Physical Health Mali Project #7509

HPV and Cervical Cancer Prevention for West Africa

by GAIA Vaccine Foundation

HPV and Cervical Cancer Prevention for West Africa

Project Report | Aug 6, 2014
Success on the fabric frontier!

By Eliza Squibb | Executive Director

Getting the ladies' opinions

We have just returned from a visit with our collaborators in Bamako, Mali!

Not only we were reporting the results of our recent study about HPV and cervical cancer in Mali, but also we are setting the stage for distribution of the HPV vaccine.

I brought 20 yards of the fabric print with me to show to neighborhood leaders and our collaborators in the scientific community. When we showed the cloth to doctors, they picked up on the imagery of the fallopian tubes, uterus, and virus, and they knew exactly what it was referring to. They were concerned, however, that patients would not have the same familiarity with scientific imagery.

In a small room at the Hope Center clinic, thirty women crowded in to hear about the cloth project and voice their opinions on the print. Leaders of the neighborhood women's groups had recently attended our conference on HPV, so in rapid-fire Bambara (the local language) they explained the connection between the virus and cervical cancer, which has an especially high mortality rate in Mali due to lack of access to testing and treatment. Although I couldn’t understand what they were saying, I watched comprehension flood their faces, as they all knew someone who had been a victim of the disease. They assured me that they could use the fabric as a teaching device when they wore it. "When people ask us questions about the pattern, we can explain the images", they said, demonstrating how they would hold out one arm with the fabric draped over it.

Even better, they all wanted the fabric! I took copious notes on the exact quantity we would need (Each lady needs 6 yards to make a matching top, skirt, and head wrap!). We received suggestions on how to tweak our slogan so that it could be better understood. The revised slogan will read, "Je me protege, je me dépiste tôt, je me vaccine", I protect myself (by avoiding risky sexual contact), I get tested early (to catch early development of cervical cancer), and I get vaccinated (against HPV).

The village chief, an elderly man, who is nonetheless very innovative and supportive of our projects, suggested the perfect slogan in Bambara to add to the cloth: “Banakoubé kafisa ni bana foura keye”, meaning, “it’s better to prevent than to cure". He understood the importance of the project right away!

We come back from this trip feeling blessed to have such fantastic collaborators in Mali. We are full of renewed energy and motivation for this project.

This fall, we will begin the "sensibilisation" or "sensitization" campaign, meaning we will print a huge batch of the cloth and hold meetings with many, many community members to ensure that everyone understands the importance and relevancy of the vaccination campaign.

We are well on our way to our goal, but we still need your continued support!

Thank you!

Our founder Annie with Mme Rokia and Mme Badiallo

Eliza and Socrates, our peer educator

Showing the print at the Regional Health Center

Showing the print at the HIV Health Center

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May 6, 2014
Recent HPV paper spurs momentum

By Eliza Squibb | Executive Director

In 2014, GAIA Vaccine Foundation completed a study to investigate knowledge of human papilloma virus and HPV vaccination as well as prevalence of cervical cancer causing strains of HPV in Mali. Rates of cervical cancer in Mali are the highest in West Africa, and it is the leading cause of cancer-related mortalities. This is due to inaccessibility to healthcare and annual exams, and a lack of knowledge about HPV. Among the 300 individuals interviewed, 43% knew what HPV was, although only 9% knew that HPV is transmitted sexually. After an ensuing information session, everyone understood that the HPV vaccine could prevent cervical cancer; 77% wanted to participate in an HPV vaccine trial, and 84% of adult participants wanted their children to receive the vaccine. Importantly, this study also verified the presence of vaccine-preventable HPV strains 16 and 18, which cause 70% of cervical cancers worldwide, in women undergoing surgery for cervical cancer in Bamako.

