November 7, 2004

Dear Friends,

As most of you already know, in Malawi, where I work, the people speak their own African languages as their mother tongues. In the northern part of the country, Tumbuka is the major tongue, and in the southern part, where I live, Chichewa is the major language. These languages are part of the Bantu family of languages, and in general they are a bit difficult for Americans to learn. Ever since I got here in 1998 I have been slowly acquiring more Chichewa. Recently I have been memorizing some sentences that I have to use at least three or four times a month.

It starts like this, “Kalikali panali zomera zoipa pa njira ya mwana.” What this means in English is, “A long time ago you had a problem on the cervix.” The rest goes something like this: “However, you did not know there was a problem there. That problem slowly grew into a tumor over a period of five to ten years. Now there is a big tumor on the cervix. It is not possible to do an operation to remove the tumor. We do not have any medicine to make the tumor go away. We do have some medicine for pain if you need it.”

As you can imagine, these sentences mean very bad news for the patient and for the health care provider as well. Always when I am telling someone this, at the back of my mind, I am hearing a voice saying, “If we could just get organized, this could have been prevented.” Cervical cancer, which is what we are talking about, is a preventable disease. There is a pre-cancerous period when a lesion on the cervix can be successfully and easily treated with either freezing or electrical cautery. Both of these methods are within the reach of developing countries. What is missing in Malawi and in other poor countries are screening programs to find the early, pre-cancerous lesions.

Happily, in Malawi, we are starting to organize a screening and early treatment program. The Ministry of Health is very much in favor of the program. It is just that the government does not have the funds to devote to a full scale, country-wide program. So we have to start small and expand.

Recently a visiting obstetrician/gynecologist from the United States shared her distress with me as she related that she had found an invasive cervical cancer in a woman who had had twelve children. She said, “That is twelve times we missed the opportunity to examine this woman and prevent this disease.”

Malawi is a very poor country overwhelmed with serious diseases, including tuberculosis, malaria, and HIV/AIDS. Health care for women, especially preventive care, is sadly neglected in this country. My friend and colleague Charlotte Gott, a family nurse practitioner, and I are committed to improving health care and preventive services for women. Will you join us in prayer for the women of Malawi and other poor countries?

Yours sincerely,

Sue Makin

The 2004 Mission Yearbook for Prayer & Study, p. 58