More than 300,000 women around the world die from cervical cancer each year, but the disease is preventable. And the World Health Organization has launched a plan to eradicate it.
The WHO has asked health providers, including the Sylvester Comprehensive Cancer Center at the University of Miami, to help people access screenings, treatment and vaccinations in places where cervical cancer rates remain high.
On Nov. 17, 2020, WHO partners announced their commitment to ending cervical cancer during a virtual press conference. The WHO's goals, as written on the organization's website, are "by the year 2030, all countries can achieve 90% HPV vaccination coverage, 70% screening coverage and 90% access to treatment for cervical pre-cancer and cancer, including access to palliative care."
Dinah Trevil spoke during the November event, representing the Sylvester center, where she's the director of the Office of Community Outreach and Engagement. Often, her work brings her to Little Haiti.
"For all of the women that we serve in South Florida and beyond, we stand with you," she said. Then she repeated the sentiment in Spanish, French and Haitian Creole. "Nosotros estamos contigo. Nous sommes avec vous."
According to the Sylvester center, clinical data suggest women of Haitian descent are more likely to be diagnosed with cervical cancer than other Black women.
"To my sisters in Haiti and across the Haitian diaspora, nou kanpe avèk ou," said Trevil, who works to get people inside Sylvester’s RV, called the Game Changer.
On a recent February morning, she gave a tour of the Game Changer's interior, including the education and consultation area where people can come learn and ask questions about cervical cancer and the testing available in the vehicle.
Most cervical cancers are due to the human papillomavirus. Inside the Game Changer, women can privately take a free HPV self-test. It involves a quick swab — but it's a test that can save lives. By the time symptoms like abnormal vaginal bleeding appear, cervical cancer is usually too advanced to cure.
"They have the belief — 'If I’m going to the physician’s, I’m going to find out some bad news. I would rather not go,'" Trevil said.
She and her colleagues connect women to gynecologists who provide free or affordable pap smears, a test that involves scraping the cervix for cells to screen for abnormalities.
Nicole Daceus recently took an HPV test in the RV after passing by and noticing the Sylvester center logo.
"A lot of people do not have insurance. They have to make [care] more accessible," Daceus said, adding that even Affordable Care Act plans are out of reach for many and few people can afford preventative screenings.
"A lot of people do not have legal papers," she continued, which makes undocumented people in South Florida hesitant to go to a doctor.
Sylvester staff offers testing without asking about immigration status.
Erin Kobetz-Kerman, associate director for Population Science and Cancer Disparity at the Sylvester center, developed the idea to put free HPV screenings on wheels.
She says getting more people tested involves building trust with the community — "showing up week in and week out" with health care workers who speak Haitian Creole fluently.
Richard Freeman, who works with the World Health Organization in Geneva, was visiting the Game Changer vehicle on that same day.
Freeman said women should have options for their health care. Some women might prefer to do their own sampling for HPV, inside the RV, rather than having an invasive pelvic exam.
"So what works in Little Haiti is not the same thing that will work in Big Haiti," Freeman said. "And it's not the same thing that will work in other countries around the world. But we can learn from what one another is doing, and that's how innovation will evolve."
That makes him feel hopeful.
"Cervical cancer is the one cancer that we can actually eliminate," he said.
The tools include testing, affordable treatment and vaccines against HPV for children.
Access to vaccines isn't equal, which, Freeman said, people have seen and experienced during the COVID-19 pandemic. That inequality also exists with the HPV vaccine.
No one should die from a disease that a vaccine can prevent.
"If we can eliminate one cancer, it's the beginning of the end for so many other major health scourges," Freeman added. "Whether one's interest is around women's health, other forms of cancer, health and justice — all of these issues manifest themselves in a disease that we have all the tools to prevent, and all it is is a choice of whether or not we're going to go ahead and put those tools into use and make it happen."
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