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Early testing can save your life. Twice.Episode 16 - Cervical Cancer

Although it is almost entirely curable, cervical cancer is still responsible for more deaths amongst women than any other type of cancer. Because the Human Papilloma Virus (HPV), which causes the lesions that may result in cervical cancer, is sexually transmitted women seem reluctant to talk about it. This is not ideal because HIV positive women are more likely to be infected with HPV because of their weakened immune systems and this can and does lead to cervical cancer.

Shalom Ncala: Sanibonani, siyanamukela kuSiyayinqoba Beat It! Uhlelo lwakhe noba ubani esihlangene naye lapha ukuze sinqobe izingqinamba esibhekene nazo zesandulela ngculaza nengculaza. Samkela ithimba elesekelayo. Namhlanje sizokhuluma ngomdlavuza wesibeletho nobungozi bawo kumuntu wesifazane ophila nesifo sengculaza. Namhlanje sihanjelwe udokotela Nomonde Mbatani ongudokotela wezifo zangasese zabesifazane phecelezi gynaecologist osuka esibhedlela sase Groote Schuur eKapa. Sawubona doctor ninjani? Kumnandi ukuba nawe namhlanje. Akhe siye eMpumalanga Koloni sikhe siyohlangana nowesimame onesibindi esimangalisayo ohpila nawo umdlavuza wesibeletho nolwela impilo yakhe (isiZulu). Hello, welcome to Siyayinqoba Beat It! The programme for everyone meeting and beating the challenges of HIV and AIDS. Welcome to the support group.  Today we are talking about Cervical Cancer and the particular risk it poses to women living with HIV. With us today we have Dr. Nomonde Mbatani a gynaecologist from Groote Schuur Hospital in Cape Town. Hello Doctor how are you? We're happy to have you joining us today. Let's go to the Eastern Cape now and meet a very brave woman who has cervical cancer and is fighting for her life.

Support group: Hello Shalom!

Dr. Nomonde Mbatani: Siyaphila ninjani nina Shalom? Siyabonga (isiXhosa). I'm very well thank you Shalom, Thank you.

Amanda Fihlani: Sikwisibhedlele iFrere sivizithele uKungiswa ophila netsholongwane kagawulayo ne-cervical cancer.(isiXhosa) Today we are in Frere Hospital to see Kungiswa who is living with HIV and Cervical cancer.