Building off of our current research, our proposal is to investigate the most effective method of vaccine delivery in West Africa, while at the same time, providing culturally integrated educational tools that can be used by the population to understand and spread information about healthy behaviors and preventative vaccination. Cultural and religious sensitivities in the region regarding vaccine programs for young girls are a common problem in most African and North African countries. Additionally, mistrust of medical personnel and the difficulty of completing the three doses required for HPV vaccination pose challenges to HPV vaccine distribution on both a social and organizational level. In order to succeed in providing young girls with a vaccine, GAIA VF has created a multifaceted plan of action to educate and incentivize vaccine completion.

GAIA VF has designed a commemorative cloth in the West African wax print style that will illustrate relevant health information to be distributed upon completion of the vaccination series to the family of girls (ages 9-12) vaccinated at the Hope Center Clinic. Completion rates for 3 dose vaccines are typically abysmally low at 50%. To encourage pharmaceutical companies to participate in vaccination campaigns, it is vitally important to investigate effective methods of encouraging people to become more proactive about their health and the health of their children.

In West Africa, the fabric of everyday clothing is loaded with symbolic meaning that sends a direct message to society. GAIA VF’s textile tool is based on a long history of commemorative prints used to promote political events and holidays. New patterns are printed each year to commemorate such events as International Women’s day and AIDS day. While slogans are frequently used, our pattern will not only speak with words that promote vaccination (our slogan is Je me soigne, Je me protége, Je m’immunise, I care for myself, I protect myself, I vaccinate), it will also educate visually by showing images of the virus, the cervix, and cancer cells. Cells that are healthy near the cervix transform into cancerous cells as they approach the image of the virus. By using this fabric as an incentive and a wearable teaching device, we will be utilizing the power of textiles as traditional social media in West Africa to encourage people to become proactive about their health and the health of their children.

The 33,000 doses that we urgently wanted to distribute have been distributed by others since we lost funding due to the political upheaval in Mali. Our overall goal is not diminished however, and we are still working towards further investigating the best methods for vaccine delivery.

We need your help!

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Mar 25, 2013
33,000 doses of HPV vaccine in Mali West Africa

By Mali Rochas | Executive Director

Using traditions of storytelling

Right now in Mali, amidst a political crisis, lie 33,000 doses of the HPV vaccine, unable to be distributed as military funding has become the country’s financial focus. However, the vaccine is perishable, and time is running out. If not utilized within the next few months, the vaccine and with it the possibility of saving thousands of lives, will be wasted.

When we conducted our Malian-based HPV study, a dismal 9.8% of female participants had even heard of cervical cancer. Yet 12%, about 1 in every 10, Malian woman has been diagnosed with HPV. Further, 80% of those diagnosed with cervical cancer will die from the disease. That is, 1,076 Malian women die each year of preventable cervical cancer due to a lack of cytotechnology screening and early treatment programs. Many of these deaths can be eradicated with the same preventative HPV vaccine that has shown success in the developing world.

How is GAIA VF taking action?

We are now gathering and analyzing data in order to validate the usability of the HPV vaccine and obtain approval for its use in Mali and to subsequently build a framework for future vaccine trials. Specifically, GAIA VF will be vaccinating adolescent women in a preventative approach for a sustainable reduction in the prevalence of HPV in Mali.

We are also developping a cloth that tells the story of strong, educated women who proclaim, “I immunize myself, I protect myself, and I take care of myself”– a mantra written as a banner across the image offlowering, healthy cervixes (see attached picture). It is the banner of strength that keeps the virus out of the healthy cervixes, a reminder of the importance of being an educated, vaccinated woman. Every Malian woman who receives the HPV vaccine will receive a cloth so that she might pass on the story of prevention and vaccination, and take on a personal role in curing cervical cancer.

Past, Present, and Future

The GAIA VF HPV vaccine initiative will use traditions of storytelling through textiles in order to change the Malian peoples’ present understanding of HPV and cervical cancer in order to create a foundation of prevention through education and vaccination in Mali. This is an integrated project that involves not only the scientists and personnel at GAIA VF, but the people of Mali in taking steps towards curing cervical cancer.

We thank you for your support.

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