Woman's Hour - Weekend Woman's Hour: HPV home-testing kits, Nigeria schoolgirl kidnappings, author Louise Doughty

Episode Date: August 29, 2026

Women who have missed a cervical screening appointment in England are to be offered HPV self-testing kits by the NHS. Over the next year, nearly four million women will receive invites on the NHS App or via text message, email or letter to order a free kit to use at home. The aim is to encourage more women to complete their potentially lifesaving screening to detect HPV, which can increase the risk of cervical cancer. Dr Sue Mann, National Clinical Director for Women's Health in England and a consultant in Sexual and Reproductive Health, joined Nuala McGovern.For more than a decade, armed gangs in northern Nigeria have repeatedly targeted schools, kidnapping children for ransom and forcing some educational establishments to close. BBC journalist Yemisi Adegoke has recently returned from the state of Zamfara, where ongoing insecurity has left many girls unable to attend school, threatening their futures. She talks to Anita about her experience.After the death of both her parents, best-selling novelist Louise Doughty made a startling discovery whilst clearing out the family home. Inside a black suitcase, she stumbled upon a treasure trove of letters that revealed the origins of her parents' love affair. She joined Nuala to discuss her first memoir On This Spot Fell One Tear of Love described as a portrait of grief and loss and family – and a love story.Presenter: Anita Rani Producer: Annette Wells

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Hello, I'm Anita Rani, and welcome to Woman's Hour from BBC Radio 4. Hello and welcome to the programme. In a moment, we'll hear why HPV self-testing kits will be offered to some women by the NHS. Twelve years on from the kidnapping of 200 girls from their school in Chabok in Nigeria by the militant Islamist group Boko Haram. Why are child abductions continuing?

Plus, the novelist Louise Doughty, who's written many novels but has now penned a memoir telling the love story between her parents that she only uncovered after the story. their deaths. But first, women who have missed a cervical screening appointment in England are to be offered HPV self-testing kits by the NHS. Over the next year, nearly four million will receive invites on the NHS app or via text message, email or letter to order a free kit to use at home. The idea is to encourage more women to complete their potentially life-saving screening to

detect HPV, which can increase the risk of cervical cancer. Figures show around a third of women who are eligible for cervical cancer screening have not taken up the offer recently. To discuss what lies behind this decision, Nula was joined by Dr. Sue Mann, National Clinical Director for Women's Health for England and a consultant in sexual and reproductive health, and she began by asking her what HPV is. So HPV is a really, really common infection. And, Many people have it. Often it doesn't cause any symptoms at all. But we do know that it is one factor that can encourage the development of a cervical cancer later in life. So it's really important that we find out if women are harboring these viruses so that we can test them and make sure

they're not at risk going forward. So these home HPV testing kits, NHS is calling them a game changer, why is there in need for them? Yes, I think it is a game changer. So if you think about the plan to eradicate cervical cancer by 2040, which is the goal, there's a sort of three-pronged strategy to that, and this is the third. So we encourage all boys and girls in school or young men and women to have their HPV vaccine, and that happens around 12 or 13. So that will significantly reduce HPV infections. We then invite every woman between 25 and 64 for the cervical screening test. This happens every five years and we would really encourage in spite of this that women still come forward for those tests because that's definitely the best way to pick up cervical abnormalities.

But we do know, as you said, that round third of women don't come from their tests and there's all sorts of reasons why not. And these are the women that we want to target now because they remain at risk they might have HPV that they don't know about. So by sending these swabs to their homes, they'll be able to do a very simple test, send it off, and then we'll be able to pick up the HPV infection, and then they'll be invited for further tests of positive. So of course, it's reassuring if they don't have it, but then if they do, then they will be invited in. Okay, I have a lot of questions. The test at home, what does that entail exactly for a woman to do? Yes. So this is a swab, which is a tiny cotton bud, really, that will arrive by post. And it requires inserting that a little way into the vagina. So it's much easier than a tampon, but much smaller than a tampon and should be relatively straightforward for someone to do. Obviously, if they require help with that, then best thing to do is to go to your GP and see if you can get some support with that. But mainly, I think women will find it quite straightforward.

