12 September is the International Day for South-South Cooperation and the theme for this year is “Solidarity, Equity and Partnership: Unlocking South-South Cooperation to Achieve the SDGs.” On this important occasion, UNFPA in China celebrates the fruitful partnerships between China and other developing countries and pays tribute to all health workers upholding women’s sexual and reproductive health and rights.

Freetown, Sierra Leone – “No matter how tough the situation is, there will be health workers right there fighting for women’s health.”

Dr. Zhang Pu, a Chinese gynaecologist from Hunan Provincial Maternal and Child Health Care Hospital, spoke to UNFPA as she finished a mission in Sierra Leone.

In July, a Chinese medical delegation consisting of three experts from the Hunan Provincial Maternal and Child Health Care Hospital travelled to Sierra Leone. They visited the Cervical Cancer Screening Center at the Sierra Leone-China Friendship Hospital in Jui, a town just outside the capital city of Freetown. Over two weeks, Dr. Zhang Pu and her colleagues worked with local health professionals to develop their capacity and attend to the needs of the women coming to the clinic.

In Sierra Leone, cervical cancer is the leading cause of deaths caused by cancer and is the second most common cancer among women. Every year, more than 500 new cases are detected in the country, and an estimated 400 women die because of it. Regular, high quality screening plays an important role in reducing cervical cancer mortality rates by enabling health professionals to diagnose cervical cancer in its early stages.

To strengthen the prevention and treatment of cervical cancer for vulnerable women in Sierra Leone, UNFPA coordinated the exchange between the health professionals from Sierra Leone and China. The exchange is part of a broader project which supports the strengthening of women’s reproductive health services in Sierra Leone with the support of the Government of China through its Global Development Fund.

Screening as many women as possible

Hunan Provincial Maternal and Child Health Care Hospital is well known in China for the quality of services in the areas of high-risk pregnancy and neonatal care, as well as other sexual and reproductive health services.

When Dr. Zhang Pu and her team arrived, they discovered that the doctors at the Cervical Screening Clinic were only able to check for cervical cancer in their patients using the naked eye or taking a picture on their cellphone and enlarging it to get a clearer image.  The local doctors knew this was not the best approach but the vaginal colposcope was broken. The two groups of doctors agreed that for the hands-on training to take place, they had to find a way to repair the colposcope.

With the equipment repaired, the doctors began to work together to provide the screening service. As news of the visiting medical team spread, more and more women arrived at the centre every day, coming early in the morning and waiting in long queues for screening.

Feeling motivated to meet the needs of the community, the teams worked late into the evening in order to see as many women as possible, even though intermittent power cuts meant the colposcope wasn’t always working.

“I was really impressed by the dedication of local doctors. They work in such a challenging environment without advanced equipment or reliable power, but they are still optimistic and use whatever resources they have to save lives,” said Professor Shu Chuqiang, a leading member of the Chinese medical mission.

During the screening sessions, the doctors worked together and identified two women aged 60 and 45 with late-stage cervical cancer that otherwise would have been missed.

In one case, a 21-year old woman was diagnosed with a highly suspected case of cervical cancer. Normally, a woman would be sent for a follow-up pathological examination and a second-time visit. However, the doctors at the Jui clinic realised that if she was sent home, she might not return for the follow-up exam and her cancer could progress. So, the team decided to take immediate action and provide treatment.  

“Local doctors told us that she is living with HIV and has no money for future visits because it is a long way to travel here. We can only do what we can by providing some palliative care and treatment during the screening process,” said Dr. Tian Qi, a member of the Chinese medical mission.

Accelerate HPV vaccination roll-out

The best and cost-effective defence is prevention. Screening is just one element for cervical cancer prevention and treatment.

As almost all cervical cancers are linked to infection with high-risk human papillomaviruses (HPV), an extremely common virus transmitted through sexual contact, the HPV vaccination has been recognised globally as an effective way to prevent cervical cancer at a very early stage.

In August, the Ministry of Health and the UNFPA team in Sierra Leone jointly launched the National Policy and Strategy for the Elimination of Cervical Cancer. As well as scaling up the national screening programme which this South-South collaboration between China and Sierra Leone is helping to advance with the support of UNFPA, the National Policy and Strategy also focuses on scaling up the HPV vaccination programme.

“Vaccination is key in preventing cervical cancer in the future. I hope this mission will promote more cooperation between China and Sierra Leone to address cervical cancer for women and girls in Sierra Leone, including by making the HPV vaccination more accessible,” commented Mr. Peng Jiong, Assistant Representative of UNFPA in China. He facilitated the Chinese medical team's visit to Sierra Leone and is the manager of the South-South and partnerships projects of UNFPA China.

For the next stage of the project, UNFPA will facilitate more knowledge exchange between the China and Sierra Leone teams and a group of health workers from the Sierra Leone-China Friendship Hospital will visit Hunan Provincial Maternal and Child Health Care Hospital in October.