Global NGO inspired by Malaysian pioneer model for cervical cancer screening


Photos By ART CHEN

Find Women's Health Programme director Dr Angela Muriuki (left) visits Malaysia to learn more about the Rose Programme and how it can be implemented in other parts of the world.

Nothing is impossible is the phrase that comes to Dr Angela Muriuku’s mind when she thinks of her recent visit to Sarawak with the Rose Foundation team to view their work firsthand.

Muriuki, the Women’s Health Programme director at Find, a global non-profit organisation that connects countries and communities, funders, decision makers, healthcare providers and developers, reveals that her visit followed a presentation on the Rose Programme during the World Health Assembly in Geneva earlier this year.

“I first met Prof Woo (Yin Ling, the founding trustee and advisor of Rose Foundation) a month ago and we hit it off instantly.

“Our vision on the importance of diagnostics in healthcare, empowering women and gender equality, were aligned so when she invited me to come to Malaysia to see what the Rose Programme is all about, I didn’t hesitate,” says Dr Muriuki who is based in Nairobi, Kenya.

Experts in first world countries have deemed cervical screening in remote areas in various parts of the world as impossible but the Rose Programme has proven otherwise, she says.

“It would have been deemed impossible by experts to do the HPV PCR testing (swab) in such a remote location and then bring it to a central location where there is a lab to obtain the results before their swab samplings expired. But, the Rose Programme has successfully done it and that’s what we spent the last week doing in Sarawak.

“We had to travel for four hours off road in four-wheel-drive vehicles deep into the jungles to reach villages where women did the HPV PCR testing and their swab samplings were sent back to Rose Laboratory to get the results,” she says.

The Rose Programme is an example of how hope has been brought to women, especially those from underserved and underprivileged communities, towards cervical cancer elimination in low-and middle-income countries.

According to Dr Muriuki, experts in first world countries often make wrong assumptions that if a woman from a remote area isn’t given her test results immediately, she might “disappear” and not show up for follow-up treatments should she test postitive. They believe that testing shouldn’t be done unless the results can be provided immediately; however such technology is still in the process of being developed.

But Dr Muriuki believes that one shouldn’t have to wait until “everything is perfect”.

“You don’t have to wait. You can start doing something now and the Rose Programme has done something. They’ve figured out a model that goes beyond what people sitting in air-conditioned offices in New York, Geneva or London have ever thought possible,” she says.

Find Women’s Health Programme director Dr Muriuki during her visit to Sarawak with the Rose Foundation to observe first-hand the implementation of the programme. Photo: Rose FoundationFind Women’s Health Programme director Dr Muriuki during her visit to Sarawak with the Rose Foundation to observe first-hand the implementation of the programme. Photo: Rose Foundation

Dr Muriuki has over 16 years’ experience working with women and girls in programme, policy, research, system strengthening and clinical roles in East, West and Central Africa and in South Asia. She is a passionate advocate for person- and people-centred approaches to addressing the needs of women and girls based on their age and life stage.

Some of her previous work includes: translating key principles from the science of developing adolescents’ brains into design and delivery of programmes for very young adolescents in Tanzania; testing risk-based approaches to provision of targeted postnatal care in Bangladesh; testing resupply approaches for conflict-affected chronic care patients (HIV, NCD) during displacement and forced movement in the Democratic Republic of Congo; adapting health systems to meet the needs of nomadic and semi-nomadic pastoralists in Kenya; and a person-centred, holistic approach to care of pregnant and parenting adolescents in Sierra Leone.

Dr Muriuki has a medical degree from the University of Nairobi and Master’s degree from The Royal Tropical Institute in Amsterdam and Queen Margaret University in Edinburgh, as part of the Erasmus Mundus Masters Programme. She is currently working on Find’s newest project – the Women’s Health Programme – to build diagnostics specifically for women in lower to middle income countries.

She believes that what she witnessed in Sarawak can be implemented elsewhere in the world too.

One shouldn’t have to wait until 'everything is perfect', says Dr Muriuki.One shouldn’t have to wait until 'everything is perfect', says Dr Muriuki.“At Find, we invest in areas which traditional manufacturers wouldn’t. Diagnostics for low-income women is one of the areas that traditional manufacturers would not find profitable to invest in. So, we work with manufacturers, governments, and other stakeholders to look at where the diagnostic gap is, and how we can help support the system to get diagnostics to the women who need it the most,” she explains.

Dr Muriuki says that certain things like sex (which is biology) and gender (which is a social construct) affect diagnostics.

“Women biologically have a cervix and require screening but in certain communities, the gender dynamics in their household or village makes it difficult for them to give permission for themselves to be screened. For example, in Sarawak, the longhouse head is the gatekeeper before we can get to the women themselves. We’ve to obtain his permission before we can approach the women for screening,” she says.

She adds that the self-swab is important because in certain communities, women can’t be seen by a male doctor or nurse because it isn’t acceptable socially and culturally.

Then, there is also the issue of access to information in certain communities, says Muriuki.

“If we send a message to the mobile phone to come for screening, who gets the message? Is it the husband who holds the only phone in the household, and he has to pass the message on to his wife?” she cites as an example.

More attention needed

Find Women's Health Programme director Dr Angela Muriuki.Find Women's Health Programme director Dr Angela Muriuki.Muruiki says that more funding and attention needs to be given to research and development related to women’s health.

“Only one per cent of global research funding goes to women’s health, and in research and development for diagnostics, only one per cent of funding goes to women, and this is shocking,” says Muriuki.

“In our Women’s Health Programme, we want to make sure that diagnostics are available to women as close to home as possible and especially for women in disadvantaged communities. This is essentially what the Rose Programme does and I hope it can be replicated in other parts of the world.”

“We share a unity despite our differences. When I was in Sarawak, I could see this village in a different community in a different country. There were so many similarities. We’re not waiting for a high-income country to come and tell us what to do. It’s a homegrown solution from a people who are like us who have come up to help us figure it out as well,” she says.

The Rose Programme’s story can potentially be a greater story to the world, she concludes.

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