Sharon Mukirwa faces stigma as she battles cervical cancer

She looks very frail and winces in pain once as she holds her lower abdomen. Sharon Mukirwa, 46, suffers from cervical cancer. When I extend my hand for a handshake I notice her fingernails have blackened, which she attributes to her sickness and the treatment she is undergoing.
Dressed in a white oversize blouse and a long blue skirt, frail and looking tired, Mukirwa sits in a chair in the corner of her one-bedroom house in a dingy corridor of houses in Kiwempe zone, Kansanga, a Kampala suburb.
She quickly objects to having her photos taken, saying she will turn down the interview altogether if we insist. “I don’t feel like I’m myself ever since I became ill. The machines they put me in have changed my body and I no longer find pleasure in letting people see me,” explains Mukirwa, who stays alone. “I hope this can hurry so I can return to my solitude. I don’t like to be bothered.”
Previously, she ran a small hotel in her area but she cannot work anymore because she is always sick and in constant pain.
Discovering the cancer
In 2009, Mukirwa started getting sickly and went to Nsambya hospital where she discovered she had HIV. “I always expected to get the disease; most of my relatives and the people I knew died from Aids.” She asked to be put on ARVs and life went on.
Around June last year, she started to feel lower abdominal pain and bleeding after sex. “I started dreading sex and also started bleeding heavily two or three times a month yet I’d always had regular periods,” she narrates. “I hadn’t given the abdominal pain much thought. But as the symptoms became more severe and persisted, I decided to seek help from Mulago National Referral Hospital in August.”
There, she was told she had cervical cancer and needed to start on radiotherapy treatment immediately because her cancer was quite advanced. Mukirwa had never heard of the disease. “I really did not know what to make of the news because no one had ever suffered from that disease in my family,” she explains.

The radiotherapy treatment
The first time Mukirwa was put under the radiotherapy machine, which she refers to as an electrical machine, she says she was terrified and her entire body was shaking. She was in the machine for three hours every day for 15 days and she says during that time, the pain had reduced and the bleeding had stopped.
However, three days after she had completed the radiotherapy treatment, she started bleeding one day during a bath and the bleeding could not stop. “For the first time, the seriousness of what I had hit me and I was scared,’ she recounts. She was admitted in hospital for two weeks during which time her skin started to darken and her entire body hurt like she had wounds all over. A fellow patient at the ward told her these were side effects of the radiotherapy.
“I was told I could not be given more drugs because I was on ARVs but they continued to put me under the machine, for less days in each week but longer hours,” she recalls.
Mukirwa says the last time she was under the radiotherapy machine in July, she spent 12 hours there. But they also did something else. “It was the most painful ordeal. I had tubes pushed into my cervix and removing them was very painful.” Now she says she has a constant foul smelling discharge and has to constantly pad herself with cotton. Her menstrual periods though have long stopped.
According to Dr David Nsibambi, a gynaecologist and obstetrician at Nakasero Hospital, the procedure Mukirwa refers to is called brachytherapy or internal radiation therapy, where the radiotherapy is directed at the cancerous cells, in this case inside the cervix. This procedure is usually done for patients who have reached Stage III cervical cancer.

Stigmatised for being sick
The 46-year-old’s biggest challenge is moving around and going to the hospital because she is usually too weak to handle public transport, which she says is uncomfortable and quite expensive. Thankfully, one of her siblings facilitates her transport fares for the treatment. Mukirwa’s other challenge has become her neigbhourhood. “I have made peace with my situation and my disease. In fact, I do not care anymore but the people who stay around this place do not give me peace,” she says in frustration. Beginning to cry, she tells me her neighbours shun her and constantly tell her to go away. “They say I will infect them with my disease, which is why I prefer to stay indoors and not go out.”
The days she is too weak to take care of herself, Mukirwa calls her siblings to come and help. However, she knows they cannot always be at her beck and call because they have their own lives to live. “I have always been an independent woman and I prefer to do things on my own,” she says stubbornly.
She has lost appetite and says her stomach cannot hold any food, the only things she can eat are boiled matooke and sweet potatoes, which she also sometimes fails to eat. Mukirwe has undergone radiotherapy treatment four times so far and has her next appointment slated for January 2016. Mukirwe seems like she has resigned to her fate and does not fear what is ahead of her.

Facts about cervical cancer

According to Dr David Nsibambi, a gynaecologist and obstetrician at Nakasero Hospital;
Early detection is key. Ninety per cent of cervical cancer cases detected early are treated successfully while only five per cent of late diagnoses live.
Your sex habits matter. Cervical cancer is caused by the HPV virus, which is sexually transmitted. People with several sexual partners are at risk. Even where a woman is monogamous but engages with a man with many sexual partners, she can get the virus. Being sexually active at a young age puts one at risk of getting the virus too. Reduced body immunity, for instance, among women with diabetes, HIV/Aids and pregnancy, also increases risk of infection.
There are no early symptoms. Cervical cancer is symptomless until later stages. In other words, when you can detect any symptoms the cancer has already advanced to the late stages.

Reading the signs

Doctor’s word. Abnormal vaginal bleeding, pain during intercourse, and bleeding when you attempt to clean the genital area might sometimes signify cervical cancer. Among older women, there is also a characteristic smell that comes from the private parts and points to having the disease.
Patient’s story.
“I don’t feel like I am myself ever since I became ill. The machines they put me in have changed my body and I no longer find pleasure in letting people see me,” says Sharon Mukirwa.

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