Kungiswa Mfiyane: Mna ke ndingu Kungiswa nguMfiyane ifani, mna ndiphila nentsholongwane kagawulayo. Nda diagnose 2002 ndahlala ke oko ndiphila nalentsholongwane kagawulayo kungekho nto ingamandla ndisebenzisa ke ezi ARV's. Ndiye ndathi mos ekufumniseni kwam ukuzazi ukuba ndine ntsholongwane kagawulayo nda joiner I support group. Kulapho ke ngoku ndaye ndathathwa khona for I peer education, ipeer education ke ithathe i2 years kum. Ndimane ndithetha ke nangentoyokubana abantu must go and do ipap smear, but ndingazange ndiyoyenza ke mna ipap smear ubomi bam bonke kokoko ndaba ngumntu. So ndayokunza ke phofu ndine problem endimana ndiyiva ileakisha apha kum kwi vagina imane isenza I bleeding. So xa ndifika pha ndamchazela udoctor ba edoctor ndizokwenza ipap smear xa ndizamxelela ba mandenze ipap smear wathi udoctor ha a. Andizokwazi ukuyenza ipap smear xa usithi kukho into eblidishayo, so bathatha ke ngoku I biopsy endaweni ye pap smear. Zibuyile iresults on the 27th September zathi I results I'm positive CA Cervix. Ewe ke kubekubi emphufumlweni wam xa kuthiwa ndine cancer. So banditshekisha ke ithe ke xa ifunyanwa kwathiwa ke ngu3A wandicacisela ke wandenzela I drawing, drawing eloluhlobo. Wathi if I cancer yam ibikulendawo ibisaqala, it is iyaqalisa phayana it's premature so xa ingu premature iyakhutshwa isibeleko. Then ke ngoku le yam inantsika icancer ihambile yahamba yazodibanisa I vagina. So no matter ikhutshiwe inantsika I uterus le izakushiyeka yona I grow iphumela kwezinye indawo imosha ezinye izinto. So kwafunyiniswa ukuba iye yapusheka yayokutsho kwi bladder then I bladder yam yashiyeka ivulekile ke ngoku umchamo ungakwazi ukubambeka. So ke ngoku kulungiswa lonto njengokuba ndilapha nje (isiXhosa). My name is Kungiswa Mfiyane. I'm HIV positive, I was diagnosed in 2002. I've been living with this HIV without any problems and taking my ARV's. When I found out that I'm HIV positive, I joined the support group. That's where I started doing peer education, I did it for two years. I'd go around advising people to go and do Pap Smear test, I had never taken the pap smear test myself. I decided to seek the help because I also noticed some bleeding from my vagina. I got to the hospital and told the doctor that I want a Pap Smear, the doctor said he couldn't do a Pap Smear if I'm bleeding. He did a Biopsy instead of the Pap Smear. The results came back on the 27th of September, showing that I'm positive for CA Cervix (Cancer of the Cervix). Obviously I was upset when I learnt that I have cancer. They did some tests and found out that the cancer was in stage 3A. The doctor explained it to me, he even gave me this drawing. He said if the cancer was still here, if it was just starting out at that premature stage they would just remove my uterus. My cancer had spread to the vagina. Even if the uterus was removed the cancer would still spread to other parts. They found that it had spread to my bladder and my bladder couldn't hold urine anymore. That's what they're trying to fix now, that is why I'm here.

Amanda: Yintoni ongayithetha kwabanye amakhosikazi angazinto nge cancer? (isiXhosa) What advice would you give other women about this cancer?

Kungiswa: Every year funeka umntu ayazi ba uyayitshekisha I Pap Smear no-positive nongekho positive (isiXhosa). Women should go for a Pap Smear at least once every year, whether you're HIV positive or not.

Shalom: Firstly bengithanda nje ukuthi ngi commend uKungiswa for istrength necourage anayo for sharing such a really touching story with us. It rings through to me because I lost a friend, a dear friend because of this particular kind of thingy opportunistic infection. I still am missing her up to this day. I think that's when I came across Cervical Cancer as a hard-hitting fact when you're a woman, that's when uLindiwe passed away. Yinto esuke ingi touch kakhulu nje ukuthi ivele ikuhlasele kabuhlungu if ever une HIV that is the most cruel part about it I think (isiZulu). Firstly I would like to commend Kungiswa for the strength and courage that she has for sharing such a touching story with us. It rings through to me because I lost a friend, a dear friend because of this particular kind of opportunistic infection. I still am missing her up to this day. I think that's when I came across Cervical Cancer as a hard-hitting fact when you're a woman, that's when Lindiwe passed away. What touches me most is that it really attacks you if you have HIV.  That is the most cruel part about it I think.

Luckyboy Mkhonzwane: There are many abantu besifazane engibaziyo abaphila neHIV abanesikhathi kuma ARV's and suddenly basebathola ukuthi bane Cervical Cancer. So like into bengifuna ukuyazi ukuthi why I common kangaka especially ebantwini besifazane who are HIV positive? (isiZulu). There are many women I know living with HIV who are on ARV's and then suddenly they find out that they have Cervical Cancer. So what I would like to know is why is it so common especially among women who are HIV positive?

