The Health workers arrive on a wooden cart, hijabs blowing in the wind, as they are pulled along a dirt road by a horse. Sand swirls in the air as children run behind, trying to keep up. When the cart comes to a stop, the health workers climb out, holding large white boxes.

“We want to reach as many of the women here as possible,” says Nagma Khatun, a paramedic working in the Kurigram district of Rangpur in northern Bangladesh. In the boxes are self-testing kits for human papillomavirus (HPV), the main cause of cervical cancer.

Cervical cancer is a growing global health challenge, with more than 604,000 new cases diagnosed worldwide in 2020 and an estimated 342,000 women killed. About 90% of the new cases and deaths occurred in low and middle-income countries, where access to preventive measures and treatment is often limited. In Bangladesh, a delta nation crisscrossed by rivers and tributaries, such access can prove particularly difficult, especially for those living on the shifting sand islands – known as chars – of the Brahmaputra and Jamuna rivers.