Geographies of Breast Cancer: Awareness and Advocacy in South Asia

 A recent op-ed written by famous actress Angeline Jolie about her decision to undergo a double mastectomy to prevent a future likelihood of breast cancer has generated discussion about all aspects of Breast cancer.  At one hand, it celebrates another milestone that science has achieved while at the other, it showcases the amount of resources a rich Western woman has at her disposal, to be proactive about the prevention of a deadly disease even before the diagnosis. Through this blogpost, I would like to throw some light on the increasing rates of Breast cancer in South Asia and the constraints of civil society in battling with it.

South Asia includes countries like Pakistan, India and SriLanka. A bird’s eye view of the Breast cancer situation in these countries paints a very deplorable picture. Pakistan has the highest rate of Breast cancer in all of Asia and 40,000 women die each year due to this disease. India, on the other hand, also has almost the same number of casualties  and is a place where 50% of the women diagnosed with Breast cancer have already reached final stage. Breast cancer is the highest cause of death in women aged 24 and above in SriLanka.

In these countries, the rich always have the monetary resources to pursue treatment in expensive healthcare facilities in developed countries.  It is the poor women who suffer the most and ironically are the most likely victims of the disease.  Often times, they only seek help when it is too late due to economic reasons.  The social stigma attached to the reproductive body parts of a female makes it even harder to bring this topic out in the public for any intelligent dialogue. 

An Urdu Advertisment from Pakistan urging women under 40 to get regular check-ups and women for 40 to get screened once a year.

One of the reasons why it is such a big issue is lack of information and stigmas surrounding the disease. Poverty, language barriers and the social taboos are also some issues which hinder the discussion. Mostly the diagnosis takes place too late and when it is past any chances to save the patient. Moreover, women are shunned by households and many die in poverty, being destitute and helpless since the treatment is so expensive. This causes further disturbances in the socio-economic fabric by displacing families, disturbing kids and upsetting budgets. Things are made further deplorable by the fact that there are not many specialized hospitals to treat cancer in South Asia. For example, Pakistan, a country of 180 million, where over 52 percent of population are women, has only one cancer hospital. 

Local school girls raise awareness about Breast Cancer
in Pakistan.

Government and civil society are working hand in hand to curb this disease. Pink Ribbon Pakistan is a fortunate NGO to be funded from various government and international organizations. They offer self diagnosis and treatment options, but on their website it clearly states, that they need greater advocacy in the sector and want a dialogue initiated. Roko Cancer is a similar NGO working in India which provides free ultrasounds and mammograms and is creating meaningful change in behaviors and perception of people. 

The civil society in these countries is striving hard to generate greater voice through advocacy and by stimulating social movement towards the Breast cancer cause. However, the mammoth size challenges they face must not be underestimated. Often times they are dealing with complex religious, cultural and social myths associated with the disease which are very hard to dispel. Considering all these elements, in my opinion, further empowerment of civil society in these countries may help increase local people’s knowledge about the disease and improve the longevity of the patients. 

Due to the advances in technology, a Breast cancer is thankfully not incurable. In fact, it is promising to see that in developed countries, such as the US, there has been a phenomenal 20% increase in 5 year survival rate, in three decades. This is a huge increase made possible due to increase in advocacy, dialogue, literacy and cheaper heath care options. Perhaps, with greater care and empathy, one day not only privileged women in the West but also the common women in developing world will be able to defeat this deadly disease. 

Indian Actress Sonam Kapoor as a spokesperson for Elle Breast Cancer Campaign India.