[female narrator] The country of Malawi is fighting a health crisis.

Women are dying from a preventable disease.

Malawi has the number one incidence of cervical cancer in the world.

[narrator] Cervical cancer is one of the most deadly but also one of the most preventable cancers in women.

[female voice] It's a very big problem for many reasons: lack of education - that there is a cervix, and it needs to be screened; lack of access to screening facilities; HPV prevalence is high; [narrator] Virtually all cases of cervical cancer are caused by the HPV virus.

The HPV vaccine can prevent the disease, but it's not readily available in Malawi.

The HPV virus is spread through sexual contact.

[doctor] Women who are unaware of that fact aren't aware they should be using condoms.

Maybe, nobody's educating them that if you sleep with more people you have more chance of having this disease, so there's a high HPV prevalence.

[narrator] If a woman is not screened regularly, the HPV virus can become a problem: [doctor] a big problem, a cancer.

[dramatic and hopeful theme] [dramatic and hopeful theme] [narrator] Malawi is a country in central East Africa.

Its economy is based on agriculture.

The Cheola District is home to a number of tea plantations, and for many Malawians, growing food on small plots of land is their only source of income.

[male voice speaks in native language] [female voice speaks in native language] [speaking native language] [music] [sounds of bird chirping and dog barking] We were living in Washington state before coming here.

I was in a small, low-risk, private practice.

We were, you know, in a comfortable home, uh, with a lovely community.

After graduating from Loma Linda University in Southern California, Dr. Casey Graybill and her husband spent a month working in Malawi.

Eight years later, she saw an ad in an alumni journal, asking for doctors to work in Malawi.

She sent an email offering to do short-term relief work.

And so, I got a call from Dr. Hart at Loma Linda, um, who works hard to staff these kinds of settings, saying, um, "That's nice."

[laughter] "But, could you consider coming long-term again, please?"

You know, "We've been looking for an OB-GYN doctor for many, many years."

And, my initial response was 'no.'

And then, basically, began to reconsider.

We uh, talked about it and prayed about it and um, it wasn't an easy decision.

So we've been living here for two and a half years.

Juggling home life and work life, Dr. Graybill and her husband, Aaron, alternate days homeschooling their four and six year-old daughters, Anna and Alice.

Aaron also works at the hospital doing logistics and community outreach projects.

The thing I realized more than ever is, you know, how easy my life was before.

You know, I just, by chance, was born in a country with many resources.

And then, somebody else isn't.

You know?

And so, I just hope that people can recognize that disparity.

There's women here who just don't have access to the basic rights that are theirs.

They should have those, those things, and it's not fair, and I just hope people can see that.

[narrator] Dr. Graybill spends a lot of her time working with Stella Norinda.

Born in South Africa, Stella always knew she would be a nurse.

[Stella] From childhood, I loved to work as a nurse.

I had a passion for that.

I think it, it was just in me, in-born.

[narrator] In 2015, Stella started working in a new department at Malamulo Adventist Hospital, where she screens women for cervical cancer.

That's when I saw that it was really a big issue.

It was most of the women, when they came in for the first time to screen, most of them they were found positive, as is in an advanced stage.

[speaking native language] [narrator] One of Stella's responsibilities is to tell women they have tested positive for cervical cancer.

In Malawi, this is often a death sentence.

Most of them, they cry.

They really cry.

And you have to stop and just be there.

And then when they finish, we'll pray with them.

Yeah.

What keeps me going is the passion for these women.

I really want to see these women not dying because of something that can be preventable.

[sound of vehicle on rough road] Today we are going to the villages to see one of our palliative patients, uh, who has been diagnosed with advanced cancer of the cervix, just to find out how they are dealing with the condition; how it is affecting the family, the children, the relatives.

It's hard to break in, especially finding someone who is very young.

It's not easy.

[speaking in native language] [narrator] Without running water, her 12-year-old daughter hikes down to the well several times a day to provide for her family.

[sound of water trickling] [speaking native language] [music] [music] [speaking native language] In high-resources countries, treatment for early cancer would be similar to what we do here.

A woman would have the procedure to either freeze or remove a portion of the cervix or have a hysterectomy.

The difference is that a woman with a cancer that has progressed beyond a certain stage would receive radio-therapy.

Here, we don't have that at all.

[narrator] If the cancer can't be removed by surgery, it's treated with radiation therapy; however, there is no radiation therapy available in the whole country of Malawi.