Dr. Mbatani: Cervical Cancer is a real disease, it exists in our communities. Yi cancer e sexually transmitted most of the time, more than 99 percent of the time eyenziwa yi virus. Ayingomntu o HIV positive yedwa obanayo in fact most young women abantu aba less than 30 years old if ba sexually active, they will harbour le HPV ivirus. But most of the time iyaklerisheka so more than 80 percent of abantu aba less than 30 years old bane Human Pappillomavirus as soon as ba besiba sexually active. But the only thing e different kubantu aba HIV positive is that I HPV ayiklerisheki quicker because umzimba awukwazi kuzilwa ezi infections. Iya persister that is ihlala emzimbeni for a long time, ngohlala emzimbeni especially kumlomo wesibeleko that is I cervix yenza I changes kwiskin somlomo wesibeleko (isiXhosa). Cervical cancer is a real disease, it exists in our communities. It's a sexually transmitted cancer most of the time, more than 99 percent of the time that is caused by a virus and it's not only HIV positive people who get it. In fact most young women who are less than 30 years old, if they're sexually active, they will harbour this HPV (Human Pappillomavirus). Most of the time it will clear. More than 80 percent of women less than 30 years of age get the Human Pappillomavirus as soon as they're sexually active. The only difference with HIV positive people is that it doesn't clear quickly because the body find it hard to fight these infections. It persists and it stays in the body for a long time. By staying in the body, especially in the cervix, it causes changes of the skin of the mouth of the cervix.

Busi Maqungo: Njengoba busowucacisile intoyokuba I cancer yomlomo wesibeleko iqala ngoba ube infected yila HPV right. But ibangaba ipikishwe kuse early xa sihamba siyokwenza ilantuka I Pap Smear then iyakwazi ukuba ingade ijike iyokwenza I cancer, but ke ngoku iproblem endinayo mna lixesha eli li inbetween inantsika ezi Pap Smear ezinziwayo especially ngabantu abaHIV negative ngoba kaloku kubantu abaHIV positive andithi its every six months. But with abantu abaHIV negative bona funeka baye every 10 years. Kule 10 years ayi progress ke ngoku nithi niphinda nimfumana nifike kuye seyi progresile? (isiXhosa). Like you've explained, Cervical Cancer starts with you being infected with HPV. If it's picked up early with a Pap Smear, it won't go all the way to the cancer. My problem is the time in between the Pap Smears that one has to do, especially with HIV negative people. With HIV positive people, it's every six months HIV negative people have to do a Pap Smear every ten years. In that ten years, doesn't the cancer progress to a more serious stage?

Dr. Mbatani: It takes a long time ba makubekhona ezi changes. In fact ixesha from the time umntu esiba nezi changes zibakhona to the time u developer I Cervical Cancer its about 10-15 years. And uyayazi ba sinepopulation e huge kwi public sector. So if you try and give each woman I mean tell each woman to have at least three Pap Smears in a lifetime. Ewe asizoyi reducer iCervical cancer ngo100 percent but at least 66 percent of abafazi will be saved from developing Cervical cancer. And this also ensures I coverage that is wonke umntu abane opportunity yokuba ebekhe wanayo I Pap Smear in lifetime (isiXhosa). It takes a long time for these changes t occur. In fact, from the time the changes occur to the time one develops Cervical cancer, it's about 10-15 years. You know that we have a huge population especially in the public sector. If we try and tell each woman to have at least three Pap Smears in a lifetime. Yes we wont' reduce Cervical Cancer by 100 percent but at least 66 percent of women will be saved from developing Cervical Cancer. This also ensures coverage that every woman gets an opportunity to have a Pap Smear in her lifetime.

Nokubonga Yawa: Gqirha mna bendithanda ukuqonda intoyokubana ingaba iHPV lena inazo na isymptoms onothi uyiqaphele ngazo ngaphadleni kwentoyokubana ude ube uyokwenza I Pap Smear ingaba zikhona into othi uzi notice? (isiXhosa) What I would like to know is does this HPV have symptoms that one can notice without having to go and do a Pap Smear? Are there any noticeable signs?

