CERVICAL CANCER: EARLY DETECTION AND MODERN PREVENTION

Kamolabonu Rasuljon qizi Inomova

6th-year student, Faculty of General Medicine, Andijan State Medical Institute

ORCID: 0009-0005-4285-4578

ABSTRACT

Cervical cancer is one of the most common malignancies among women, and persistent infection with high-risk human papillomavirus (HPV) is the principal etiological factor in its development. A defining feature of the disease is that it is preceded by a precancerous stage, meaning that invasive cancer does not develop suddenly. Consequently, cervical cancer can be substantially prevented through HPV vaccination, screening, and timely treatment of precancerous lesions. This article reviews current epidemiological indicators of cervical cancer, the pathogenetic role of HPV infection, and the clinical significance of HPV vaccination, HPV-DNA-based screening, genotyping, and individual risk assessment. According to GLOBOCAN 2022, 662,301 new cases of cervical cancer and 348,874 deaths were recorded worldwide. A modern prevention strategy integrates HPV vaccination, high-performance screening, risk stratification of HPV-positive results, and timely treatment of detected precancerous changes into a single continuum of care. In conclusion, reducing the burden of cervical cancer requires strengthening an uninterrupted system of prevention and early diagnosis.

Keywords: cervical cancer, HPV, human papillomavirus, screening, HPV-DNA, vaccination, genotyping, CIN, precancerous lesions, gynecologic oncology.

INTRODUCTION

Cervical cancer remains one of the major medical and social problems affecting women’s health. According to the World Health Organization (WHO), approximately 660,000 women worldwide were diagnosed with cervical cancer in 2022, and nearly 350,000 women died of the disease. Cervical cancer is among the most common cancers in women, ranking fourth among female cancers worldwide according to the WHO [1,2].

According to the IARC Global Cancer Observatory, 662,301 new cases and 348,874 deaths from cervical cancer were recorded in 2022. The age-standardized incidence rate was 14.1 per 100,000 women, and the age-standardized mortality rate was 7.1 per 100,000 [3].

Nearly all cases of cervical cancer are associated with high-risk HPV infection. According to the WHO, approximately 99% of cervical cancer cases are linked to high-risk HPV [1].

An important feature of this disease is that precancerous changes develop in the cervical epithelium before an invasive tumor forms. Detecting and appropriately treating the disease at this stage can prevent progression to invasive cancer. HPV vaccination and screening are therefore the cornerstones of modern prevention.

The aim of this review is to analyze current approaches to the prevention and early detection of cervical cancer, in particular HPV vaccination, HPV-DNA-based screening, and individual risk assessment through HPV genotyping.

MATERIALS AND METHODS

This article was prepared as a narrative scientific review. WHO and IARC documents, together with contemporary scientific literature on cervical cancer epidemiology, HPV infection, vaccination, screening, and HPV genotyping, were analyzed.

Primary attention was given to international clinical recommendations, epidemiological data, and recent meta-analyses. Epidemiological indicators were assessed using GLOBOCAN 2022 data, while screening and HPV genotyping recommendations were evaluated against current WHO guidance documents [3–6].

RESULTS AND DISCUSSION

The role of HPV infection in cervical cancer

HPV is a widespread group of viruses, certain genotypes of which carry high oncogenic risk. HPV-16 and HPV-18 in particular are strongly associated with cervical cancer [1,2].

HPV infection does not always lead to cancer. Most infections are controlled by the immune system and resolve spontaneously. However, if high-risk HPV infection persists, cervical intraepithelial neoplasia may develop [1].

This pathological process can be summarized schematically as follows:

High-risk HPV infection → persistent infection → cervical intraepithelial neoplasia (CIN) → high-grade precancerous changes → invasive cancer.

Table 1. Key epidemiological indicators of cervical cancer, 2022

Indicator	Value
New cases	662,301
Deaths	348,874
Age-standardized incidence rate	14.1 per 100,000
Age-standardized mortality rate	7.1 per 100,000

Source: IARC Global Cancer Observatory, GLOBOCAN 2022 [3].

HPV vaccination

HPV vaccination is one of the most important tools of primary prevention for cervical cancer. The WHO identifies girls aged 9–14 as the primary target group for HPV vaccination. Vaccination before HPV exposure provides the greatest preventive benefit [4].

A large cohort study demonstrating the clinical effectiveness of HPV vaccination followed 1,672,983 girls and women aged 10–30 years in Sweden. The study found that HPV vaccination was associated with a significant reduction in the risk of invasive cervical cancer, with the protective effect being greatest among those vaccinated before age 17 [5].

However, HPV vaccination does not eliminate the need for screening. Screening in accordance with national recommendations must continue even after vaccination.

HPV-based screening

For many years, the Pap test was the principal cytological screening method for the prevention of cervical cancer. High-risk HPV-DNA testing has since become a major primary screening method owing to its high sensitivity.

The WHO recommends HPV-DNA-based testing as the preferred method for primary cervical cancer screening. The starting age and screening interval depend on the national program; the WHO’s 2021 recommendations describe strategies using HPV-DNA testing from age 30, with a 5–10-year interval [6].

