Blantyre, Malawi – 2023


Alice Authier, head of the oncology unit, MSF


Here we see the chemotherapy ward at Queen Elizabeth Hospital in Blantyre. What strikes you when you enter is the rows of chairs lined up side by side, with patients receiving chemotherapy.

Some of these women have already traveled a long way to get here. They have been diagnosed with cancer and now need support to understand what the treatment will mean for them and, above all, how to cope with the side effects and feel encouraged to return.

On-screen text : This oncology service is one of only two available in Malawi.

In Malawi, cervical cancer is one of the most prevalent cancers, with one of the highest mortality rates in the world.

This cancer is now rarely seen in developed countries thanks to funded prevention programs, information, and strong awareness campaigns, which is not the case in Malawi.

Médecins Sans Frontières has set up a cervical cancer prevention and treatment program in partnership with the Ministry of Health in the south of the country, in Blantyre, to address this inequality in access to care.

When you arrive in Malawi, you also see a very high incidence of HIV, which is another reason why cervical cancer rates are much higher. Women living with HIV are six times more likely to develop cervical cancer.


This photo shows the waiting room. Some women have traveled a long way and will stay overnight in Blantyre so they can be on time for their treatment. We accompany them throughout their day or morning at the hospital and make sure they have as many healthcare professionals around them as possible to support them through this experience. It is not necessarily an easy experience. For some, it’s their first time in the city. And even if you’re used to going to the hospital, when it comes to cancer, it’s a whole new level, with many unknowns and preconceptions. The teams will try to meet the needs of waiting patients and offer them the full range of treatments available.

On-screen text : Since 2022, an average of 600 women with cervical cancer have been diagnosed each year at Blantyre Hospital.


It is clear that for people with cervical cancer, there are excessive delays in treatment. A woman diagnosed with cancer may have to wait three months for her first chemotherapy appointment. We know this is too long and reduces her chances of survival. We would like to be able to reduce these delays.

I recently went to Malawi to work with the teams, including an architect, on the space where MSF collaborates with the Ministry of Health to treat these patients, a space that quickly became very limited. The idea was to streamline the patient journey and work with the authorities to expand the space, with the aim of reducing treatment delays. The less space we have, the fewer human resources we have, and the longer the delays will be.

One of our colleagues is trained to explain nutrition to patients and the side effects that chemotherapy treatments can sometimes have.

The feedback from our colleagues and the women themselves was: “We appreciate having this space on mats on the floor rather than sitting in a consultation room.” In any case, it's complementary; you need both.


This photo illustrates one of the services we offer women: individual physical therapy sessions and sometimes group sessions as well. Why is this so important? We know that treatments, whether surgery or radiation therapy, impact women’s health and pelvic function.

These are pelvic floor rehabilitation sessions. There is also a section on anatomical explanations, offering different types of exercises they can do preventively before treatment, and then after treatment, educating them about the pelvic floor and ensuring that side effects are minimized.


Here, we are in the hospitalization department with mental health colleagues who will talk to her before and after treatment. Some surgeries can be serious when it comes to cervical cancer. If it is already invasive, we will remove the entire uterus, and in a woman’s life, we have to consider what that means. Colleagues conduct individual sessions. It is important to note that we continue to support patients for three to five years after treatment.

All of these types of services can also be offered afterwards to listen to their experiences, their illness, their constraints, how those around them perceive them, etc. What we seek to support above all is everything related to the stigma surrounding cancer, the representations of cancer that are fairly universal.


On-screen text : The WHO predicts a 150% increase in cancer cases in resource-limited countries by 2050.

We know the burden of cancer will be much greater in countries with limited resources. One of the main reasons for this inequality in access is that prevention programs are not yet sufficiently funded or deployed on a national scale. Confirmed cancer cases and the need for treatment will continue to overwhelm existing services.



On-screen text : Faced with this challenge, MSF’s task is to roll out HPV vaccination, early screening, and treatment of precancerous lesions on a widespread basis in order to to protect women against the onset of cancer.

All this while continuing to develop treatment capabilities, such as radiotherapy, which has only recently become available in the country.