Dr. Mbatani: Akukho zimpawu uzibonayo emzimbeni. So by the time uqalisa ukuba neempawu yazi intoyokuba seku late if mhlawumbi ufunyenwe yi cancer le yomlomo wesibeleko. That is why sisithi ngelixesha usaphilileyo do not assume intoyokubana mhlawumbi njengoba uhamba nje awunayo iCervical cancer. Yiya ekliniki okanye uye kugqirha wakho uyokwenza I Pap Smear at least if ufumene i-reassurance yentoyokubana I Pap Smear yakho I alright, then uyayazi intoyokubana ungahlala up to 10 years ungakhange uye for I Pap Smear (isiXhosa). There are no visible symptoms. No, not at all. By the time you start seeing signs, it's usually too late, you already have Cervical Cancer. That is why we say while you're still feeling healthy, do not assume that you don't have Cervical Cancer. Go to your clinic or doctor and do a Pap Smear. At least if you get that reassurance that your Pap Smear is alright, then you can stay for up to 10 years without getting another Pap Smear.

Shalom: No abdominal pains or anything?

Shalom: Ninganyakazi sizobuya maduzane nje. Siyanamukela futhi kuSiyayinqoba Beat It! Namhlanje sikhuluma ngomdlavuza wesibeletho nengculaza. Akhe sibheke udaba lwase Khayelitsha ngase Kapa (isiZulu). Don't go away, we'll be right back.  Welcome back to Siyayinqoba Beat It! Today we're talking about Cervical Cancer and HIV. Let's take a look at this story from Khayelitsha near Cape Town.

Vuyo Nibe: Namhlanje sise Site B day hospital, ndihamba noNokubonga ezokwenza I Pap Smear (isiXhosa). Today we're at the Site B hospital with Nokubonga, she's going to do the Pap Smear test.

Nokubonga Yawa: Namhlanje ndithathe isigqibo sokubana mandize apha ekliniki ndizokwenza I Pap Smear because kudala ndisiva ba I Pap Smear kubalulekile ukuyenza especially xa ungumntu o HIV positive. So ndithathe isigqibo sokubana mandize kengoku na ke ndizoyenza because kudala ndifuna ukuzoyenza but ndiyoyika. Izinto bendenza mna ba mandoyike uzokwenza ilentoza I Pap Smear kukubana, yi instrument abayisebenzisayo okokuqala sekhe ndayibona and abantu abathethayo baye bathi kubuhlungu. And ndoyika nentoyokuba kunothiwa mhlawumbi ifunyenwe ndinayo ukhubone andiyazi maan but ndiyoyika nyani nyani. But ke ndiyafuna ukuyenza (isiXhosa). I have decided to come to the clinic today for a Pap Smear because I've heard that it's very important especially if you're HIV positive. I'm here also because I've always wanted to do it but I'm scared. One of the reasons I was scared of doing the Pap Smear is the instrument they use. I've seen it and people say it's painful. I'm also scared of hearing that I've got this cancer. I don't know I'm just really scared. But I want to do this!

Dr. Mbatani: Esi ke sispeculum esizakusisebenzisa ne! Uyabona ukuthi sincinci? Then ke ngoku kwesi speculum sizofaka le KY jelly kanje. Ndenzela intoyokubana ithambise ke ngoku. Uyabona njengoba bendithe ndizakuyifaka pha kumlomo wesibeleko then ke ndizokuyijikelezisa kanjena. Xa sendiyithathile lencindi yonke ne then ke ngoku ndizayifaka apha kwesi slide sam, si slide sam esi sinegama lakho nokuthi ungubani. Sendisifakile ke yabona ngoku ndizakuvula nje bandikhangela umlomo wesibeleko nhe, useright? Mhmh. Bekunjani phofu? Ndiyavuya ndingakhange ndikulimaze ke but ke anyway nail icard lakho so nge 2nd ka October uzobuya for I results zakho (isiXhosa). This is the speculum we're going to use. You see how small it is? What we do is we rub KY jelly on the speculum so that it can slide in. I put this on the mouth of the uterus and roll it like this. Once I've extracted enough fluid from the mouth of the uterus, I will put it in this slide. This is your slide, it has your name on it. I'm pushing the speculum in now, are you alright? So how was it? I'm glad I didn't hurt you. This is your card, come back on the 2nd October for your results.