A systematic review and meta-analysis published in 2026 analyzed data from 8 studies involving 414,846 participants. HPV-based screening detected CIN2+ lesions at a 61% higher rate than cytology (RR 1.61; 95% CI 1.30–1.98). The authors emphasized the need for risk stratification to appropriately manage HPV-positive patients and to avoid overdiagnosis and overtreatment [7].

Table 2. Comparison of cervical cancer screening methods

Method	What it detects	Advantage	Limitation
Pap test	Cytological changes	Extensive clinical experience	Potential for subjective interpretation
HPV-DNA test	High-risk HPV	High sensitivity	A positive result does not indicate cancer is present
HPV genotyping	Specific HPV genotypes	Individual risk assessment	Requires specialized laboratory capacity
Self-sampling	HPV	Can expand screening coverage	Requires follow-up after a positive result

HPV genotyping and individual risk assessment

Modern screening strategy is not limited to determining whether HPV is present. Equally important is assessing, among HPV-positive women, the risk of developing clinically significant precancerous changes.

On 8 May 2026, the WHO issued an updated guideline on HPV-DNA genotyping. It describes three approaches to HPV genotyping — no genotyping, partial genotyping, and extended genotyping — and their role in risk stratification and molecular triage [8].

This approach can be represented through the following algorithm:

HPV-DNA test → genotyping → risk stratification → triage → colposcopy/biopsy → treatment or follow-up.

The purpose of this strategy is not to examine all HPV-positive women with the same intensity, but to more rapidly identify clinically high-risk groups and provide them with priority diagnostic and treatment support.

The WHO’s 2026 recommendations note that the choice of genotyping strategy must take into account laboratory capacity, availability of follow-up and treatment services, and the resources and capabilities of the health system [8].

The WHO 90–70–90 strategy

To eliminate cervical cancer as a public health problem, the WHO has established the 90–70–90 global targets [9].

Table 3. WHO 90–70–90 global targets

Domain	Target
HPV vaccination	≥90% of girls fully vaccinated by age 15
Screening	≥70% of women screened with a high-performance test by ages 35 and 45
Treatment	≥90% of women with identified cervical disease appropriately managed

The essence of this strategy is to unite all stages of prevention into a single system: strengthening primary prevention through HPV vaccination, detecting precancerous changes through high-performance screening, and providing timely treatment of identified disease.

The WHO has defined the elimination threshold for cervical cancer as fewer than 4 new cases per 100,000 women per year [9].

Self-sampling and digital technologies

HPV self-sampling — in which a woman collects her own specimen for HPV testing — can expand access to screening services. This approach may be particularly important for women with limited access to healthcare or those who are less engaged with conventional screening.

However, the effectiveness of self-sampling is not determined by specimen collection alone. Triage, colposcopy, and appropriate treatment must also be available following a positive HPV result.

Digital medicine and artificial intelligence are also promising directions in gynecologic oncology. They may be used to analyze colposcopic images, digitize cytological material, monitor patients, and support clinical decision-making. However, before such technologies are introduced into clinical practice, their diagnostic accuracy, validation across diverse populations, and patient data privacy must be evaluated.

PRACTICAL RELEVANCE FOR UZBEKISTAN

International strategies for the prevention of cervical cancer are also of practical relevance to the healthcare system of Uzbekistan.

To improve the effectiveness of prevention, it is important to engage women in screening at the primary healthcare level, raise public health literacy regarding HPV and its prevention, refer patients with positive results to further diagnostic stages, and build an uninterrupted system through to treatment.

Family physicians can play an important role at the primary healthcare level in identifying at-risk groups, referring patients for screening, and ensuring follow-up of patients with positive screening results.

At the same time, in improving screening programs in Uzbekistan, it is important to adapt international recommendations to the local epidemiological situation, laboratory capacity, medical infrastructure, and available resources.

CONCLUSION

Cervical cancer is one of the oncological diseases with the greatest potential for prevention. Persistent high-risk HPV infection is the principal etiological factor in its development, a feature that makes it possible to control the disease through primary and secondary prevention.

HPV vaccination is a key component of primary prevention, while HPV-DNA-based screening is a key component of secondary prevention. Modern HPV genotyping technologies make it possible to stratify HPV-positive women by individual risk level and to improve clinical management.

An effective prevention system should be built on the following sequence:

HPV vaccination → HPV-DNA-based screening → risk stratification → triage → colposcopy and biopsy where indicated → treatment of precancerous lesions → follow-up.

Thus, integrating prevention, early detection, and individualized risk-based clinical management into a single system remains one of the most promising strategies for reducing the global burden of cervical cancer.

REFERENCES

1. World Health Organization. Cervical cancer [Internet]. Geneva: World Health Organization; 2026 [cited 2026 Sep 14].

2. World Health Organization. Human papillomavirus and cancer [Internet]. Geneva: World Health Organization; 2024 [cited 2026 Sep 14].

3. International Agency for Research on Cancer. Global Cancer Observatory: Cancer Today. Cervix uteri. Lyon: IARC; 2024.

4. World Health Organization. Human papillomavirus vaccines: WHO position paper, December 2022. Wkly Epidemiol Rec. 2022;97(50):645-672.