With 70 percent of the population living on less than two dollars a day, Alice and almost every woman with advanced cervical cancer do not have the resources to seek treatment outside the country.

Alice is on palliative care; care for patients with a terminal diagnosis.

That doesn't mean that we're done with that patient.

Palliative care is part of whole-person care, recognizing that not only the physical needs need to be addressed but the emotional needs, the spiritual needs, but also offering things like pain control.

[soft piano chords] In Malawi, right now what we are giving is just painkillers.

The low dose and then come to a, a moderate and then the maximum, only the painkillers, that's what we are able to give right now.

[soft piano chords] Chisomo is Alice's younger sister.

Since Alice was diagnosed with cervical cancer, she helps out as much as she can.

She's also afraid that she may have cancer, too.

[speaking native language] [rooster crow] [fly buzzing] [narrator] Chisomo will learn what her cervical cancer screening results are in a few days.

Unlike many women in rural Malawi, she lives close enough to a hospital to go there for screenings.

Access to health care, in many villages, is not so easy.

[upbeat driving piano] Twice a month, Malamulo Adventist Hospital runs a rural clinic headed by Dr. Graybill and Stella.

Up to 200 women begin lining up as early as two o'clock in the morning to be seen.

Many of them walk for hours to get to the clinic.

For most of these women, this is the only option they have to get cervical cancer screenings and follow-up care.

So, we started, um, going to clinics that are farther away, less accessible, and to offer screening there.

And many women have been screened so far.

Our numbers have tripled since we started doing those outreaches.

So the women there, they get educated; they get results from, you know, the previous screening days, and then they're screened.

[speaking native language] [driving piano cont.]

[Stella] The next step for her she will have to come for follow-up after two weeks, at Malamulo Hospital, and then from there, that's when the doctor know what steps to take.

[Dr. Greybill] Yeah, so they all know somebody who's had it.

And um, for them to feel empowered, like, we can come somewhere and be seen and be helped, um, you can just see that in their faces that they're so grateful.

So, that makes me feel like all that hard work and the sweat and the, the long days, is well worth it.

[Stella] It is very long, very tiresome.

And sometimes we are not even able to finish all of them.

Sometimes we run short of supplies.

Sometimes we get so tired and it's dark, we can't see.

But when I see that we have screened so many clients, I feel good about it.

On this Sunday, over 100 women received cervical cancer screening, and 76 got the results from previous tests.

[Dr. Greybill] How many did you do?

[Stella] I only did thirty.

Only thirty.

Yeah.

Ha ha ha ha.

And uh-- So only, a hundred and one.

Seventy-six for results.

Seventy-six for results.

That, that's pretty solid, I think.

Yeah.

[V.O.

Dr. Greybill] Stella.

[giggle] She just has the same passion I do for um, what we do here.

And she sees that these women really need help, and so um, she has just been a huge blessing for me.

She's one of those, one of those things that, that keeps me going and doing what we do here.

All the places where we have the Malamulo Clinics, I wish we could open up cervical cancer clinics also.

[Dr. Greybill] My vision would be to expand greatly on the number of women that we're able to screen and treat.

We've seen how successful an outreach clinic can be.

And we're only doing two a month.

But what if we were doing two a week?

That's really my goal, is to screen the, the women in at least our area to the point where we aren't having to give that bad news anymore.

[sound of engine running] [piano chords] [narrator] Today is the day that Alice's sister, Jesomo, gets her test results.

The day she finds out if she has cervical cancer, too.

She came with her friends.

Because Alice tested positive, they have all been screened and will get their test results today.

[speaking native language] Chisomo Paulo, Chisomo Paulo!

She was so excited to have her results negative because seeing that her sister had cancer of the cervix, and how she's suffering, she was also scared that she would be found positive for cancer.

Now that it's negative, she's so happy.

[music] [sound of bird chirping] [speaking native language] [music] I was wondering what was going in their minds.

That maybe she was thinking, I won't be able to see my daughter growing, getting married, or things like that.

Thinking maybe I'm gonna die earlier.

So, a lot of things was going in my mind.

Of which I thought could have prevented that.

Yeah.

[music] [touching piano music] [bird chirping] [speaking native language] [rhytmic yet somber music] [rhytmic yet somber music] This program was made possible by the Ralph and Carolyn Thompson Charitable Foundation and Ed and Ann Zinke.