It is early morning at Makhaweli Primary School in Bungoma County. As learners settle down for classes, Jackline Kwamboka, the teacher, sits at a corner in the staff room, armed with a contact list of parents and guardians.
One by one, she reaches out to the parents seeking consent for their daughters to be vaccinated against Human Papillomavirus (HPV).
An HPV vaccination outreach exercise is underway at the school and Kwamboka is on a mission to ensure that no girl contracts HPV - a virus that causes cervical cancer.
Her resolve is inspired by the death of her sister, who succumbed to breast cancer in 2019. She vowed to do ‘anything in her power’ to stop anyone else from going through a similar experience.
“My sister was in anguish. I do not want to see anyone go through such an experience. Cancer has an emotional and financial drain,” says Kwamboka.
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Kwamboka is a mother of three, among them two girls aged 12 and one-year-old.
“As a mother, I was intrigued when the Ministry of Health announced the roll-out of the vaccine that offers protection from HPV, a virus that causes cancer.
I look at my girls and see a brighter future. It would be unfortunate to have any contract (cervical) cancer, a disease that can be prevented through vaccination,” she adds.
Chebet is a Grade Seven pupil with a fear of needles. But the thought of contracting cancer has forced her to get the jab.
“I do not have an understanding about cervical cancer, but I know the jab will prevent it,” says Chebet.
She has already received two doses of the vaccine – the first when she was in Grade Five, and the second one early this year.
HPV is a sexually transmitted virus that causes cervical cancer in women, which is a leading cause of cancer-related deaths, and the second most common cancer among women.
Cervical cancer kills at least nine women in Kenya every day. Data reveals that more than 5,250 new cases and 3,268 deaths from cervical cancer are reported annually.
Robby Cheruto is a nurse at Bungoma County Referral Hospital leading a team of health workers vaccinating girls at the school. Before administering the jab, she counsels pupils on the importance of the jab.
“I take girls through a health education sensitisation programme to let them know what cervical cancer is, and why we need to prevent it,” explains Cheruto.
Interviews with girls at the school reveal that the majority have little knowledge of what cervical cancer is by virtue of their age. Interestingly, the girls fear contracting it, terming it is as a “deadly disease that kills”.
Bonvencher Wanjala, a teacher at the school, incorporates the concept of cancer during HIV/AIDS lessons to help the girls understand the disease.
“I normally put the concept of cancer in my lessons; I tell girls that it is a chronic disease that can only be prevented through vaccination,” says Wanjala, whose two daughters aged nine, have already been vaccinated.
Makhaweli Primary School has a population of 859 learners, among them 486 girls. Out of the total population, at least 200 girls aged between nine and 15 years have received the HPV vaccine.
The school Head Teacher, Benedict Wanyonyi, says through sensitisation, the acceptability of the vaccine among parents and girls at the school is impressive.
But he pleads with the government to scale down the vaccination age to seven, saying a number of girls engage in sexual activities at a tender age which puts them at risk of contracting HPV.
“I am optimistic that with knowledge, we shall have all our girls vaccinated, and prevent cervical cancer in future,” says Wanyonyi.
Dr Juliet Maina, a clinical radiation oncologist at Nanyuki Teaching and Referral Hospital, explains that the HPV vaccine is the only effective way of preventing cervical cancer.
“HPV vaccine allows the body to create antibodies which fight against HPV virus that causes cervical cancer,” says the expert.
HPV vaccination was rolled out by President Uhuru Kenyatta in 2019, following a successful pilot programme in Kitui between 2013 and 2015.
Under the programme, the Ministry of Health targeted vaccinating 3.2 million girls across the country by June 2023.
However, according to the CEO of the Cancer Institute of Kenya, Dr Elias Melly, uptake of the jab has been low.
Melly adds that the programme has been plagued by a number of challenges but a public sensitisation and awareness initiative is ongoing to help change attitudes and culture towards the vaccine.
“Current vaccination rate, average across the country, we are at 26 per cent,” says Melly.
Despite the low national uptake of the jab, it is higher in some counties but remains low in others. For example, Kirinyanga has 80 per cent of target girls vaccinated, whereas Kwale is among counties with low vaccination rates at only 12 per cent.
The CEO of the National Syndemic Diseases Control Council (NSDCC)Ruth Laibon Masha notes that despite early sex contributing to HIV infections in children and adolescents, it is also contributing to increased cases of HPV. “Early sex doesn’t only risk HIV infections, but we are recording more cases of HPV in these children,” says Dr Masha.
In a mass campaign conducted in Bungoma County in February by the NSDCC in partnership with the Ministry of Health and Cancer Institute, at least 2,000 were vaccinated.
Prof Nelly Mugo, Director of Research and Development Education at the Kenya Medical Research Institute (Kemri), notes that HPV causes about 99 per cent of cervical cancer, reported at a tender age of 25 years.
“My conversation with parents and guardians is that it is irresponsible to fail taking our girls for the vaccine. Cervical cancer is not a disease to wish anybody. It bleeds and kills, and needs not to happen,” says Prof Mugo.