Okay. With the regular cervical screening, it's a more invasive procedure. Can you tell me the difference? That's a little swab that you say you can do at home. Instead, if you go to your GP, what happens? Yes. So what happens is that we use something called Speculum, which is an instrument for want of a better word. That makes it sound a bit cold. But it is something that goes inside the vagina to have a direct look at the cervix, which you probably know is tucked inside the vagina. So it's probably around. or several centimetres up the vagina. So we like to take a look at it and then we take a small sample from the cervix and we send it off for HPV testing. And if we find HPV, we then look at the cells to check there are no abnormalities.

Now, with this self-taken swab, we'll do the HPV bit of it. But if it was showing HPV infection, you would still need to have the test actually from the cervix. I understand that. But I suppose some women might be asking, why can I not just do the swab and go for part B of getting cells from the cervix at a later date if in fact HPV has shown up? Yes, I understand that.

And I think that what we do know is that it may well be better to take the cells directly, these infection sampling directly from the cervix itself. We don't have enough evidence yet to say that the self-taken swab is as good as. This may come later, but at the moment we need to wait for the evidence to support that that is as good. So that's why I said at the beginning we would really encourage women to come forward. And even if you find it very difficult, there are lots of things that we can do. I mean, I regularly see women in my clinic who find it extremely uncomfortable, and I do understand why. And there are lots of ways that we can make that easier by having some.

someone in the room, by taking it very slowly, by taking it at the pace of the woman and, you know, actually being able to stop at any point that the woman wants to. So I would encourage you to talk to your GP or your practice nurse or your sexual health clinic to see how this can be made easier. Just so I understand correctly, is it that the swab won't always pick up HPV, that women are being instructed to go for a cervical screening if they can? So we know that the swab is very good at picking up HBV, but we don't know whether it is as good as the direct smear from the surface. I understand. You talk about trying to, I suppose, gather women up who would not previously have come forward. How do you understand some of the barriers that are in the way? What are they?

Yes, so I think that there are very many barriers. And I think the biggest one is about often, you know, we hear, don't we, that women don't feel listened to. They don't feel, you know, that the care that they get often is, you know, is sympathetic as they want. So we're working on that very importantly. I think sometimes women have experienced specific traumas. Sometimes that might be sexual trauma. Sometimes it might just be they might have some pain around that area or they've had previous experiences with a procedure that has really, really put them off. And so, yeah, so that can be very, very difficult. And I completely understand that. But then there's another group of women who I think we haven't maybe got the message out as well as we can do about why

cervical screening is so important. And I think really the take home is that, you know, it's a very, very simple test to prevent a fairly unusual but devastating condition from happening. So it's before that condition actually takes hold. What are some of the symptoms that women can experience? So commonly people with HPV virus can have warts that they can see genital warts, but that's only some strange of HPV. And actually, in fact, the ones that commonly cause changes in the cervix are not those ones. HPV itself otherwise is not symptomatic,

but I would encourage people who have abnormal bleeding, particularly after they have sex, that's where women get bleeding when they have abnormalities on the cervix to come forward and be checked. So this is for women who don't have symptoms. If you do have symptoms that you're worried about, then do go to your GP or your practice nurse and get them checked out. Do you have any concerns that, and we've outlined here, the differences between the swab and actually going in clinic for a cervical screening?