Nokubonga: Ugqibile? Khange kube loluhlobo mna bendicinga kuzabalulo. Umntu oyitshomi yam osekhe wayenza but akazange aphinde abuyele back ayothatha iresults because wayesoyika uyothatha iresults. Kwa intoyokubana mandide ndibekanti ndisithathile esisigqibo sokuba ndizoyenza, andiqondi inoba khona into enondibangela ba mandoyike ndingazozithatha iresults zam because ekugqibeleni Ndenzela for mna yimpilo yam so kunyanzelekile ndizinakekele. Ok sisi. (isiXhosa). Are you done? It wasn't as I had expected. This one friend of mine had a Pap Smear test but she never went back for her results because she got scared. I was brave enough to come here and do this test, so nothing should scare me enough not to come back for my results. At the end of the day, this is for my health and I have to take good care of it.

Dr. Mbatani: Ok bye!

Busi: I think mna I like that "are you done" part because ibonakala ingathi khange uve nokuva ba seyenziwe okanye ingathi usazoqala, because yenye yezinto ezoyikisa abantu ezo Gqirha uMbatani. Intoyokuba abafuni uyokwenza I Pap Smear ngoba beva ukuba kukho icephe elifakwayo and ba imagine ingathi lizabuhlungu elacephe xa lifakwayo. And you don't even feel it uNokubonga nanku khange alifilishe nolifilisha uve sesithi ugqirha ndigqibile but where is this pain abantu abakhala ngayo ukuthi it's painful (isiXhosa). I think I like that "are you done" part because it shows that it's not painful. People are scared Dr. Mbatani. They don't want to do a Pap Smear because they heard about the speculum and they think it's painful. You don't even feel it Nokubonga didn't feel anything. She just heard the nurse saying I'm done, where is this pain people talk about?

Shalom: No, but Busi ke it goes with explaining uyazi ba iTreatment Literacy isifundisa one thing you can never fear what's in front of you, if ever you get proper explanations. UNokubonga saw photos ukuthi kwenzekalani nad this is what I'm gin got use nani nani. It puts you at ease as the patient to understand iprocess elandelayo (isiZulu). It goes with explaining.  Treatment Literacy taught us one thing; you can never fear what's in front of you if you get proper explanations. Nokubonga saw the photos and the nurse said this is what I'm going to use. It puts you at ease as the patient to understand the entire process.

Nokubonga: And again mna ndingathi enye into ebendiyoyika kukubana ndi HIV positive then xa kunophindwa kuthiwe kengoku na ndine cancer lanto izaba sistress ngakumbi kum. Ndinalanto yokubana hayi ngcono ndisuke ndiyazi xa seyikhona bhetele and ndinalanto yokuba andikafuni ukushiya umntanam ngaske ndiqhubekeke ndimbone ekhula yabona (isiXhosa). The one thing I was scared of is that I'm HIV positive and if they say I have cancer as well, that will stress me even more. I thought about waiting until the signs show. I don't want to leave my baby, I would like to see her grow up.

Busi: But kulento ayithethayo uNokubonga yokuba kungcono ndazi xa sele ikhona okanye yondele. Unfortunately njenge case kaKungiswa kungelixesha kengoku sekungekho nto inkwenziwa. The same with inantsika iHIV ngoba kaloku kwiHIV umzekelo if bangabana wazi kuse early uyakwazi ukuzikhathelela nawe ukhathalelwe nangogqirha uhambe nezibhedlele uthathe iARV's and so on. Same thing nakwi Cervical cancer ubangaba aza change zibonwe kuse early iyakwazi be njengoko ubutshilo ngaphambili ba iregress andithi (isiXhosa). What Nokubonga just said about waiting until the signs show unfortunately, like we saw with Kungiswa's case, that may be too late. It's the same thing with HIV, if you know that you have it quite early you can take care of yourself, go to doctors, take ARV's and so on. It's the same thing with Cervical Cancer. If the changes are picked up early, the infection can regress.

