POPULATION: Sri Lanka Makes Cancer Detection a Priority

By Feizal Samath Reprint | | Print |

Feizal Samath

COLOMBO, Apr 30 1998 (IPS) - The United Nations Population Fund (UNFPA) is formulating a novel “early warning” system to detect cancer amongst women in Sri Lanka and link it up with government- run women’s clinics across the island.

The ‘Well Women’s Clinics’, as the concept is called, were formed in 1996 and started as screening clinics for women over 35 years for diabetes, hypertension, cervical and breast cancer.

The government has now sought UNFPA assistance to develop these clinics to provide a more integrated package of services on reproductive health.

“We want to reach out to the most vulnerable groups in the detection of cancer. The early detection and prevention of cancer amongst women is the main aim of these clinics,” said Sunita Mukherjee, UNFPA representative in Colombo.

Cervical and breast cancer are the second largest killer disease amongst women and UNFPA hopes to drastically reduce the number of deaths, through the early detection system at these clinics.

Mukherjee said that UNFPA was providing equipment and training manpower to enable the clinics to offer a variety of services in addition to cancer detection.

“We don’t want the clinics to be limited to cancer detection. When a woman goes for an examination, she wants every aspect examined. They would want examination in cancer, reproductive tract infections (RTIs) or family planning. We want the clinics to be more client-oriented,” she said.

The government set up between 250 and 300 clinics, across the island, two years back, which are run by regional medical officers. The UNFPA programme will be linked to these clinics, using the same infrastructure but providing a more comprehensive and integrated package of services.

The new scheme is said to be the first of its kind in South Asia, experts say. UNFPA recently held discussions with a group of obstetricians and gynaecologists, pathologists and surgeons to discuss the concept and prepare a protocol of work.

“It was clear from these discussions that quality service should be ensured at these clinics. So, all activities under the programme would not start in all clinics at the same time. It would start from place to place depending on the availability of trained personnel,” Mukherjee noted.

Government midwives form a vital part of the programme. They would be trained to select women from the 45-59 year age group – considered the most vulnerable to cancer – and in addition to preliminary examinations at home, suggest that they visit these clinics for testing.

The clinics, after targetting the most vulnerable age groups, would then extend their services to women of all ages, UNFPA officials said.

“We are looking at people who are apparently healthy but may not know they would be developing some form of cancer. If we can pick up these signs at an early stage then it is possible to treat them,” a local UNFPA official said.

He said cancer was bound to affect a lot more people in the next few years because the country’s population is ageing.

According to government figures last reported in 1996, there were 500 cases of cancer amongst women, most of who were incurable – because victims are often detected during advanced stages of the cancer.

The official noted that there may be lot more cases as government figures are often under-reported. The UNFPA programme is also in line with the plan of action of the 1994 International Conference on Population and Development, where 180 countries accepted universal access to reproductive health information and services as a goal to be reached by the year 2015.

The clinics are set to provide reproductive health services to women who are in their late and immediately post-reproductive years, those who normally do not use such services. Women are more prone to develop complications than men in reproductive tract infections or RTIs.

These infections, which include sexually transmitted diseases, can cause pelvic inflammatory disease, infertility, other problems of pregnancy and childbirth, chronic pelvic pain and cervical cancer.

Reproductive services available at the government clinics normally tend to serve only married women of reproductive age. But under the UNFPA-assisted programme, these clinics will

ultimately help women of all ages – after they have reached out to the targetted groups.