Do you worry at all that home testing could lead people to think that they don't need to go to their GP in the same way? Yes, I think that's a valid concern. And I really hope it won't because, of course, this mail-out depends on you waiting for right until after the screening interval is over before you get invited. So it means that there's a significant delay. And as I say, the disadvantage is around, one, visualising the cervix so we can reassure someone that actually it looks normal and two, doing that better test. And three, actually, that someone who has positive

HPV swab will still need to have their cervix visualised. I mentioned this is England where the home tests are being rolled out. Will it be on offer to women in other parts of the UK? So obviously I'm the national... For England. So I'm proud to say that I think we're the first to roll it out based on the recommendations of our national screening committee. So the research findings are there and I imagine though I can't speak for other nations will come on board. That was Dr. Sue Mann and if you have a medical query, do go to your GP. Now you may remember the tragic event of 20. 2014, when more than 200 school girls were kidnapped by the militant Islamist group Boko Haram in the town of Chibok, Nigeria.

Over 12 years on, armed criminal gangs continue to carry out kidnappings, in some cases even forcing educational establishments to close. In northwest Nigeria, the number of attacks rose by 78% in the first half of this year compared to the same period last year, according to an international conflict monitoring group. And recent data from Nigeria's National Human Rights Commission shows that the number of kidnappings across the country doubled over the same period. Well, BBC journalist Yemisi Adagoke has recently returned from the northern state of Zamfara, where ongoing insecurity has left many girls unable to attend school,

threatening, she says, a whole generation's future. Yemasey joined me this week, and I started by asking her, how straightforward was it getting there? It was really tricky to get to. The state that we went to Zamfara has no airport, so we had to fly into a neighbouring state and drive. And the safest way to do that was with a military escort. So we had two military trucks following us decked out in full PPE for about four and a half hours.

It was really a tough journey to get there. I mean, I started by saying there's been a 78% increase just in the first half of this year compared to last year. So, I mean, what's behind this increased violence? Well, the people that are responsible for this violence within the Northwest are locally known as bandits. They are criminal gangs who are heavily armed who tend to target soft places like schools and mosques and kidnap people for ransom. They sometimes lay siege on villages, killing everybody. In certain cases, they take over communities and then extort villagers there asking them to pay for protection. So even farmers aren't able to go to work without pay.

these people who are essentially holding their community hostage. And they do this because they know that they can get a lot of money by holding people for ransom. I think we need to take a step back of it and sort of zoom out and sort of look at Nigeria and maybe start 12 years ago. Because I think it's in people's in the back of their memories somewhere about these 200 girls. I mean horrific that were taken from Chibok and sort of where we've got to now. So mass abductions, unfortunately, they're nothing new in Nigeria. Chibok was the one that made global headlines in 2014, 200 schoolgirls were taken from their dorm.

Even now 12 years later, there are still 80 to 90 girls that are still missing that have never come home. And sadly, the situation has deteriorated since then. That has been described by some people who engage in this violence as a sort of gateway that they recognise that this type of attack would garner a huge attention

and they would be able to get a lot of money by doing this because, you know, these are young, vulnerable people. Every family, you know, wants their children home and will do anything in order to facilitate that. That means either paying the ransom themselves or pressurising the government to act. And are these, the girls that are being kidnapped? Are the families able to pay these ransoms? Who's paying the ransom? No, a lot of the time they're not. So that's where it slightly becomes a little bit more complicated because the government then have to intervene. Now, the Nigerian government, you know, has said publicly that they don't pay ransoms, but they have

been conflicting reports about that. And why girls over boys? There are several reasons in terms of education, keeping them out of education is something. And also there's a vulnerability there that these violent groups are keen to exploit. Do we know how many young girls are currently out of school? Yes, sadly, Nigeria has one of the highest number of out of school children in the world. Figures differ, but it's between 18 to 20 million and 60% of that number according to UNICEF are girls. Can you tell us about Hanatu? So Hanatu is one of the girls that featured in a previous documentary called The Bandit Warlords of Sanfara. Her school in Jangebert in Sanfara State was attacked in 2021 and hundreds of girls were abducted.