5. Lei J, Ploner A, Elfström KM, Wang J, Roth A, Fang F, et al. HPV vaccination and the risk of invasive cervical cancer. N Engl J Med. 2020;383(14):1340-1348. doi:10.1056/NEJMoa1917338.

6. World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention. 2nd ed. Geneva: World Health Organization; 2021.

7. da Rocha KC, Castanha EB, Elias MEM, da Silva CML. Human papillomavirus-based vs. cytology for cervical cancer screening: a systematic review with meta-analysis. Rev Bras Ginecol Obstet. 2026;48:e-rbgo130. doi:10.61622/rbgo/2026rbgo130.

8. World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention: use of human papillomavirus (HPV) DNA genotyping. Geneva: World Health Organization; 2026.

9. World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: World Health Organization; 2020.

10. Ronco G, Dillner J, Elfström KM, Tunesi S, Snijders PJF, Arbyn M, et al. Efficacy of HPV-based screening for preventing invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet. 2014;383(9916):524-532.

11. Sankaranarayanan R, Nene BM, Shastri SS, Jayant K, Muwonge R, Budukh AM, et al. HPV screening for cervical cancer in rural India. N Engl J Med. 2009;360(14):1385-1394.

12. Joura EA, Giuliano AR, Iversen OE, Bouchard C, Mao C, Mehlsen J, et al. A 9-valent HPV vaccine against infection and intraepithelial neoplasia in women. N Engl J Med. 2015;372(8):711-723.

13. Mayrand MH, Duarte-Franco E, Rodrigues I, Walter SD, Hanley J, Ferenczy A, et al. Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer. N Engl J Med. 2007;357(16):1579-1588.

14. World Health Organization. Evidence-informed guidance for the implementation of HPV-based cervical cancer screening programmes. Geneva: World Health Organization; 2026.

Our regular contributor Rui Carvalho invites readers and contributors to submit poetry to the next annual Nature Writing Contest.

Our contest, Nature 2025-2026, is a new opportunity that we, as organizers, create to reach the rest of the world. Every Contest is a challenge for authors participating and to people that make it happen. This year we invite all authors to write poetry about:
(i) Flowers;
(ii) Trees and wind;
(iii) Water;
(iv) Nature Conservation;
(v) Turtles;
(vi) Love for people and nature;
(vii) Hope and Happiness.

Rules and submission information here.

Also, one of our regular contributors, Jaylan Salah, whom I’ve known for nearly 20 years, is an Egyptian national and a feminist film critic in the Arab world. She’s spoken virtually on panels at professional conferences and has a few books of poetry published.

Her father, who has been a consistent and encouraging presence in her life, has heart disease and needs a lifesaving bypass surgery. In Egypt people can get this done for $3,500 USD even without insurance, so she’s put together a GoFundMe to raise this. She’d appreciate any contributions or people resharing the fundraiser.

Fundraiser by Shadan Larki : Help My Father Receive Life-Saving Open-Heart Surgery

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The Wildness of Being: Voices Against the Beige World

Across these pages runs a stubborn, beautiful refusal to become beige. The writers and artists gathered here confront conformity, grief, displacement, history, education, love, work, politics, memory, and the natural world, yet again and again they discover that the deepest form of resistance is simply to remain fully alive. The Wildness of Being is their shared territory: a place where imagination challenges obedience, memory challenges erasure, and tenderness survives even when the world seems determined to make tenderness impossible.

Olive Springman opens this territory with a determination to remain rooted while staying militantly imaginative in a world demanding conformity, beige normalcy, and patriotic duplication. Her stance establishes the collection’s essential tension: belonging need not mean surrendering individuality. That tension extends into Suleiman Mansir Gado’s essay, which applies Jean Piaget’s theory of childhood development to practical observations of children, reminding us that human beings begin life as curious interpreters of their surroundings and that education must respect that developing intelligence.

Dr. Jernail Singh Anand carries the educational question further. In his reflections on improving education, he asks how schools can encourage original thought rather than manufacture students like products on a factory line. Sobirova Husniyabonu Axrorjon qizi similarly outlines effective pedagogical techniques for foreign-language learning, while Iroda Sobirova considers human capital and its relationship to broader economic growth. Together, these contributions suggest that education is not merely an economic instrument or a mechanism for producing conformity; at its best, it is an investment in human possibility.

That possibility also appears in the work of young professionals defining themselves through their own emerging identities. Alamgir Hossain Raj presents a self-portrait as an emerging Bangladeshi journalist, musician, and digital content creator, while Shinha Sarder offers a profile of himself as an aspiring Bangladeshi musician and entrepreneur. Kamolabonu Inomova presents her research as an emerging medical scientist on the use of artificial intelligence in the diagnosis of stroke. Their portraits capture lives still being assembled—careers, ambitions, identities, and futures that resist the idea that a person must fit neatly into one predetermined role.

