OCTOBER is the month of campaigning for raising awareness of breast cancer. Although women across the world suffer from this disease indiscriminately, those in middle- and low-income countries are the worst hit because of lack of awareness, inadequate healthcare services and limited access to the latter. These factors lead to late diagnosis and breast cancer mortalities. Thus, breast cancer is becoming a major public health concern and low-income countries are likely to have more breast cancer-related deaths, putting more burden on healthcare resources.

Those who campaign to raise awareness of breast cancer or are engaged with the healthcare sector must focus on two aspects of the illness: one, inadequate facilities that affect women’s access to treatment; second, the prevalent gender order to assess how patriarchy impacts women’s health-seeking behaviour for a life-threatening disease. This will help to analyse where the possible interventions are needed and whether or not there is a need to alter healthcare-seeking methods with regard to breast cancer.

Pakistani women are surrounded by sev­ere gender inequalities and socioeconomic insecurities. Pakistan is one of the worst countries for women to live in as women are exposed to sexual violence, discrimination in socioeconomic resources, revolting cultural practices such as ‘honour’ killing etc. Its health indicators for women are among the worst anywhere; women suffer the most whether in terms of maternal mortality, malnutrition or first-day deaths. All this results in women’s poor physical and mental health.

In terms of breast cancer, Pakistan has the highest rate of mortality in Asia: one in every nine women is at the risk of breast cancer. It is reported that 40,000 women die of breast cancer with 90,000 new cases emerging every year in Pakistan. Early detection is doubtless key to survival, but people’s attitudes, beliefs and misconceptions can be hurdles to early detection. The belief in divine help or a miracle cure or, fatalistically, cancer being incurable is a major barrier in the way of patients taking a decision to avail of treatment.

Awareness of breast cancer among women remains low.

Pakistani women do not make autonomous decisions with regard to their health. While their family’s level of understanding and su­p­port can be central to cancer patients’ sur­­vival and psychological well-being, beli­efs and perceptions play a decisive role in dea­ling with cancer treatment. Women may often find themselves helpless before the misconceptions and beliefs being harboured. Thus, it is important to understand how bre­ast cancer is perceived by those who influence women and make decisions for them.

In Pakistan and other low-income countries, the patriarchal system significantly influences women’s health-seeking behaviour. With their limited decision-making authority, women may find it hard to negotiate on every front. Socioeconomic and geographical challenges in the way of breast cancer treatment as well as attitudes, perceptions and beliefs regarding the disease further complicate the lives of the patients. Women suffering from breast cancer have to face psychological issues such as severe anxiety and depression and there is hardly any venue available to them for psychological support. Women’s poor mental and physical health comes at great cost not only to productivity but also to public health resources.

The family’s attitude, prevalence of negative perceptions and beliefs about cancer coupled with socioeconomic challenges determine breast cancer patients’ fate, and are likely to eliminate chances of a speedy recovery. In order to remove misconceptions and panic, it is essential to make wise interventions. Extreme gender inequalities perpetuated by patriarchy need to be addressed to enhance women’s understanding of breast cancer and facilitate their access to healthcare services.

It must not be forgotten that the majority of the female population is deprived of education. The majority of women living in remote areas cannot read and write and are unable to comprehend the symptoms of life-threatening diseases. Studies on breast cancer awareness and reporting show that literacy has a strong correlation with women’s level of awareness regarding breast cancer. Cancer patients with low levels of education and awareness are full of misconceptions.

One cannot neglect the importance of health literacy. Women must be educated about breast cancer, breast self-examination, mammography screening and possible treatment. Healthcare workers, breast cancer survivors, community leaders, religious groups, psychologists and media personnel should be included in informing people that cancer is a curable disease.

This will help to dispel negative perceptions. The network of cancer hospitals should be widened and made accessible at regional levels. Particularly, mammography services should be available at the district level to facilitate women from remote areas.

The writer has a doctorate degree in women’s studies.

Twitter: @AghaNadia

Published in Dawn, October 7th, 2020