She witnessed that raid. And afterwards, when the girls were returned, an NGO decided to support some of the girls in terms of furthering their education. So Hanatu is one of those girls. She's been able to go back to school. She has just graduated from secondary school. She wants to be a doctor. She's a very typical teenager, loves BTS, loves K-pop, but she's overcome a lot of trauma.

We have a clip of you speaking to Hanatu about her experience. Let's have a listen. It's been six years. I remember it often and it makes me feel sad. I cry. On the other hand, I feel happy. I've been given the opportunity to study and live in peace. I feel happy I was selected.

I study and I can now do a lot of things I couldn't do now that I'm here. That's why even when I feel sad, I remember this fact and I feel happy. I want to be a doctor so I can help the community and my relatives and people that have supported me. And you also met with women working for NGOs helping to educate out of school young girls. So tell me more about who you spoke to and what they told you. Yes, as a young woman. called Tovia Moy, who works for the Illimi Children's Fund.

And that NGO is the one that supported Hanatu and some of the other girls getting back into education. And that NGO is extremely passionate and working really hard to try to combat the issue of young girls not being in school. You know, she spoke really passionately about why it's so important to educate girls, keeping them out of child marriage, increasing maternal health rates, child health rates. child health rates, and she spoke about the worrying way that insecurity is affecting children's education, that we could potentially be faced with a whole lost generation of young Nigerians

who are not being educated because of this. Yeah, and what is the long-term impact of that? Exactly, especially for girls. It's so devastating, not only just being locked out of economic opportunities, but there are instances of young women who are not educated being more likely to experience domestic violence and all sorts of other issues. And what is the government doing about this? Well, the government is talking tough, as they usually do. They have allocated a record number of dollars.

I think it's four billion to defence, which is the highest in the country's history. They've also recruited 28,000 new soldiers. And they are saying that they're taking a zero tolerance approach. But for many Nigerians, this just isn't enough. We're in a crisis state, is what I've heard many, many times before. they are pushing for the government to do more. Yemisei Adagocke there. Your sales order says one thing.

Your inventory says another. Your spreadsheet says, good luck. Odu brings your business together on a single platform from sales and accounting to inventory and marketing. Visit Odu.com to book a demo. It's ODbbolo.com. Get more with BBC podcasts, wherever you listen. Be the first to listen to your favourite shows

Like evil genius, good bad billionaire and you're dead to me, with a subscription to BBC Podcasts Premium on Apple Podcasts. You can also enjoy a range of our podcasts ad-free with an Amazon music subscription. Now, after the death of both her parents, Avis and Ken, best-selling novelist Louise Doughty made a startling discovery whilst clearing out the family home. Inside a black suitcase, she stumbled upon a treasure trove of letters that reveals the origins of her parents' illicit love affair.

And this led her to write a memoir. She introduces us to two hopeful young people, full of spirit and determination, people she'd simply known as mum and dad. On this spot fell one tear of love. It's a portrait of grief and loss and family, but most of all, it's a love story. Louise joined Nula this week,

and she began by asking her why she'd said that this is the only love story she's ever like. to write. Well, it's true. I'm famous for being something of a cynic and my most recent novels have been what people call psychological thrillers. It was Apple Triad, which was on the television and the most recent was called a bird in winter. That was a spy story. And I do make a joke, although it's not entirely a joke in the preface to, on this spot fell one tier of love. And I say, no woman gives up everything for a man in any of my novels. She's more likely to stab him with a chisel. And it's true. And I am a fully paid up cynic in terms.

