Dili, December: Saozinha Noronha’s heart sank when doctors at the Colposcopy Centre at HNGV diagnosed her with cervical cancer. Fearful of the worst, she found solace in the assurances of the country’s referral hospital, which provided timely detection and treatment that saved her life. “I have visited the centre four times, and the health workers have been incredibly supportive throughout. My health was poor when I first arrived, but after the treatment and counseling, I feel motivated, eat better, and am in much better shape,” she said. Saozinha’s story is one of hope and determination as she now encourages other women to seek early detection if they notice any symptoms.
Saozinha and Clotilde, Midwife at HNGV at the Colposcopy Center
For many women like Saozinha, 2024 was a pivotal year in Timor-Leste’s fight against cervical cancer. The country made life-saving health services more accessible, reducing the need for long, arduous travel. As the second most common cancer among women in Timor-Leste, cervical cancer demanded urgent action—and the country with WHO’s support responded with a multi-faceted strategy to prevent, detect, and treat the disease.
“Together with the WHO, the Ministry of Health launched a 360-degree fight against cervical cancer—preventing illness through HPV vaccinations for young girls, expanding testing and screening facilities, improving treatment access, and driving awareness nationwide,” said Dr Arvind Mathur, WHO Representative.
Strengthening Prevention
Prevention became a cornerstone of the country’s strategy. In July 2024, Timor-Leste launched a historic HPV vaccination campaign targeting girls aged 11–14. Achieving an unprecedented 99% coverage within six weeks of its September rollout, the campaign delivered over 62,000 vaccine doses. This initiative marked a groundbreaking step in safeguarding the next generation from cervical cancer, significantly reducing the risk of HPV infections.
“Vaccination is the most effective way to prevent HPV infections, and Timor-Leste’s campaign is a model for other countries,” added Dr Mathur. “The commitment shown by health workers and the community is commendable.”
Enhancing Detection
Detection efforts reached new heights in 2024 with the introduction of high-quality HPV testing. Among the primary screening methods—VIA, Pap Smears, and HPV testing—the latter stands out for its accuracy in identifying high-risk HPV strains. Nearly 400 women underwent HPV screening using repurposed PCR technology initially developed for COVID-19 testing, paving the way for earlier and more reliable diagnoses..
To bolster accessibility, the country expanded its colposcopy centers to three locations—HNGV, HoREX Bacau, and CHC Formosa. Collectively, these centers screened over 900 women, detecting 25 precancerous cases, most of which were treated locally, with only one requiring referral abroad.
Screening camp at FDTL military camp in Baucau
Screening services also reached remote areas through population-based screening camps. At CHC Gleno in Ermera, over 64 women were screened during National Health Day. Special screening services for National Defense personnel at FFDTL camps in Hera, Bacau, and Fatuhada screened 233 women. In February, a camp at CHC Tirilolo, Bacau, utilized VIA to screen 38 women, highlighting the country’s efforts to make early detection accessible to all.
Standardized care and training
Timor-Leste’s commitment to high-quality care was reinforced with the launch of Standard Operating Procedures (SOPs) in July 2024 for screening and managing cervical precancer lesions. These guidelines standardized services across the nation, ensuring consistent care.
Training in progress at HNGV
Training was another critical component. In January and February, health workers at CHC Tirilolo received specialized training in VIA screenings and managing precancerous lesions, led by experts from HNGV. Between January and May, WHO facilitated online refresher sessions for HNGV’s colposcopy team, enhancing their skills in identifying and addressing challenges in VIA screenings.
Community Engagement and Awareness
Community engagement played a pivotal role in driving awareness. On Cervical Cancer Elimination Day of Action (November 17), two massive billboards were installed at Comoro and Mandarin in Dili, urging early diagnosis and timely intervention. A digital board near the Presidential Palace displayed critical information about symptoms, detection methods, and testing locations, empowering women to take proactive steps for their health.
Hoarding at Nicolau Lobato Roundabout put up during the Cervical Cancer Elimination Day of Action
Saozinha herself became an advocate, urging women to seek care if they notice symptoms such as unusual discharge, abdominal pain, or irregular menstrual cycles. “Early detection is key. I am living proof of the importance of seeking help on time,” she said.
Dr Augusto Gusmão, a specialist at HNGV, reinforced this message: “If you experience symptoms such as unusual discharge, pain in the lower abdomen, discomfort in the genital area, or an irregular menstrual cycle, seek help immediately. Early detection saves lives.”