Eritrea: Preventing Cervical Cancer

Our guest today, Doctor Tiblets Tesfamichael, is a gynecologist at Orotta National Referral Hospital and has been serving as a physician for over 30 years. Here, she enlightens our readers about cervical cancer and ways to prevent it.

Let's start with your background, Dr. Tiblets.

Sure. I was born and raised in Asmara. I got an opportunity to study in Cuba and took medical and specialization training there and graduated as a medical doctor with specialization in Obstetrics. After graduation, I went to Ethiopia in 1990 and worked there until the end of 1992 in the Northern part of the country. I came back to my country in 1993 and worked in Keren for around six years. In 1998, I was transferred to Orotta Hospital in Asmara and have been working there ever since.

To give our readers a general understanding of our topic, tell us the functions of the uterus.

The uterus is part of the female reproduction system found inside the pelvis. In a mature woman who isn't pregnant, it is equal to the size of a lemon that weighs 50 grams. The weight grows to 1 kilogram in pregnant women. It's where the menstrual cycle begins and where an infant is carried for nine months. And the cervix is the narrow passage at the opening of a woman's womb. It tightens and closes during pregnancy helping the womb to carry the infant for nine months, and it opens up to 10 centimeters during birth.

Cervical cancer used to be one of the most common diseases that killed women. What is its status today?

In the past, it was ranked as the number one cause of death in women. At present, however, it's ranked sixth due to new cures and people's awareness. There are two reasons for the change in the ranking. First, it takes 10-15 years for the signs of the disease to begin and develop into cancer. And second, there is a device that helps change the cells in the body before they develop into cancer.

What are the risk factors that may expose women to cervical cancer?

We can name a couple of factors. Having unprotected sexual intercourse and diseases that are sexually transmitted such as HIV, gonorrhea and syphilis can cause the cervix to develop cancer. Giving continuous births can be another reason. The continuous friction while giving birth can cause the passageway to be torn, and this may expose it to cancer. Human PapillomaVirus (HPV) is also a disease that can hide for a period ranging from weeks to a couple of years. Smoking for a long time and taking pregnancy pills (progesterone) make this disease develop and evolve without being noticed. Underage marriage can also be a risk factor as the cells' order gets messed up, leading to cancer. Having sexual intercourse with an uncircumcised male can also be a risk factor for cervical cancer.

How can we prevent cervical cancer?

First of all, taking a pap smear is really important. This is an examination given to women who engage in sexual intercourse. This examination helps track the changes that happen in the womb using a device such as colposcopy that helps see the affected cells in magnified size.

Giving HPV vaccination, which is given to females aged 9 to 14, is another method of prevention. Placing a speculum inside the womb also helps as prevention because it helps see the cervix so that you could put iodine on it to heal the harmed part. Avoiding underage marriage, giving fewer births, having one sexual partner, raising people's awareness through the media, encouraging women to give birth at hospitals, enlightening people about the benefits of pregnancy control pills and encouraging male circumcision can also be some of the main means to prevent cervical cancer.

What is supposed to be done to an affected cervix before it develops into cancer?

Before the infected part develops into cancer, it's vital to put these things into consideration: the age of the female, the number of kids she's got and the stage of the affected or infected area. If the female is young, a cancer tissue can be removed in an operation from the cervix or the affected part can be burnt using electricity. Healing through cryotherapy is also an option. This means healing the affected area through nitrate-oxide (-89 degree centigrade) or Carbon dioxide (-65 degree centigrade).

In addition to these, if only the cervix is affected, the eggs of the womb are removed. And if the cervix as a whole and the womb are affected, it all gets removed.

Is there any advice you would like to share with our readers?

I would love to encourage the media to keep on enlightening the people. And for the information to be heard and understood well, it should be made available in all nine Eritrean ethnic languages. The main actors in this that should work hand in hand are the ministries of Information, Health, Education and the National Union of Eritrean Women and more.

Thank you!

Thank you for your time, Doctor Tiblets.

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