Dr. Jernail Singh’s career journey, discussed in his interview with writer Rupa Rao, reinforces this spirit. He argues that there is no secret formula for success, only honest work, dedication, and creativity. Alan Catlin offers a grittier version of the same struggle: his poetic speaker is worn down by grunt work but cannot quit, partly because he needs the money and partly because continuing to work is proof that he still exists. Between Anand’s faith in purposeful labor and Catlin’s exhausted persistence lies a fundamental question: how do we preserve a sense of self inside systems that can make people feel interchangeable?

For some contributors, authenticity is inseparable from resistance. Bill Tope’s short story imagines love and the courage to be one’s true self transcending age, gender, and even conventional definitions of what it means to be human. Young-eun Kang’s pieces explore the complexity of personhood and the many facets we contain and radiate to our worlds. Christopher Bernard’s latest installment of Otherwise explores choice under impossible conditions and the struggle to keep the idea of alternatives to oppressive regimes alive. Stephen Betts’ ekphrastic poems continue Marcel Duchamp’s wit and playful satire through another medium. Ismatullayeva Maxliyo discusses a study looking into a protocol weaning toddlers off of excessive screen use and helping them learn to think for themselves and engage with others. Yaqubjonova Madinabonu To’lqinbek qizi urges us to moderate our screen time and maintain our attention by reading paper books. Bobomurodova Gulzina Fazliddin qizi discusses how, while social media and artificial intelligence may be useful tools, we should not let them replace our humanity. These pieces insist that freedom begins in imagination—the ability to conceive that another way of living might exist.

Duane Vorhees discovers a similar freedom in the ordinary, suggesting that the fantastical may be present directly inside mundane life if we learn to look at familiar things with a slant. Mark Young takes that principle onto the page, playing with maps and opening new possibilities through text, line, and color. Adam Fieled’s prose poems turn toward the complicated lives and roles of creative artists, examining what it means to make art while inhabiting the many identities, expectations, and pressures attached to being an artist. Together, these works turn perception itself into an act of rebellion.

Jerome Berglund takes a darker route. His dense, free-associative poems weave images of conspiracy and corruption into a critique of society’s normalization of evil. Adjekpagbon Blessed Mudiaga, meanwhile, speaks truth and vision from within the specific realities, struggles, and beauty of his own time and place. J.J. Campbell writes from a specific posture: middle-aged, weathered, romantic under a crust of cynicism, aware of death’s proximity. Ahmed Miqdad mourns the ongoing violence in Gaza. These works demonstrate that resistance need not have a single voice or aesthetic. It may emerge as surrealism, social criticism, local testimony, fragmented association, or uncompromising witness.

History becomes another battleground against erasure. Charos Ismoilova honors the strength and perseverance of her Uzbek homeland across 35 years of modern-day independence. Shokhida Nazirova’s essay declares that Uzbekistan’s reforms have succeeded in creating a generation that is educated, globally confident, and deeply patriotic, while Sabrina Ravshanova encourages modern Uzbek youth not to become obsessed with the vapid aspects of global consumer culture but instead to live up to the dreams of their ancestors. Zarnigor Salayeva Bekmamad qizi stresses the importance of preserving the ancient Uzbek fortress and city of Katkala. Eshniyozova Sevinch Jumanazar qizi discusses how to understand various cultures’ contributions to syncretic literature, teasing out the long and varied cultural history that has inspired many works. These contributions place modern identity in conversation with history, asking how a culture can enter the future without abandoning the memory that made the future possible.

Shokhida Nazirova’s gratitude for her mother’s consistent care and Berdinazarova Jasmina Mirshod qizi’s celebration of her mother’s steady, devoted love bring history down to the intimate scale of family. Their tributes are echoed by To‘raqulova Dilso‘z Anvar qizi, who resolves to mourn the loss of love while continuing to live, and by Yongbo Ma, whose poems ask how one lives after love ends: by memorializing, ritualizing, and honoring what has been lost.

Love throughout these pages is rarely simple. John Dorsey’s poetry traces the tender outlines of romantic longing and unrequited love. Perwaiz Shaharyar mourns a dead love while remaining suspended in grief and still wondering whether a future might be possible. Mykyta Ryzhykh presents love as a slow, beautiful, ultimately fatal suffocation. Faleeha Hassan’s poem, translated into English by Hussein Nasser Jabr and Raida Jarjes’ essay on Geoffrey Chaucer’s The Knight’s Tale embrace love in all its contradictions: whatever human beings make of it, whether exalted or ridiculous, sacred or sweaty. These writers refuse the polished mythology of romance and instead explore its tenderness, absurdity, danger, persistence, and aftermath.

Randi Rohde approaches love through an especially painful maternal memory. She reflects on the baby teeth of her child that she saved but never shared, realizing that what was intended as a treasured relic of childhood innocence would have been cruelly overshadowed by the adult teeth violently taken by cancer treatment. The keepsake becomes a meditation on how memory can preserve both love and unbearable pain.

