Help for Uganda's cervical cancer patients Sarah Mwesigwa is 37 and the mother of four children. UWHI nurses found abnormal cells on her cervix in 2007, and she was treated with cryotherapy and medication. Her fourth child, a boy, was born in 2009. 'I thank God for the nurses here,' she says. I advise every woman to come. If something is detected very early, you won't reach the time of dying, and suffering, and leaving orphans.' Joy Mirembe Abola, who is 33, was also treated for precancerous cells. She says, 'If it could be me, it could be anyone. So I use every opportunity to tell women that they should get tested. In 2009 the UWHI built a radiotherapy hostel within the grounds of Mulago Hospital. Christine Babirye, 48, who was diagnosed with cervical cancer in 2008, travelled from eastern Uganda, about 125 miles from Kampala, a journey that took her five hours. 'To be with women with the same kind of problem and to be able to talk to them has been a great help to me,' she says. So far the UWHI has screened more than 12,000 women. The smear test used in Britain, which relies on sending samples to laboratories, is not an option in a country with poor communications - it is also prohibitively expensive. The cheap and effective method used at the UWHI is to dab acetic acid (basically vinegar) on the cervix and then to look (with the naked eye and a bright light) for the telltale white patches that indicate abnormal cells. The simplicity of these screenings means that women can come to a clinic, be screened and, if necessary, treated all on the same day. To date, the UWHI has found more than 440 women with pre-cancer and 60 women with established cervical cancer who have been treated with radiotherapy. 'I won't claim that what we've done is unique,' Prof Jacobs says. 'There's really good work going on elsewhere in Africa, Asia and South America. But we have a unique opportunity, working with the health ministry, to roll this out across the country in an organised way. If that happens in Uganda, it's a model that may work in other countries.' It was an anonymous donation of £500,000 in 2005 that allowed the work to begin. 'There were agonising discussions,' Prof Jacobs says. What were we going to do when that money ran out? Were we raising false hopes? But my personal view, and I thought about this quite carefully, was that if we stop just a hundred women getting cervical cancer, and nothing else ever happens, we will still have done something worthwhile. Sustainability is a target, but I wasn't going to let that paralyse us.' Uganda struggles with a lack of resources. Mulago Hospital, for example, delivers 30,000 babies a year in a facility which, in Britain, would probably manage only 3,000. 'It's overwhelmed,' Prof Jacobs says. 'Sometimes the operating theatres aren't working because there's no electricity or equipment.' A pregnant woman who has travelled for days on dirt roads to seek emergency treatment may arrive too late: her baby might die, and the pressure caused by obstructed labour may have permanently damaged her bladder. An emphasis on prevention and research has run through the whole of Prof Jacobs's career. Now 54, he trained in obstetrics before specialising as a surgical gynaecological oncologist at the Royal London Hospital. Very early on it became obvious to me that although I loved clinical work it was like blocking up the holes in a dam. If you don't repair the dam, the same trickle of disease is going to continue. We need screening and prevention. And we need research to make that possible. It was in the 1980s, when he was working as a young house officer, that this became agonisingly clear. One day we operated on a number of women with ovarian cancer. And we knew that despite everything we'd done, these women were probably going to die.' Over 25 years he has built up a research programme on ovarian cancer focused on risk prediction, screening and prevention which now has funding of more than £25 million from the Medical Research Council, the National Institute of Health Research, Cancer Research UK and the Eve Appeal. The programme involves some 50 researchers based in the University of Manchester, UCL and collaborating centres in Cambridge, Harvard and the University of Southern California, as well as screening trials units in more than 30 centres in Britain. In 2011 Prof Jacobs was appointed the vice-president and dean of medical/human sciences at the University of Manchester and the director of the Manchester Academic Health Science Centre. He is driven to succeed. I love it when I have the chance to make things happen by bringing people together. I get energy from taking on challenges and seeing them through. At the UWHI, the plan is to offer the most effective form of cervical screening across Uganda within the next 10 years. It is ambitious but achievable. The Uganda Ministry of Health is committed to contributing facilities and staff time, costing an estimated £12 million, roughly six per cent of Uganda's total health budget. The UWHI will raise £4 million for equipment and for the core screening team. Janet Museveni, the First Lady of Uganda, an MP and international activist for women's rights, is the patron of the UWHI. 'We're properly tied in to the Ugandan structure at the most senior level,' Prof Jacobs tells me. The UWHI needs £100,000 to secure its immediate future. '£15 will screen one woman; £300 will screen 20 women and save the life of a woman who would have died of cervical cancer,' Jacobs adds. To donate go to uwhi.org, or send a cheque made out to 'The Eve Appeal (Uganda Women's Health Initiative) ' to The Eve Appeal (Uganda), Butler House, 177-178 Tottenham Court Road, London W1T 7NY. A book on the work of the UWHI, 'The Uganda Women's Health Initiative: The First Five Years', is available through the website for a donation of £100