Dr. Mbatani: I think the other thing ne, it's the way i-up-bringing ne attitude yabantu towards the private parts I think that' the main issue eyenza because I education the only way or indlela onga testwa ngayo yintoyokubana mhlawumbi kukhona ichanges ezikhoyo ezinolidishela kwi Cervical cancer yintoyokuba umntu azinikezele. Siyiqhelile lento Akukho mahluko and si-comfortable siyibona yonke imihla ayonto and yipart yomzimba wakho nayo neyiphi na i-female (isiXhosa). I think the other thing is our up-bringing and attitude towards the private parts. I think that's the main issue here and educating people that this is the only way to test for the changes that can lead to Cervical cancer is to go there. We are used to seeing it (vagina), we're comfortable, we see it everyday and its part of every female's body.

Pholokgolo Ramothwala: (SeSotho) I'm just wondering, are the any men who accompany their partners to go and do the testing, if you've ever seen anybody? Whether it would be important for people to take their partners as part of support. I don't have to do it but it scares me, just the thought of having a partner who does not know that they might be having Cervical Cancer. So do you see men who go with their partners?

Dr. Mbatani: Unfortunately, very few amadoda ayayo but we usually encourage intoyokubana partners should come even if it does not necessarily have to be the male partner. It could be any relative or even somebody that you're comfortable with. Especially if ufumanisa intoyokubangaba umntu has got the disease (isiXhosa). Unfortunately there are very few men who accompany their partners but we usually encourage that partners come. It does not necessarily have to be the male partner. It could be any relative or somebody that you're comfortable with. Especially if we find that you have the disease.

Busi: But the other thing endicinga ba mhlawumbi amadoda anga-contribute kuyo ekwndeni kwalento is to encourage i-partners zabo their female partners to go for ilantuka i-Pap Smear not necessarily i-Cervical cancer but as in Pap Smear. Ubangaba sikhuthazwa sifumana inkuthazo kwalapha endlini at least lonto leyo nayo izakwenza ukhuthazeke. I think inganomthelela omkhulu (isiXhosa). Another way in which men can contribute in all this is to encourage their female partners to go for a Pap Smear for Cervical Cancer. If we get that encouragement from home, it will make us stronger. I think that would have a positive effect.

Luckyboy: Doctor ngikuzwe uthi i-Cervical Cancer nhe i-cause yi-virus Human Pappillomavirus nhe. So ngifuna ukwazi ukuthi i-virus le i-sexually transmitted angithi and ebantwini besifazane inga leader ukuthi agcine ene Cervical cancer. So ngifuna ukwazi ukuthi abantu besilisa bona iba affect kanjani as sazi ukuthi abanayo i-cervix? So if kuyenzakala ukuthi uba infected with i-virus le kwenzekalani kuwe as umuntu wesilisa? (isiZulu) Doctor, earlier you said that Cervical Cancer is caused by the Human Pappillomavirus. This virus is sexually transmitted and in women it can cause Cervical Cancer so how does it affect men because they don't have a cervix? What happens in men if they happen to be infected with the virus?

Dr. Mbatani: Abafazi bafumana iCervical cancer eyenziwa yiHuman Pappillomavirus. Amadoda nawo ayayifumana iPenile cancer and amadoda nawo anoyifumana ne-Anul Carcinoma that is i-carcinoma of the anus nayo icause yiHuman Pappillomavirus. But if uyajonga u-compare ukuba ngabaphi abantu eba affect kakhulu, it's females than amadoda (isiXhosa). Women get the Cervical Cancer caused by the Human Pappillomavirus. Men can get Penile cancer and Anul Carcinoma, that is the cancer of the anus, also caused by the Human Pappillomavirus. But if you look at who is affected the most, it's more females than males.

Shalom: Akhe sithathe ikhefu sizobuya khona manje. Siyanamukela futhi kuSiyayinqoba Beat It! Namhlanje sikhuluma ngomdlavuza wesibeletho. Akhe sihlole izindlela ezintsha ezenziwayo ukuvimbela umdlavuza wesibeletho. (isiZulu). Let's take a break, we'll be right back. Welcome back to Siyayinqoba Beat It! Today we're talking about Cervical Cancer. Let's go and find out about a new development in preventing Cervical Cancer.

