Uganda Hospice Screens 29,000 Women, Saves Lives From Cancer

When Deborah Nantenza walked into a hospital screening in eastern Uganda four years ago, she was terrified of what doctors might find.

The 46-year-old mother of six had watched women in her community die from cervical cancer, a disease that kills 4,600 Ugandans every year. But the health workers from Rays of Hope Hospice Jinja encouraged her to get tested. They found precancerous cells during that June 2022 visit and treated her immediately.

Today, Nantenza is cancer-free and advocates for other women to get screened. Her story shows what happens when one hospice decided death didn't have to be the only outcome.

For years, Sylvia Nakami and her team at Rays of Hope could only ease the suffering of dying patients. Women with cervical cancer "didn't just die a normal death," says Nakami, the hospice's executive director. "They died after suffering, suffering."

In 2017, the team analyzed their data and discovered that more than 60% of cancer cases among their female patients were cervical or breast cancer. Both diseases can usually be treated successfully when caught early. So in 2018, they made a radical decision to expand beyond hospice care into prevention.

Since then, they've screened nearly 29,000 women in Uganda's mostly rural Busoga region. Their clinical staff treats precancerous cervical lesions on-site and educates communities about the HPV vaccine, which protects against cervical cancer. They counter dangerous myths about the vaccine causing infertility.

In 2023, Rays of Hope partnered with the district health department to bring HPV vaccinations to more than 47,000 girls. "There is something we can do about it," says Nakami. "And it gives us hope."

The hospice's first mass screening in 2019 drew almost 700 women over a few days. Fewer than one in 20 had ever been screened for cervical cancer before.

Some in Africa's palliative care community initially worried the hospice was abandoning its core mission. Instead, Rays of Hope doubled its hospice patient count from about 750 in 2018 to more than 1,500 by 2025. The staff grew from 16 to 34 people to meet the expanding needs.

The Ripple Effect

Rays of Hope's model is sparking a paradigm shift across Africa and beyond. The African Palliative Care Association, which represents more than 500 members across 52 countries, now recommends screening and HPV vaccination support to its network.

"This is something that is doable, and it puts a very significant dent in the occurrence of cervical cancer before it develops into something very serious," says Emmanuel Luyirika, the association's recently retired executive director.

The hospice still provides critical end-of-life care for patients who need it. But now staff members witness more than just "one exit: death." They're seeing women like Nantenza walk out healthy, ready to encourage their neighbors and daughters to get screened.

The work continues despite global health funding dropping by an estimated $10.5 billion between 2024 and 2025, putting pressure on organizations trying to fill healthcare gaps across Africa.

For every life saved through early detection, there's hope that fewer families will lose mothers, sisters, and daughters to a preventable disease.