I'm very antagonistic towards the idea that women are supposed to be obsessed with romance and hearts and flowers and pink and all the rest of it. So it's something of an irony that my first work of narrative nonfiction is actually a love story. And why was it important to tell this story? Well, I suppose at the most fundamental human level, I didn't want my parents to be dead. I didn't want them to die Well they very much came alive for me Oh thank you That's a lovely thing to say

And it's my highest hope for this book really That readers will read it And simply have a small place in their hearts It's a very odd thing as an adult I mean my parents were in their 80s They didn't die young But I still felt this enormous resistance To the idea that they were just going to slip away into history

You know they were two working class people they'd left school in their mid-teens. They were destined by birth to live, work hard, raise their family and then just disappear. And I railed against that. I wanted to sort of save them from that. Although I do say in the book that I realise towards the end, one of my most important tasks was not to rescue them from a bivian. It was also to rescue them from my memories of them,

which are, of course, flawed and partial. Yes, our parents are human beings. Who knew? You talk, there is a quote used in the book by Raghu Karnad. People have two deaths. The first at the end of their lives when they go away and the second at the end of the memory of their lives when all who remember them are gone.

It's very poignant. It is really poignant and he puts it so beautifully and I would recommend his memoir as well. I think what is it that we can't let go? It's very odd. I mean, people hang on to dresses that their mothers wore. Almost everybody listening will probably be hanging on to an item that has no value and we hang on to our memories and obviously we can't

fill the world with things that belong to previous generations but I think the memories it's not just about our individual parents I think there's something also broader about history about honoring how hard life was for previous generations about not having a romantic view of the past and that's an important aspect of the book for me because most of it takes place. in the 1950s, the post-war era, which some people tend to be nostalgic about. The cars were great, the dresses were great, the suits were great. But actually, it was a very hard time. Rationing stayed in place for many years after the war.

It was a time of prejudice. If you were a person of colour or gay or having an adulterous affair, life could be extremely difficult. Or a woman. Women were expected to give up work when they married and had children. and I think acknowledging how tough life was for previous generations, but yet how people could still triumph over that toughness is incredibly important. Your parents were born in, well, your mum definitely in the 30s.

In the 30s. And dad in the 20s, my age. Which I always think is fascinating. My parents would have been around the same age as yours as well, but that we have that connection to like 100 years ago, you know, a century way and the way of living. then. It's quite incredible to actually have that insight. And just coming to the woman part of it, when I talk about women's error, there was a line I wrote down because it stayed with me. I'll read it

in your words. What I understood instinctively throughout my childhood and adolescence and what women and girls have understood through history and across continents is that the price you pay for male protection is obedience. Yes. Can you expand on that for me? Yes. You know, our father was a very traditional husband and father. And obviously there was a great deal of good that came that way. He absolutely thought that masculinity was about marrying, fathering children and providing for them. He was a provider and a protector in a very traditional way and he was very good at it. But I think as a woman, even as a young woman, you cannot be unaware that the price you pay for that is a certain level of obedience. Our household did revolve around his needs.

And our mother was a very traditional housewife. Dad came first after that housework, the management of the house. And, you know, when people eulogise full-time mothers from the past, they were full-time wives and housekeepers before being full-time mothers. I mean, when we were small and mum was very open about this, you know, she would change our nappies, give us a bottle, then stick us in the garden with a cat net over the pram. That was a new word for me.

So the cat couldn't get into your pram? Absolutely. Did you not have catnets? They probably did, but I don't remember them. I mean, that was what you did. And if the baby screamed and screamed and screamed, mothers were told, well, it's good for the baby to get some air in their lungs. And mum got on with the housework, cleaned the skirting boards,

and our father came home at lunchtime every day from work and expected a cooked meal on the table the minute he got through the door. And that was the traditional housewife's role in many areas. of the country in many different classes for that generation of women. And I think remembering that is important. And that she was always, I suppose, put second. You know, you describe her so beautifully and paint this lovely picture of her that we get to know in various levels as we go through the book.

I just have to let people know that you describe your dad as the Errol Flynn of the East Midlands. He was, bless him. He was tall, mustachowed handsome and he could fence. Let us turn. So you have a brother and sister that you're going through with it as well

and you're very clear to say it in your words what was happening there, what they were thinking, etc. There was a great line I was reading as well what was it that

once a writer were you quoting some once a writer is in the family that's the end of the family or whatever. It's like all the secrets are out. But all the secrets

were actually in a black suitcase that you eventually managed to open and tell us a little about the treasure trove you found inside. Well, honestly, it sounds as if I've made it up as a novelist the way I discovered that, but I promise I haven't. We started clearing out mum's bedroom. There was this battered black suitcase at the bottom of her wardrobe.