Vuyo: Namhlanje siseGroote Schuur. Sithetha noDr. Mbatani nge vaccine ze Cervical cancer neHPV. Masiye! (isiXhosa) Today we're in Groote Schuur Hospital. We're talking to Dr. Mbatani about Cervical Cancer and HPV vaccines. Let's go inside.

Dr. Mbatani: iHPV igama layo xa liphelele yi Human Pappillomavirus, that is intsholongwane efana nezinye iviruses ezinjenge HIV, Flu nevirus ezenza ezinye izinto ezinjenge Small Pox. Yintsholongwane e belonger kulo group ye viruses, xa ezinye i-viruses mhlawumbi into ezinje nge flu umntu uyaziva apha emzimbeni ba ikhona into erongo apha kuye angaziva mnandi. But ngelishwa iHPV yona akukho nto umntu ayivayo akho symptoms ezibonakalayo, ngaphandle beni ukuba umntu mhlawumbi angahamba ayokwenza itest ekhangelayo ba unayo na okanye awunayo iHPV leyo. iCervical cancer that is icancer yomlomo wesibeleko ine-association enayo nevirus le ebizwa ukuba yiHPV. Kangangokuba almost kuzozonke 100 percent cases that is abantu abafunyenwe benomhlaza wemlomo wesibeleko bekuthi kwakuthathwa incidi kufunyaniswe almost 100 percent yabo inale HPV. Iyasuleleka and iyi virus efunyanwa kakhulu ngokwelicala lecantsi it's a sexually acquired infection. Le vaccine zikhoyo eyokuqala iye ya approve ngo2006 andayazi noba uyakhumbula na that is the one iGardasil. Iqale e United States ba mayi approve iye isehla kengoku nalapha eSouth Africa sinayo i-available. Unfortunately ke asikabinayo thina apha kwi-public sector ikhona kodwa apha kwi-private sector kulomntu ukwaziyo intoyokuba angayihlawulela. Kufuneka umntu atofwe kathathu over a period of six months that is ufumana i-injections ezintathu. I-injection nganye cost about hundred and twenty US Dollars. So ungazenzela ke icalculation ba inoba zingaphi xa zizakuba ntathu and then uyi convert wena mntu waseMzantsi into Rands ba inoba yimalini. So ndingacebisa intoyokubana abantu at least ngelixesha zingekabikho ezi vaccines zingekabikho available especially kwi-public sector and xa sesijonga necost yazo sinethemba intoyokubana mhlawumbi emveni kweminyaka iyakude yehle ne price le yazo. Abantu at least bahambe bayokwenza iPap Smear eziklinikini zabo (isiXhosa). HPV stands for Human Pappillomavirus. It is a virus like any other virus, such as HIV, the Flu virus and the virus that causes Small Pox, they all belong to the same group of viruses. Now with other viruses such as the Flu, one can feel when they have it in their body. Unfortunately with HPV there are no signs, there are no symptoms unless a person goes for a test that will determine whether they have HPV. Cervical Cancer is closely associated to this virus, HPV. So close that almost all the people that have Cervical Cancer also test positive for HPV. It is contagious and it is transmitted mostly through sexual intercourse. The only HPV vaccine we have, IGardasil, was approved in 2006. It was first approved in the United States but it is also available here in South Africa. Unfortunately we don't have it in the public sector, it is available in the private sector, for those that can afford it. You must get three vaccine injections over a period of six months. Each injection costs about a hundred and twenty US Dollars. So you can calculate three of those and convert the total into Rand. So while these vaccines are not yet available in the public sector and also looking at the costs hoping that they'll be cheaper with time, people should please go for Pap Smear tests at their clinic.

Shalom: Dr. bengifuna ukwazi mina ukuthi ulokunjana how effective are these lokunjana are these vaccines? And umangabe ufuna sisebenze kahle at what stage do you give to a person umupha esasemncane or umupha seka well developed seka sexually active and that? (isiZulu) Dr. what I would like to know is how effective are these vaccines? If we want it to work properly, at what stage do we give it to a person, when they are young or when they're well developed and sexually active?

