Friends of Monkole bring 'elikia' (hope) to women in the Congo so that uterine cancer will no longer be so deadly.

At the beginning of May, Silvia Carlos, a professor of preventive medicine and public health at the University of Navarra, traveled to Eliba, a rural suburb of Kinsasha, the capital of the Democratic Republic of the Congo. A group of women were waiting for her at the health center in this poor neighborhood, which even cars cannot reach due to the mud accumulated during the rainy season. Gathered at the local health center, all very young, though many already widowed, they came to meet the Spanish doctor in search of "elikia," which means "hope" in Lingala and gives its name to the solidarity cervical cancer screening project that the Friends of Monkole Foundation has been implementing in the African country for seven years.

"You see them all there with the little they have, but hoping they're not infected, that they don't have precancerous lesions, or cancer. But knowing that if they do have an infection or lesions, this project gives them that small hope of preventing it from developing into cancer ," says Dr. Silvia Carlos upon her return from the Congo.

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At the Eliba health center—a clinic opened with donations from the Friends of Monkole Foundation , created to help implement public health in a neighborhood of the same name in Kinsasha—women take a vaginal swab themselves on the day they are seen by the doctor to detect whether they are carriers of the HPV virus , the results of which they will be able to know the same day.

"The important thing is that all women in Congo can gradually benefit from a screening that ultimately saves lives."

Cervical cancer is the most common cancer among women in the Congo and the cause of the highest mortality. "It's a real public health problem," says Silvia Carlos, coordinator of the project launched by Spanish gynecologist Luis Chiva in 2017 to expand HPV diagnostic testing. Dr. Carlos explains that the goal is "to do our part to prevent women from dying from a preventable cancer."

Microbiologist Gabriel Reina is part of the Elikia Project team and is already preparing for his third trip to the heart of Africa. He will travel with a team of volunteers to the summer screening campaign at the clinic in Monkole, a suburb of overcrowded Kinsasha.

"What we've seen there is a very high incidence of human papillomavirus infection, approximately 25% . And that goes hand in hand with the impact of cervical cancer, which is the leading cause of cancer death in women in the country, while in Spain it isn't even among the top 20 causes. This is because no prevention measures are being implemented in the Congo," Reina points out.

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Many Congolese "mamas," as women in Monkole are known, come to the clinic after being notified by vehicles with loudspeakers that tour the capital's neighborhoods without electricity or water. Others come because, unfortunately, they have friends or relatives affected by cervical cancer. Spanish volunteers will see and test between 50 and 100 women each day.

The PCR tests for papillomavirus (HPV) that Reina will take to Congo this summer cost 15 euros each. "But we've tried to put a twist on the way we work and do what's called 'sample pooling,' which is combining samples from three patients, thus investing $5 per woman. You can resolve negative cases this way. In positive cases, you have to determine which of the three samples you used is positive by performing an individual test. By applying this system, we've managed to reduce the cost to $9 or $10 per woman screened ," she explains.

For the past couple of years, with support and grants from Friends of Monkole , the Elikia project has been able to train a small team of local healthcare workers to conduct testing throughout the year . This team holds weekly videoconference meetings with Silvia Carlos to coordinate the test results. "The important thing is that all women in Congo can gradually benefit from a screening that ultimately saves lives," Reina argues.

Their goal is to reduce cervical cancer cases in the Monkole area from 30 to 4-6 per 1,000,000 inhabitants within ten years. This would make the hospital a national model of preventive healthcare, effectiveness, and solidarity.

The link between Monkole Hospital and Spain is Enrique Barrio. A professor in Vallecas, he is the president and founder of Friends of Monkole. Barrios first visited the suburb of the Congolese capital in 2003 thanks to a doctor friend, who called to tell him that "his children were dying due to lack of medicine." That's why he decided to create the foundation, which, since the pandemic, has managed to send 400,000 euros annually and volunteers to help the hospital, which specializes in caring for pregnant women and children with rickets.

The coordinator of the Elikia Project, Silvia Carlos, explains that of the tests conducted in May at the rural Elibia clinic, the one with difficult access, 20% were positive for human papillomavirus (HPV) infection. Those found to have precancerous lesions were able to receive early treatment. But some women arrived in more advanced stages. They are being offered the possibility of access to surgery when the summer volunteer team arrives, which includes microbiologist Gabriel Reina and at least one gynecologist. "We're confident it will happen. The idea is to take advantage of it and perform the interventions." That is the hope, the "Elikia," that the women have come seeking.