Other contributors examine suffering without allowing it to have the final word. Steven Croft’s literary review of William Walsh’s Haircuts for the Dead describes a protagonist who confronts trauma but refuses to let trauma define her. Jacques Fleury’s “Hills and Valleys” follows a painful yet transformative inner journey through life’s external hardships and internal contradictions toward the discovery and embrace of an authentic self. Claire Photini Karamouzis Chalkias meditates on living with depression as a continual balancing act between despair and defiance, frozen numbness and the dangerous courage of confronting what lies beneath. Philip Butera’s poem is a sustained meditation on existential acedia: the specific kind of sadness that doesn’t come from any single loss but from the gap between what life promises and what living delivers. Isaac Dominion Aju speaks to the responsibility and ability of writers and artists to empathize with, hold, and transmute pain. Nedaa Al-Durubi’s two poems trace an equally painful arc, from a young soul wishing for death rather than endurance to one who has fought countless battles and still wonders whether anything has truly changed.

Yet survival repeatedly becomes a form of creation. Eva Petropoulou Lianou’s poetic cycle moves from disillusionment toward faith in the resilience of the human spirit. Abigail George transforms continual unfulfilled cravings into a guide and a path for helping others. Kushi Nanayakkara insists that peace is not merely the exhaustion of angry words or the emptying of bullets but an active choice that must be planned, written, and released into the world. Thi Lan Anh Tran and Musharraf Hussain make that commitment collective, offering a unified call for the world to choose and learn peace. Stephen Jarrell Williams’ poetry shows the Earth itself healing after a human-caused apocalypse, coming back not exactly as before but something new and different. Mahbub Alam’s piece laments a homeland remembered as beautiful but irrecoverably lost.

Bahtiyar Hidayet’s dark humor provides a devastating counterpoint, showing how, for many displaced and impoverished refugees, happiness can seem possible only in death. His poem exposes the terrible distance between abstract ideals of happiness and the realities of people denied security, home, and dignity. Joshua W. J. Brown similarly turns memory into a form of mourning in his elegy for the burning of Zanzibar Tavern, the historic Toronto strip club at 359 Yonge Street. For him, the fire destroyed more than a building: it erased a working-class, unpolished piece of the city’s memory, a place that had housed decades of lives, labor, loneliness, and desire atop an old morgue. Both works ask what happens when places and people deemed marginal are allowed to disappear without witnesses.

Ri Hossain’s satire attacks another form of social disappearance: the male intellectual who imagines himself exceptionally important while objectifying women and his poetic subjects and fearing humility and genuine intimacy. Anna Zanidaki’s poem explores the ethics of seeing, and the refusal to be seen on any terms but one’s own. Saeed Koushan confronts the inculcation of shame in children for natural joy and exploration. In different registers, both writers challenge systems that teach people to distrust their own humanity.

The natural world offers an alternative vocabulary. Dr. Muhammad Ishaq Abbasi, in a piece translated from Urdu by Neelum Waqar, paints a quiet summer evening in which the speaker climbs a hill, eats wild jambolan fruits, watches monkeys and a peacock, hears a cuckoo, and feels a light rain. Brian Barbeito finds joy in ordinary days in his garden among deer, cardinals, raccoons, basil, and raspberries. Christina Chin’s haibun celebrates a moment of pure, adorable happiness with a soft puppy. Jerrice Baptiste’s art blossoms into another colorful, joyful flower.

Ravshanova Shakhina Rustamovna celebrates Uzbekistan’s seasons and changing weather. Egor Cherkasov reflects on how meteorologist Luke Howard’s naming and categorizing ethereal clouds opens the door for a quieter kind of reverence — the little god of an afternoon, a birdhouse, a piece of bread, a truth that fits in your palm. In poet Alan Patrick Traynor’s new release The Silence of the Desert, the quiet of the Sahara and the Atlas Mountains becomes not an absence but a place for listening, the space between notes where love and truth become audible. Ali Hasnain echoes this theme with his short story where a speaker rediscovers the value of seemingly “unproductive” moments. Ike Boat celebrates the work and seeks partners for a youth outdoor soccer program in Ghana. These works remind us that wonder need not be spectacular. Sometimes resistance to despair begins with noticing what is alive.

Yeon Myung-Ji gives that natural resilience a more precarious form: cows and sheep huddle together, creatures confronting indifference and uncertainty with something resembling grace. Sayani Mukherjee likewise turns toward the earth, finding solace not as an escape from ruin but as an active contrast to it—something that lives and sings despite destruction.

Sheila Murphy’s poetic response to David Chorlton’s painting occupies a quieter border between nature and consciousness. The painting offers a serene, painterly landscape populated by birds, a mountain, a palm, a hawk, a pear, and a pitcher, while gently wondering whether this stillness possesses its own interior life at night. Against that imagined wholeness stands the speaker’s fractured, restless inner world. The landscape becomes a mirror: apparently still outside, tumultuous within.

Patrick Sweeney’s monostich poems create another kind of landscape. Taken together, they seem to form a lyric sequence or poem in fragments, circling transience, inheritance, and the collision between the natural world and human-made structures of meaning. Mark Young’s maps, meanwhile, transform geography into possibility. Both poets show that landscape is never merely scenery. It is memory, structure, history, inheritance, and imagination.