Dr. Mbatani: Ezi vaccines ziyi2 ngoku ezi approviweyo nezi available nalapha e South Africa yi Gardasil le buyibona pha kwi insert neyakwa GSK ebizwa Cervarix. Zombini ezi vaccines zi prophylactic vaccines, that is ideally zezomntana omncimnci ongekabi sexually active that is ongekayi acquire iHPV. Ziseza zona  ivaccines ezizaku treata that is therapeutic vaccines but unfortunately azika approve (isiXhosa). Two vaccines have been approved and they're available in South Africa. It's the Gardasil we saw in the insert and GSK's Cervarix. Both these vaccines are prophylactic vaccines, that is, ideally they are for little children who are not yet sexually active and have not yet acquired HPV. They are working on therapeutic vaccines to treat HPV but unfortunately they are not yet to be approved.

Busi: Kodwa the other thing mna endibene worry ngayo kula nantsika ubuyichaphazela phayana yimali. Ndifuna ukuqonda ba yintoni edala intoyokuba ibe available only kwabo ba afford kwi-private sector but ingabikho kwi-public sector okokuqala? (isiXhosa) What worries me about the vaccine in the insert is the cost. Why is it available only for those that can afford it in the private sector and not available in the public sector?

Dr. Mbatani: It will take some time lonto leyo inida i-government intoyokuba ithethathethane nezi drug companies to reduce the price. (isiXhosa) It will take some time and it needs government to persuade drug companies to reduce the price.

Pholokgolo: (SeSotho) We must look at the companies producing the vaccine because drug companies are notorious for ownership of patents and they drive the prices up, so you need to look at that also. Government can claim that we can't afford it.

Luckyboy: Ngithi mina angithi siyazi ukuthi ama pharmaceutical company or any company if you come up with something new you have I right on that patent for 20 years. But ngiyacabanga ukuthi uyakwazi ukuthi unikele enye i-company like bayibiza ngokuthi yi compulsory licensing. Ukuthi uvumele enye i-company to make a generic version yalo drug leyo onayo. I think nawo ama pharmaceutical company it's something ekufanele ukuthi ngabe bayayibona le ukuthi into esinayo manje ingakwazi ukuthi incede abantu and lesifo lesi yisifo esiyasibhebhethela. For the sake of impilo enhle yabantu let them give ilona i-license to one of the companies ezi produce amalona ama-generics. You know ukuthi ama-generics they are never like at the same price as ilona i-patent (isiZulu). We know that pharmaceutical companies or any company if they come up with something new, they have a right on that patent for 20 years. But they can allow other companies, it's called compulsory licensing, to allow another company to make a generic version of the drug they have. Pharmaceutical companies should realize that what they have can help a lot of people and this disease is spreading. For the sake of good health let them give a license to one of the companies that produce generics. And we know that generics are never at the same price as the patent.

Shalom: Umdlavuza wesibeletho uhlobo olwejwayelekile lomdlavuza kubantu besifazane eningizim Afrika, futhi lolu uhlobo oluvikelekayo. Abantu besifazane abaphila negciwane lesandulela ngculaza basebungozini obukhulu bokuthola umdlavuza wesibeletho. Bonke abantu besifazane abaphila negciwane lesandulela ngculaza kufanele baye koxilongwa isitho sabo sangasese kanye ngonyaka. Uma sigqoke lamabhengela sibonisa ukuthi sizigcina siphephile futhi silawula izimpilo zethu. Zivikele, uvikele nabanye. Size sibonane ngeviki elizayo, nisale kahle emakhaya (isiZulu). Cervical Cancer is the most common type of cancer amongst women in South Africa. However, it is also one of the most preventable. Women living with HIV are particularly at risk of Cervical cancer. All women living with HIV should have a pap smear every year. These bangles show that we're keeping it safe and taking responsibility. Protect yourself. Protect others! Until next week, goodbye!

Support group: Goodbye!