreds of thousands of women who missed out on the vaccine. Health systems need to be strengthened so that all women who need access to treatment can access affordable, quality care.

Utilising official data from reports by the World Health Organisation, United Nations, The World Bank and IARC Globocan, this list of 50 countries were chosen to provide a snapshot of the world and reflect geographic, economic and population variations (and where data was available — some countries like Afghanistan have insufficient data). Cervical cancer data can be found for all countries at the World Health Organisation website

Cervical Cancer Global Crisis Card

tableCervical Cancer Crisis

Cervical cancer kills an estimated 275,000 women every year and 500,000 new cases are reported worldwide. This entirely preventable disease is the second largest cancer killer of women in low and middle-income countries, with most women dying in the prime of life.

While numerous tools and technologies exist to prevent cervical cancer, these interventions remain largely inaccessible to the girls and women who need them most. Despite the proven link between the Human Papillomavirus (HPV) and cervical cancer, HPV vaccines are not yet widely available and screening rates remain low in much of the world. Lack of awareness and deep-seated stigma associated with the disease also pose significant barriers to access.

Projections show that by 2030, almost half a million women will die of cervical cancer, with over 98% of these deaths expected to occur in low and middle-income countries.

The hard facts

Using data from the WHO, United Nations, the World Bank and IARC Globocan, the cervical cancer crisis cards highlight the inequity women face depending on where they live. Fifty countries were selected to provide a snapshot of the world and reflect geographic, economic and population variations (and where data was available).

The Cervical Cancer Crisis Card: Death Count, reveals the huge number of women dying in Asia. India alone represents 26.4% of all women dying of cervical cancer globally, with China, Bangladesh, Pakistan, Indonesia and Thailand also showing high death incidence.

The Cervical Cancer Crisis Card:table 2

Mortality Rates highlights that Africa is the most dangerous place to be a woman with cervical cancer. All ten of the countries with the highest cervical cancer mortality rate can be found in Africa. In a positive sign of what can be achieved, Australia has had a successful national rollout of the HPV vaccine and has seen a decline in genital warts and cervical abnormalities among young women since its introduction.

Overcoming the crisis

Cervical cancer is almost entirely preventable and if the world followed Australia’s example of rolling out comprehensive vaccination, screening and treatment, we would see mortality rates and the death rates dramatically reduce.

We have safe and efficacious HPV vaccines available on the market to prevent infection with the main cancer causing strands. For early screening of precancers the pap smear (colposcopy), visual inspection with acetic acid (VIA) and HPV testing can help diagnose early cancerous cells. Treatment of precancers is also advancing, which provides hope to the hundreds of thousands of women who missed out on the vaccine. This also emphasizes the need for women to be screened regularly.

Innovative funding mechanisms to increase access to HPV vaccines and screening tools are being developed. Several countries around the world, such as Malaysia, Mexico and Rwanda have shown leadership in strengthening cervical cancer prevention. With funders and country governments increasingly working together with vaccine manufacturers and donors to ensure access and affordability of HPV vaccines, we must ensure that we take action to cut both the death count and mortality rate of cervical cancer.

Global Form on Cervical Cancer Prevention

World leaders and experts are uniting in Kuala Lumpur later this month to plot out a roadmap to ensure that all women and girls have equitable access to HPV vaccines, screening and treatment.
Whatever the outcome, it will be critical that at the local, national and international levels we work in partnership to ensure that words are turned into action and we use the tools and technologies available to prevent cervical cancer.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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