SpongeBob, warm baths, and big dreams: what three Malawi girls are thinking about instead of cervical cancer
Malawi’s HPV vaccination rates are rebounding post-pandemic, which means more girls are being protected from a threat that, to them, lies far away in the misty future of adulthood.
- 10 October 2024
- 7 min read
- by Josephine Chinele
In the first year of Malawi’s mass human papillomavirus (HPV) vaccine roll-out, an impressive 85% of eligible girls got the jab. But then came the pandemic, and schools – the principal venue for HPV vaccination – closed. According to the World Health Organization’s (WHO’s) immunisation dashboard, coverage with the cervical-cancer-blocking shot had plummeted to just 13% in 2021.
But that year, Malawi’s HPV programme also moved beyond simple campaign mode, and the jab began to be made regularly available to girls aged nine to 14 years. Girls can now get the vaccine on quarterly “campaign days”, either in schools or local health centres. That’s clearly an opportunity many are jumping at: 2023’s figures show a heartening bounce-back, with coverage rates of 68%.
However, post-COVID-19, vaccine misinformation swirls, and some parents continue to shy away from a shot that could spare their daughters in adulthood. According to a 2023 fact sheet by the HPV Information Centre, nearly 4,200 new cases of cervical cancer are diagnosed in Malawi each year. Nearly 3,000 die of the disease.
The prospect of a cancer that strikes most women in middle age must seem very far away to the girls getting vaccinated – preteens and teens, with more important preoccupations: rope-skipping games, making art, growing up to be just like mum.
In Blantyre, VaccinesWork spoke to three girls who recently got the shot or are about to, to hear about their lives, and the vaccine, in their own words. We also chatted with their mothers: the women making sure their daughters are better protected than they were able to be.
Meet Lindiwe Malinda and her mum, Ida Nkhoma
Lindiwe Malinda
Age: 13
Occupation: Standard 8 student at Mlambalala Primary School in Blantyre
Likes: Playing netball, a rope-jumping game called jingo, listening to music (particularly the song “Controller”), discussions with friends, being woken up to a ready, warm bath by her mother in the morning
Dislikes: Bullying and gossip
Fears: When the power goes out at night.
On the HPV vaccine…
“I didn’t feel that much pain when I had it. It was just like a pin flash. But I never got sick, or had any side effects as others or parents claimed.”
On cervical cancer…
She’s never met a survivor, but she’s heard enough to know: “I don’t want to have it.”
On her mother…
“I wish to be like her. I like her looks, dressing and how she handles herself.”
On her future…
“When I complete school, I would like to become a doctor, so I could help sick people. When I look at those people wearing white uniform, I admire them lots.”
Ida Nkhoma (Lindiwe’s mum) on Lindiwe
“She is a good girl, obedient, prayerful…. She’s just that kind of a kid who is loved by many.” Lindiwe loves school, and loves to tell stories: “we chat as friends.”
…on the HPV vaccine
Nkhoma consented for Lindiwe to receive the HPV shot at school when she was in Standard 7 “because cervical cancer is fatal,” and because she believes it’s every parent’s duty to protect their daughters from it.
“I was absent, but I consented because I knew that whoever was going to provide the vaccine was good at their job and nothing would happen to my daughter. I was happy that she received part of her future healthy body.”
On cervical cancer…
Nkhoma knows several people who have had cervical cancer. Her neighbour died of it, after a long period of suffering.
“I particularly noted an increase in cervical cancer cases in the 2000s years, that’s when my curiosity to know more grew, and that’s when I came to know about the threat. I feel so good that my daughter has been vaccinated against this disease.”
On vaccination in general…
Nkhoma has always believed in vaccines, so much that her children have received all routine immunisations, including newly introduced ones.
“I knew by getting them vaccinated, they would be protected from various diseases. These vaccines are for our own good... My children rarely fall ill, and I believe this is partly because of my adherence to health standards for them.”
Meet Watipaso Mwaungulu and her mum, Everyn Mwaungulu
Watipaso Mwaungulu
Age: 12
Occupation: Standard 8 student at Mlambalala Primary School in Blantyre
Likes: Art, music, watching cartoons (particularly SpongeBob, because her friends in school say she has SpongeBob’s teeth)
Dislikes: Being distracted from watching cartoons
Fears: Horror movies (especially the night after watching them)
“My teacher told me about the HPV vaccine a day before vaccination, for me to sort out consent from my mom. She said this vaccine will protect me from cervical cancer.
“My friends told me it was painful; I was afraid – but [it was] not as painful.
“[The] vaccine was great because I will be protected from having cervical cancer. I’m encouraging others to also have the vaccine because it’s good for their health.
“Others cried lots after receiving the jab and this frightened me, but I got a totally different experience when I received it.”
On her mother…
Watipaso’s mother is “a greatest person in the world” – because when Watipaso makes a mistake, her mother helps her kindly to understand what that mistake was, and guides her on the right way of doing things.
“I’m so proud of my mom because she likes to bake and cook delicious meals that I like.
“When I grow up, I want to be everything that God wants me to be. Maybe somehow like my mum.”
On her future…
Apart from aspiring to become an artist, she also aspires to be a scientist, because it is “very interesting to be exposed to the whole world.
“I want people to see me as a better person in the world. I want people to appreciate what scientists do.”
Everyn Mwaungulu (Watipaso’s mum) on Watipaso
Wati is the second and “probably” the last-born child in the family. She loves her dad, can be lazy, and sometimes tells lies, which she later admits to.
“I’m so proud of her because she makes me laugh, and we chat a lot – although she is not open to many things she ought to be to me as a mum.”
On the HPV vaccine…
Some parents at the school discouraged Everyn from consenting, due to the misconceptions that they had been exposed to.
“I somehow was sceptical, but my conviction told me to consent as a way of preparing my daughter’s future. There’s too much talk about the vaccines, but I believe it’s a good thing that these children should have it.
“When Wati had this vaccine, I didn’t notice anything or changes on her not even fever or sickness, everything has been fine until now: she is fine. So, fellow parents that are not consenting to having their children have this vaccine are just denying their children good things.”
On cervical cancer…
Everyn knows women personally who have suffered from cervical cancer. “I know someone who had it but had been on treatment and was told to abstain from sex for six months. Cervical cancer is a big threat to women’s health.”
Meet Nthanda Kachipeya and her mum, Kamuoli Kachipeya
Nthanda Kachipeya
Age: 9
Occupation: Standard 4 learner at Jolly Kids Private Primary School in Blantyre
Likes: Gospel music, cake, playing country games
Dislikes: Eating lemons (because it’s sour)
Fears: Lions
On the HPV vaccine…
She doesn’t understand much about the HPV vaccine, but she is not afraid to receive it, because her mum and teachers have told her that it’s for her own good.
On her mother…
She loves her mum because she is kind, and she makes her look nice. “When I grow up, I would like to be like my mum.”
On her future…
She would like to be a doctor: “I want to help people.”
Kamuoli Kachipeya (Nthanda’s mum) on Nthanda
Nthanda is the last-born of three children.
“She is clever, understanding, and likes to play with friends. She likes joking and is a bit stubborn.”
On the HPV vaccine…
“I am ready to have my child to be vaccinated against cervical cancer through the HPV vaccine to protect her from struggling with this disease when she grows up.”
“I already consented to having Nthanda be vaccinated, just that there have been logistical challenges. But any day, she will be one of the learners to receive this jab at their school.”
“As a mother I consented because [the] vaccine is important to human health.”
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