Beauty in Bungoma County & Hope to Fight Cervical Cancer

 The sugar cane fields of Bungoma County

The sugar cane fields of Bungoma County

As we rolled into Kanduyi, "beautiful" was not a word that came to mind, but now whenever I think of the place, it is the first. The bucolic sugar cane fields we passed on the way from Webuye gave way to a dusty town: wooden snack shacks selling mangoes, bananas, and soda, tin-roofed butchers, patches of grass, and semis - so many semis - headed this way and that way, clogging the main intersection of town. They were parked on the shoulder of the two-lane highway and akimbo in dirt lots. It was late morning, nearly lunchtime, and snack shacks were bustling with people doing business and living daily life. The Ugandan border lay 35 km ahead on A104. It's a busy highway, part of the great ring road that covers 2,300 kg (1,430 miles, or roughly the distance between Chicago, IL and Miami, FL) connecting the countries around Lake Victoria - Kenya, Uganda, Rwanda, Burundi, and Tanzania - to each other. It is also part of the main land route between the Indian Ocean port of Mombasa and Uganda, Rwanda, South Sudan, and perhaps points beyond.

The meeting was outside on a grassy patch between buildings set up with white plastic chairs. The six of us from Lilly and the two AMPATH workers, Mercy and Elizabeth, who invited us as guests, sat facing the women of Group Wasupu. They were there to promote the free cervical cancer screening and treatment available at the Webuye clinic to the women in this remote support group and listen to their questions and stories to understand the barriers to care.

 Group Wasupu, Lilly guests, and Elizabeth and Mercy of AMPATH. Elizabeth is standing in the first row all the way to the left. Seated in chairs (left to right) are me, a woman from the group, Surabhi Dosi (holding baby), Mercy, Karlee Moore, and Sean Yao.

Group Wasupu, Lilly guests, and Elizabeth and Mercy of AMPATH. Elizabeth is standing in the first row all the way to the left. Seated in chairs (left to right) are me, a woman from the group, Surabhi Dosi (holding baby), Mercy, Karlee Moore, and Sean Yao.

The seventeen women were tidy and dressed in bright, colorful patterns, as if in defiance of their drab and disheveled surroundings. They welcomed each other, and us, with handshakes, smiles, and warm embraces. Elizabeth, a psychological counselor based in Webuye, told us "Wasupu means 'Beautiful Ones' in their language." A few men peeked towards us from the street, but kept their distance. A rooster in the yard did the same.

Elizabeth stood tall in her black leather jacket, smiled effusively, and started the introductions. She exuded a relaxed, easy joy. After each of us visitors introduced ourselves, she revealed herself in a matter-of-fact manner to be HIV-positive for the last 18 years and the mother of three HIV-negative children. She spoke of her experience with cervical cancer screening and her compliance with her medication. I didn't see a reaction in any of the faces. She could have been talking about her hair color. One by one, the women stood up, introduced themselves by giving their name and, with similar placidity, how long they have been infected with HIV, their viral load, if and when they had been screened for cervical cancer, and in some cases, a personal story about how they have been affected by cancer. A baby boy bounced on his grandmother's knee.

Mercy, a patient outreach leader for AMPATH, told us that she visits thirty two groups like this one in Bungoma County. "We are here to sensitize (get women to understand risks to their health and what they can do) and encourage screening. When I sensitize, I talk to women woman-to-woman." Dispelling myths is an important part of the job. It saves lives. Some of the myths the women mentioned included a variety of things rumored to cause cervical cancer, from cooking oil to contraceptives to screening itself. One woman, who lost her mother to cancer, talked about how her attitude to screening has changed over time: "Before, when (AMPATH personnel) talked to us, we hid. Now, I am happy to be screened and know the results so that I know how I can live."  

Before, when (AMPATH personnel) talked to us, we hid. Now, I am happy to be screened and know the results so that I know how I can live.
— Member of Group Wasupu

There was plenty of beauty in that dusty lot. Friendship. Knowledge. Support. Healing. Health. Hope. With the continued work of AMPATH workers like Mercy and Elizabeth and the growth of programs like outreach screenings that bring care to the people and bring down the barriers to community health, more women like The Beautiful Ones can lead longer, healthy lives and lift up their families and their communities. 

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Tony Wiederhold has been an employee at Eli Lilly and Company since 2004. He has traveled to Kenya in November 2016 and March 2018 as part of Lilly's Connecting Hearts Abroad (CHA) program. Through CHA, since 2010, Lilly has sponsored two-week global health volunteer assignments for 100-200 employees each year. The volunteers staff projects in areas of need around the world. Lilly's CHA program in Kenya, new in 2016, is an expansion of the company's longstanding partnership with AMPATH to improve population health in Kenya. Cervical cancer and breast cancer early detection and treatment are current areas of focus of this partnership, through which Lilly provides funding, medicine, and CHA volunteers.