Susie Gharib expands the sense of loss into an encompassing elegy. Her poetry collection reads as one multilayered lament for a world losing its substance to surveillance, noise, and decay. Against this erosion, the collection repeatedly proposes acts of attention: remembering, observing, imagining, preserving, creating, loving, and refusing to accept the given world as the only possible world.

Even humor becomes part of that resistance. Noah Berlatsky lightens the atmosphere with a brief, amusing observation about perennial skin problems, while Duane Vorhees finds the fantastic lurking in everyday existence. Humor does not cancel suffering; rather, it gives the imagination room to breathe inside it.

The same mixture of gravity and play appears in Mesfakus Salahin’s portrait of the human mind, whose stubbornness can be simultaneously heroic and tragic. We cling to beliefs because persistence can help us survive, yet that same persistence can prevent transformation. This paradox runs throughout the collection. To remain rooted can be courageous, but roots can also become chains. To preserve memory can honor the past, but memory can also imprison us. To mourn can be necessary, but mourning must sometimes become the road back into life.

That is why To‘raqulova Dilso‘z Anvar qizi’s resolve to mourn and continue living matters so deeply beside Yongbo Ma’s rituals of remembrance. Grief does not require forgetting. It requires learning how to carry what cannot be changed. Faleeha Hassan’s expansive vision of love, John Dorsey’s longing, Perwaiz Shaharyar’s suspended grief, and Mykyta Ryzhykh’s suffocating romance all become variations on the same question: what do we do with what has transformed us?

The collection’s answer is not uniform, but it is persistent: we make something from it.

We teach. We write. We paint. We remember. We preserve old cities. We profile ourselves into existence. We question oppressive systems. We challenge shame. We garden. We listen to birds. We laugh about our skin. We honor mothers. We mourn lost children and lost lovers. We imagine alternatives. We choose peace. We keep creating.

Olive Springman’s determination to stay imaginatively rooted therefore becomes an apt emblem for the entire gathering. These contributors do not deny the pressures of conformity, grief, violence, economic hardship, displacement, decay, or historical erasure. Instead, they answer those pressures with multiplicity.

Their worlds contain Piaget and Katkala, mothers and refugees, maps and mountains, musicians and journalists, factory-like classrooms and stubborn brains, baby teeth and adult wounds, puppies and sheep, gardens and strip clubs, dead lovers and living possibilities. They contain ethereal melodies and guttural growls, as Alex S. Johnson’s interview with musician Leila Abdul-Rauf makes especially vivid: her music enacts an internal conflict between ethereal melody and guttural growl, between psychoanalytic self-examination and geopolitical rage. That contradiction is not a flaw. It is the sound of a complex human being refusing to simplify herself for anyone.

In the end, The Wildness of Being is not about escaping the world. It is about looking at the world more intensely and refusing to accept its first definition of us. The fantastical may hide inside the mundane. Peace may begin as a sentence. A map may become an opening. A garden may become a sanctuary. A ruined building may become a memory. A mother’s care may become an inheritance. A dead love may become a ritual. A painful past may become a source of compassion. A classroom may become a place where original minds are liberated rather than standardized.

And a world determined to make us beige may discover, despite itself, that we remain gloriously, stubbornly, irreducibly alive.

The Eternal Question

Bug bite

or zit?

Adam Fieled/for Synchronized Chaos

From This Charming Lab (reading), Kelly Writers House, West Philadelphia, March 27, 2004

Stoning the Devil

In Baudelaire’s famous prose poem, The Generous Gambler, we follow the narrator, ostensibly Charlie B. himself, as he encounters a mysterious stranger on a Parisian boulevard. The stranger, lo and behold, turns out to be Lucifer himself. Baudelaire depicts him as a man of wealth and taste, who has, indeed, been around for many a long year, and stolen many a man’s soul and faith. Of course, Baudelaire follows him. They get regally smashed, and the Devil reveals to him the secrets of the universe. For Baudelaire, stoning the devil means getting him stoned, wooing him, bringing him into the human fold for a little Dionysian sport. The problem with the Baudelairian method of Satan-handling is that you lose your soul. The Devil corrupts you to the point that right and wrong have no meaning; irony enters the blood and chills it; paradox becomes poison; everybody looks like a leper; and you can’t feel anything. It helps to remember our good old read-it-in-seventh-grade friend Young Goodman Brown. His encounter with Beelzebub leaves him embittered, disenchanted, but at least he still has a soul (or, as much of a soul as a tee-totaling Puritan can have). Young Goodman Brown stones the devil by rejecting him out of hand. Stoning here means throwing stones: even if it be from the glass house of mortal ignorance.

So, somewhere between the Baudelairian and Hawthornian models of Lucifer-human relations, we may find an ideal solution. We can lure the Devil into drunkenness and then bash him over the head with a rock, or we can bash him over the head with a rock and then slip him a joint to ease the pain (mostly our pain, of course). The Devil, the epitome of imperviousness, will go on being the great professional Ironist he is (a bit like Frank Zappa). The reward of this balanced approach for us, as writers, is that we can lure the Devil close to us, just close enough to learn some of his simpler tricks, then send him on his way when he starts demanding blood. Muslims the world over “stone the Devil,” but I fear their ritual lacks a certain subtlety and understanding of Satanic grandeur- how it can be harnessed, refined, made to serve human ends. The Devil, more than any other Being, understands the complexity of existence. I would guess that things are as complicated in Hell as they are here. In the end, what is art but a testament to the complexity of life: manifold levels and layers, perpetually enclosing us in a wide web. One could make the argument that art is essentially ironic, in the sense that it posits unreachable worlds that we long for, but cannot touch. We must face it: art is a Devil’s game. We’re here to play, and we guarantee you it will be more fun than Yahtzee.

