A bold new mission: saving lives at Uganda's Rays of Hope Hospice.
In a rural region of Uganda, where early cancer diagnosis is rare, a hospice is taking a bold step to prevent and treat cancer, particularly cervical cancer. This innovative approach is led by Sylvia Nakami, the executive director of Rays of Hope Hospice Jinja.
Deborah Nantenza, a 46-year-old mother, shares her story. Despite knowing the risks, she feared getting tested for cervical cancer, having witnessed the tragic deaths of women from this disease. However, with encouragement from healthcare workers, she took the brave step and underwent screening in June 2022. The results revealed precancerous cells, and swift treatment followed. Today, Nantenza advocates for other women, many of whom have never had a screening before.
But here's where it gets controversial... traditionally, hospices have focused on end-of-life care, easing the pain of the dying. Yet, Rays of Hope Hospice has expanded its mission, offering cancer screenings, education, and treatment. Since 2018, they've conducted nearly 29,000 screenings, mostly in the rural Busoga region.
The team provides on-site treatments for precancerous lesions and educates communities about the HPV vaccine, dispelling myths about infertility. In a remarkable project launched in 2023, they've helped vaccinate over 47,000 girls against HPV, a significant step in preventing cervical cancer.
Nakami emphasizes, "There is something we can do about it. And it gives us hope." The hospice's initiative is a paradigm shift in palliative care, inspiring similar efforts in Africa, India, and beyond.
Cervical cancer remains a stubborn killer, claiming 350,000 lives worldwide annually, with Uganda topping the list of cancer deaths in the country. Nakami and her staff were determined to make a difference, especially in regions hardest hit by the disease.
In 2017, they analyzed data from over 700 patients, finding that over 60% of cancer cases among women were cervical or breast cancer. Knowing that early detection leads to successful treatment, they focused their prevention efforts there. By the end of 2025, they had screened over 12,000 women for breast cancer and over 16,000 for cervical cancer, while also providing hospice and palliative care to patients with HIV and other diseases.
When the hospice expanded its strategy, some in the palliative care community were skeptical, fearing they were abandoning their core mission. However, Rays of Hope has doubled the number of patients receiving hospice and palliative care, from around 750 in 2018 to over 1,500 in 2025.
The first mass screening in 2019 drew almost 700 women, with fewer than one in 20 having been screened before. Emmanuel Luyirika, recently retired executive director of the African Palliative Care Association, praises their efforts, saying, "This is something that is doable and makes a significant impact on cervical cancer occurrence."
But there's a catch... these prevention efforts require significant funding. Rays of Hope relies on donors, but with global health funding declining, the need continues to grow. NGOs and nonprofits face challenges in filling healthcare gaps, especially in countries like Uganda, which leads in palliative care efforts in Africa.
Last year, Rays of Hope witnessed a surge in patients, including those with advanced HIV/AIDS cases following funding cuts. "We will have to raise more funds because there will be more people sick," says Margrethe Juncker, a Danish physician and hospice doctor.
While the traditional work of symptom relief remains crucial, the hospice's expansion into prevention is a game-changer.
Deborah Nanyonga, a 35-year-old widow battling advanced cervical cancer and HIV, relies on Rays of Hope for support. With no family to turn to, she receives help with food, pain medications, and social support.
Nanyonga's story highlights the importance of early intervention and the impact of the hospice's work.
Hospices offering cancer prevention programs are few, but models like Island Hospice in Zimbabwe show promise. Across Africa, patients are often referred for cancer care late, emphasizing the need for early involvement.
Research on palliative care innovations is gaining traction, with studies in rural India showing the potential for effective cancer control strategies through household visits. Rays of Hope, in collaboration with academics, is researching the factors contributing to advanced breast and cervical cancer cases in rural areas.
Luyirika urges the adoption of similar models, recognizing the limited resources available. He adds, "They are able to reach more patients."
There's hope that those benefiting from these services will become grassroots advocates, and indeed, peer advocacy is already showing positive results.
Deborah Nantenza, having overcome her own cancer scare, now shares her story with two to three women weekly, inspiring them to take action.
"I found that at least you'd rather get treated than get cancer," she says.
This story, supported by the Pulitzer Center, highlights the transformative work of Rays of Hope Hospice and the potential for similar initiatives to save lives.
