Rays of Hope Hospice Jinja in Uganda has expanded its mission beyond traditional end-of-life palliative care to include cancer prevention and early detection services. This shift began in 2018 in response to the high number of cervical and breast cancer deaths observed among their patients.
Prevention Initiatives
Since its expansion, the hospice has conducted nearly 29,000 screenings for cervical and breast cancer in the Busoga region. Clinical staff provide on-site treatments for precancerous cervical lesions and educate communities on the HPV vaccine, dispelling myths about infertility. In 2023, Rays of Hope assisted the district health department in vaccinating over 47,000 girls against HPV.
One beneficiary, Deborah Nantenza, 46, was diagnosed with precancerous cervical cells in June 2022 during a clinic screening and received treatment. She now advocates for other women to get screened.
Impact and Growth
Executive Director Sylvia Nakami noted that 60% of cancer cases among women in their patient data were cervical or breast cancer, leading to the focus on prevention. This initiative represents an emerging paradigm shift in palliative care globally, with organizations like the African Palliative Care Association (APCA) recommending similar screening and HPV vaccination support. Despite initial discomfort from some in the palliative care community about expanding beyond end-of-life care, Rays of Hope has doubled its hospice and palliative care patient numbers since 2018 and expanded staff from 16 to 34 by 2025.
Funding Challenges
The hospice relies on donors to cover its annual operational budget. Global health funding has declined, impacting NGOs and nonprofits, including Rays of Hope. Last year, the hospice experienced a surge in patients, particularly those with advanced HIV/AIDS, following funding cuts, with over 1,500 patients assisted in 2025. This underscores the continued importance of their traditional palliative care work, as exemplified by Deborah Nanyonga, a 35-year-old widow receiving food, pain medication, and social support for advanced cervical cancer and HIV.
Global Context
Cervical cancer causes 350,000 deaths worldwide annually, with Uganda accounting for 4,600, making it the country's leading cause of cancer deaths. Other organizations, such as Island Hospice and Healthcare in Zimbabwe and the Tata Cancer Care Foundation in India, are also exploring or implementing similar integrated models for cancer prevention within palliative care frameworks. Research by Rays of Hope, in collaboration with academic colleagues, indicates that insufficient rural health care contributes to advanced cancer cases.