Dominique

So many stories are wrapped up in this next poem, some hilarious, some harrowing. It all revolves around a single woman and her phenomenal ability to enthrall men. Her name was, and is, Dominique, and I’ve never met anyone like her. When I met her, I was a high school junior and she was a freshman. She was stunningly beautiful, with a seductive, feline grace that suggested both Lolita and Liv Tyler. This alone wouldn’t qualify her to play such an interesting part in my life and the lives of those around me; there were a lot of beautiful girls at Cheltenham; but Dominique had something more. What do we call that ineffable IT, that compelling magnetism that certain people have? Is it merely beauty, or charisma, or youth? For me, Dominique’s charm lay in all these things, and also in something extra— a certain mischievous glint in her eye, a certain toss of her head, that suggested a sort of supernatural ecstasy, as if she were walking around in a narcotic trance all the time (which, I was later to learn, she was). Dominique was, quite simply, the most compelling female I’d met up to that point. Oddly enough, I didn’t fall hard for her at all. I was able to keep my distance because, to a certain extent, I saw a hollowness beneath the charisma, an unwillingness to dig beneath surfaces and live truly. Dominique for me was a sort of caricature of adolescent sexiness, and I loved her archly condescending smile, but it didn’t pierce me to the bone.

My best friend at the time, however, was absolutely, unbelievably, and pitifully smitten. He hung on her every word as though she was Godhead incarnate, recorded every encounter in an especially prized notebook, and just basically made an idiot of himself whenever she was around. Then, Dominique started dating another one of my friends, simultaneously making me her “Man of the Month,” and things started to get really messy. A fist fight for me outside math class; a death threat; notes for me in the mail inscribed with lipstick, reading “He finds a deep satisfaction in pain; for that pain comes from her”; and other such nonsense. Basically Chris, aka Mr. Smitten, never forgave me for going after Dominique when he was so desperately in love, while Adam, Mr. Better-Attack-Me-Outside-Math-Class, became contrite years later and started randomly showing up at my gigs, camera in hand. 

Having given you this background, you’ll probably understand why running into Dominique on a sultry night in the East Village was such a big deal for me. I was lonely as hell in New York, overwhelmed, numbing myself with huge quantities of pot and speed pills. Dominique, for all her cattiness, rose to the occasion and delivered a knock-out performance as supportive friend with benefits. Unsurprisingly, she supported her academic career at NYU by dealing drugs, and I thought it would be fair game to throw that in, seeing as it was honest. Formally, this piece is me trying my best to write like Keats, sort of the same thing William Carlos Williams was doing in his early twenties. For me, WCW’s Keatsian poems aren’t that good, probably because he didn’t know Dominique. She’s a Muse— a real, honest-to-God morsel of madness. Not that I’ve ever forgotten her implacable selfishness, remorseless narcissism and insufferable insularity; but it pays to remember what’s best in her. 

Adam Fieled is a writer based in Philadelphia. His books include Equations, Beams, Apparition Poems, Opera Bufa, and Cheltenham. Manuscripts-in-progress include Something Solid and Curiosities.  

FANTASTIC MUNDANITIES 

Dawn is the prelude  

to the opera called Sunset,

with movements and motifs between. 

And we audience 

intent upon every set, 

witness the progress of each scene, 

the sky’s chorus, 

clouds of sopranos, 

sun’s tenor, 

Picador piccolos 

incite the arena, 

the crowd, the bull, 

and the matador 

towards the scarletted bull fight 

that will climax the day’s events. 

There will be bravery 

on full display, 

and doomed passions 

of hope and faith and death, 

fate and undying love. 

We believe the dramatic fantasies that we see 

mirror our own realities. 

LOVE’S LOVING PARTS 

I eyed your eye, I smelled your smile, 

and I knew you’d be my New. 

My Former (that former of technique) 

had just passed into the past,

but I recalled what she called “love’s loving parts.” 

Our fingers feel and our feelings expand. 

Our hands in hands handed us the signal, 

fingers on arms rearmed my advance. 

Your skin was like felt as I felt your Every. 

Then we undressed to address our opened desires. 

In the design of the phallus a size fallacy 

is sometimes alleged, but it fits where most fit: 

We prove it as we apply love’s loving parts. 

From these shadows you’ll shadow me some tomorrow 

though absent as the scent of your here-and-there hairs, 

but in this happy present you’re my present  

with love’s loving parts.  

THE LUNAR DIET 

On late nights you’ve seen that Diana chick 

and you’ve heard her weightloss achtick. 

”In one month all your bulk will be gone,” 

But of course it’s all a con. 