There was some damp on the wall behind it. I tried to open it. The clasps were rusted shut. We started using one room as a kind of dumping ground for things that we would excavate at a later date. And it was actually on the last day that I was alone in the house Almost two years later, it was about to be sold finally And there were just these few boxes and things that we had to look at again Before we threw them out And had I been unable to open those clasps, I probably would have put that black suitcase

It was very battered and very dusty out by the bins But they flew open with this clunk And I lifted the lid and I thought this is just junk paper It was letterhead paper. It was letterhead paper from the engineering firm where our parents had met in the 1950s. And I turned it over and there was some rather awful, sorry, dad, rather awful poetry written in my father's hand in pencil. Which was a surprise and I gave a small disloyal chortle at that. And then there was a letter and it was a letter from our father to our mother ending their relationship.

And it was very, very poignant and beautifully written. a heartbroken and heartbreaking letter to read. And then I started turning over all the other bits of scrap paper. And there were scores of letters, which charted the entire history of their love affair, their secret love affair when they met. Mum was a teenage village lass and dad was 10 years older and, as it turned out, married to another woman.

I should probably say it was quite an exercise in literary criticism because there were no dates on any of the letters. So when I finally, at a much later date, got round to reading them all more thoroughly and spreading them out on the kitchen table, I had to try and put them in order from their contents. So there were references to Easter, an attempted Easter break. There were references to Christmas. And it took place over many years, this affair as well, because it took them years and years. It took my father years and years to get a divorce. And then suddenly I had this whole narrative on my.

hands written by my parents in their own words. And I do want to say that if this book is anything, it is something because of their words, not mine. I am no more than, if you like, the introduction to what they have written about themselves. You talk about, you know, they're telling about live in the 1950s, etc. But you are really interested in social mobility, which resonates so much as well today. There was a few lines you heard about specifically being a middle class girl slash woman coming from working class roots of parents that gave you a grittiness. You probably remember the words a little bit better than the way I'm saying it. I mean, I do acknowledge in the book.

I say maybe there's an argument for saying it's the most privileged upbringing of all. Correct. Because there was no serious hardship when we were growing up. You know, we didn't go hungry. I mean, the food was not exciting. It has to be said. But that, hey, that was the East Midlands of the 1970s. But yet, I think we grew up with a sense of being underdog.

within the privileged arena with which we were being raised and also constantly being told, you know, how hard life was, particularly by our father who was very keen that we should know what he had come from. And I think that slightly chippy sense of being an underdog, but without any real life. Without actually having to do the hard work of it. I'm so conscious of my own privileges now. And that's also part of the rationale behind wanting to write this book

is to acknowledge my own privileges, and particularly to capture that moment, as you say, of post-war social mobility in the 1950s, which we have to say has now gone. Our parents had left school at 13, 15, they raised their children, they got us all to university, and we were the first generation in either family, not just to go to university, but to even finish secondary education. You know, we were uniquely privileged,

and we could afford to buy our own homes when we were working growing up. That's simply not true for my children's generation. And I do hope, although this book is primarily a love story, that that's also the message behind it. Louise Doughty there, and her memoir is out now. That's it from me. Coming up on Bank Holiday Monday, Woman's Hour is exploring Women and Water. Nula talks to the writer and wild swimmer, Bridget Lowe,

about finding freedom in Scotland's locks, musician Tricia Duffy about water and creativity, and Seren Jones of the Black Swimming Association, who has a guide to enjoying the water safely. That's Monday on Woman's Hour. Enjoy the rest of your weekend. That's all for today's Woman's Hour. Join us again next time.

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