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.

Men, Boobs and Pink shirts

We will be talking about the correlation between men, pink shirts and women's breasts today. Before I start, a little FYI for you. Originally, Pink was considered a masculine color (due to its association with  Red) and Blue was considered dainty,  feminine and hence speculated as an ideal color for girls. Up until 1985, gender neutral clothes were being used for both sexes but soon after, a whole generation of parents, somehow bought into this idea of Blue=masculine and Pink=feminine. This segregation would turn out to be great for maternity businesses but it also managed to crush the psyche of men for a long time. Long-lasting prejudices against these two beautiful colors were ingrained in people’s minds forever. These days, men are actually ashamed to wear something pink because apparently they don’t have enough balls for that.


Independent UK recently published the findings of a study, which claims to have found that men who (dare to ) wear pink shirts to their workplace, earn on average 1000 pounds more than those who do not, are better qualified, more confident and get a greater number of compliments from female colleagues than their more traditionally beshirted colleagues. It is obvious, that by taking that extra leap of faith in their ‘masculinity’, these guys become cultural rebels in a way and rebels are always sexy.

The color Pink is so synonymous with women that International Breast Cancer society uses it as a sign of moral support. Every October millions of people buy pink ribbons and contribute to the Breast Cancer cause. Pink Ribbon Campaign is also endorsed by many celebrities. When Australian cricketer Glen McGrath’s wife, Jane McGrath, died in 2008 after a lengthy battle with cancer, the Australian team, wore pink ribbons on their sleeves during international matches to show moral support to McGrath and millions of other survivors, patients and relatives. They made an excellent show of support to the cause.

While what the Aussies did was quite commendable, it was the South Africans, who took the cake. They played an international cricket match in PINK UNIFORMS to create awareness about Breast Cancer in the native South Africa.

Display A: This viral picture had more than 5000 likes.

Yes, they did it and pulled it off with their traditional charm.  Fortunately, that day they were playing against Pakistan, a developing country which has the highest rate of Breast cancer amongst all of Asia and where every year about 40,000women die due to this disease. The very nature of  the Pakistani society is such that anything containing or involving any reproductive female body part is automatically sexualized/eroticized. It is also a highly male dominated society, where even most educated men, are rifed up with prejudices and biases against women. Following is a status update from one of the biggest online cultural hubs in Pakistan, Mango People. They tried to pass this status off as mere “good-humor” (very funny indeed!) and interestingly, this is also the so-called the English speaking elite of the country. When this is the level of maturity shown by the well exposured elite, what exactly can we expect from the lower segments of the society? These attitudes are not breeding ground for good, solid and intelligent discourse.

Display B: This status update had more than 400 likes, although  it is refreshing to notice that it is only 0.08 percent of the likes that display A got,still some comments were quite disturbing.

Unintentionally, South Africa has done for Breast Cancer in Pakistan, what years of small scale campaigning by nonprofits and government have been failed at doing. They have penetrated the market and created a lot of awareness in just one day. By acting on the tough call to wear Pink, Team South Africa has caused a ripple effect of huge momentum. Sure, some people laughed at them, but majority got the message behind the medium. People started asking questions. They wanted to know more and were willing to discuss it further in disease terms rather than in physical attraction terms.

Display C: Can masculinity get anymore real than this?

South Africa won that match , advocated a very noble cause and managed to raise 200,000 dollars at the end of the day. But in my opinion, their real victory came with their own conviction in their masculinity and their commitment to a cause as a team. They proved that colors are meaningless and what really matters is the strength of character which cannot be masked or enhanced by wearing any color. Celebrities have a lot of referent power and Team South Africa used it for a good cause with great elegance.
 

What are your thoughts on men wearing pink? If you are a girl, will you date a guy who likes wearing pink shirts? If you are a guy would you like to try pink shirts and if you have ever done so  please let me know how was that experience for you? What do you think about this Western practice of general gender specific color culture which is influencing the elite in third world countries? Please leave your valuable comments in the discussion board below.