Although her so-called Diet of the Moon 

with its traces of selenium and witchesbroom 

will indeed disappear your unwanted shape 

and you’ll vanish all your extra weight, 

but it will all come back again, 

your loss will become your gain 

and all too soon 

you’ll mushroom, you’ll boomerang, you’ll balloon. 

COLLIDOSCOPE

Angry dark air, pinkandoranging outside, banners in on HEADLINES of tragedy-war-genocide.

In Arthur MacArthur’s granite shade (his slow gray empire sword picketed by peacenik pigeons)

old plaid men playchessplaychessplaychessplaychess for their lives. Stability checks liberty bleeding,

Justice dies en passant.

And HEADLINE’s black arts wrestle my gentled soul to earth. But then enter golden wonder sun’s Blue Commandos, infiltrating the park even as new mozzarella tourists wander cluelessly in. 

And teeter-totter boombox juniors skitter zigzag

across old decorums, untutored yet in the

long division between war games and their play (these innocent! Alien alike to criticism and discipline).

And improvised ivory and emerald and ruby

and amethyst and sapphire devices

explode explode along the green, and  

HEADLINE, distracted, loses its hold. O, inconsolable

Morning: captured by its own good looks.

LOCKS & BOXES

Accords between meek aand might are accordions

compressed and stretched, stung and tortured between locks and boxes:

to manufacture the din sequence,

bands stumble past breaks and lost jams.

Women are not alone in reading the omen,

watching World serally unfold as locks and boxes.

And so it goes with the Innocent,

who humbly pray, “Break the logjam.” 

…

MOTHERLAND

MY MOTHERLAND IS UZBEKISTAN

THE PEOPLE ARE FRIENDLY

I CAN WRITE POEMS  

ABOUT MY COUNTRY

O MY DEAR COUNTRY

I SING FOR YOU 

FOREVER KIND 

FOREVER TRUE

SEASONS

THERE ARE FOUR SEASONS IN A YEAR

SPRING SUMMER AUTUMN AND WINTER

THERE ARE DIFFERENT WEATHER 

WARM    HOT   COOL  AND  COLD

IN THE WINTER THE RIVERS ARE FREEZED

 IN AUTUMN OFTEN RAINS

 BUT SUMMER IS SUNNY AND

SPRING IS VERY NICE.

RAIN

PITTER PATTER LITTLE RAIN

FILLED OUR HEARTS WITH  ENJOY AGAIN

SUMMER RAIN OUR CHEERFUL FRIEND

CAME SO FAST THEN REACHED ITS END 

ON A HOT AND SUNNY DAYS

COOL FRESH AIR CHASED HEAT AWAY

DARK CLOUDS GATHERED IN THE SKY

BRINGING SMILES TO EVERY EYE.

Ravshanova Shahina Rustamovna was born on January 28, 2016 in a family of entrepreneurs. From the age of 4 to 5, she has started easily read books in Creole and Latin. She has read more than 30 epics, short stories, novels and favourite work is the novel “The land of sweet melons” by Khudoyberdi Tokhtaboyev. Jonathan Swift’s  “Gulliver’s Adventures”. She finished reading four epics while she was in kindergarten. Her interest in poetry began at the age of seven. In the first grade, her poems began to be published in the newspapers “Haqiqat “of the Khojaabad district. Her first book of poetry is a book of poetry called “Khakim buvamga salom”. The regional governor, taking into account her wishes, presented Shahina with a library at a meeting of regional governors and talented young readers. In addition, she showed great dedication in publishing her poetry book. She also presented a computer.

For an 8 years old girl, such confidence opened the way to great opportunities. More than 100 students are improving their knowledge in the library, Shahina was able to gather her friends. Articles were written about Shahina. She was shown as an example to many. All this was a reward for her bookishness and her sense of responsibility. At the age of 9, Nur founded the Nur Charity Foundation. Together with her friends. Currently, she is sharing love and affection with children and the elderly from the charity foundation. At the age of 10, she was one of the first to be accepted into the youth club of the Republican Library Foundation and began working as the youngest volunteer. In March of this year, at a meeting with the Minister of Education, she managed to share her knowledge with everyone and gave them a tablet and collection of books to Alisher Sadullayev, and , expressing her gratitude, helped Shahina open a club called “ Avlodlar dovoni”.

Currently, together with 30 club members, she is organizing sherkhanlik evenings and reading books evening. At a meeting with the presidential advisor, she was appointed a member of the Writers’ Union of Uzbekistan. Currently, she is a member of the Writers’ Union of Uzbekistan. She is doing a lot of work as a youth spiritual promoter. She attends the English language club at the Arizone educational center in the district. She continues her creativity in English as well. She has started her work titled Kadam, which will be presented in March next year, in order to try her hand at writing. She was recently awarded the badge of the New Creators of Uzbekistan.

Solace

The sun is dappling my skin

It hastened and the stream flowed

My dreamscape a new reverie

Reverse all the wrongdoing

The earth needs more solace

My happenings are coded

Angels are with my beloved

My forever symphonic silence

A dilemma is known to the world

It harbours a new silence

The fate is singing to me.