Where there is no pink pandemic

As we enter the month of Breast Cancer Awareness it is true that Pinktober might be upon many of us.  However, I would urge us to remember that the world is not an equal place.  I ask myself whether it is a good thing or not that the pink pandemic has not reached all corners of the globe?

I am keenly aware that I am physically and intellectually very distant from the sophisticated marketing and campaigning of the Breast Cancer Awareness Month.  I have yet to see any pink products with my own eyes, and with the exception of pink ribbon postering in the hospital I go to, I could actually remain unaware of the Pink Month.  Except for my online life that is.  I find it a very confusing and conflicting period, both emotionally and intellectually.  I follow the debates.  And I humbly appreciate and value the efforts family and friends put towards many cancer related causes, in my support.

One of the concerns I frequently hear is that there we are past the stage of raising awareness, everyone knows about breast cancer, and that the focus must change.  I respect and acknowledge that, and believe it is true I many contexts.  However, as I have mentioned here, there are still many places where accurate and fair awareness raising are essential.  There are indeed contexts where breast cancer is misunderstood and where the causes and treatments are limited.  I have already described my reaction when my colleague expressed her surprise that I had been diagnosed because I am not a spinster.  Now it is easy to be shocked at this but let’s put things in context a bit.  Cancer is (a far as I understand) a disease which flourishes in the developing world.  Childbirth at an early age and breast feedingare acknowledged to be mitigating risk factors in Breast Cancer vulnerability.  So in a situation where there are few touches of the modern world it would not be surprising to learn that the disease probably appears to be seen more among women who have neither borne children and therefore not breast fed.  In traditional settings, these women would tend to be unmarried. Hence, a spinster disease.

This has prompted me to try and put together some awareness raising activities locally, so that I can at least highlight signs which should be recognised and which should prompt women to seek medical advice.  In this context my starting point will be to talk with women.  Initially women only, though I will seek ways which are appropriate and respectful of raising awareness with men too at some point.  At the very least, I hope that it means that Breast Cancer will be talked about openly in a fairly private and comfortable setting. We will explore together what breast cancer means, starting from what people already know and believe. I expect we will also talk about what kind of treatment options exist.

In order to try and understand the situation more clearly in preparation for this, I have been talking with friends about their experience and understanding of breast cancer.  I have had some fascinating discussions and learned a great deal about beliefs about the cause of breast cancer, who is “susceptible” and treatment options for people diagnosed with breast cancer, and for that matter other cancers too.  I was not prepared for the response, and do bear in mind that I have been in Asia for 11 years in working in some very untouched areas.  From what I have learned, cancer was not openly talked about and the term “cancer” not used until more recent times.  Even today, I hear a number of references to “that kind of illness” and “the serious disease”. When it comes to treatment, traditional remedies are what people trust and feel comfortable with, and indeed are often the only option available.  When exploring this together, I am sure I will learn a great deal more about breast cancer in settings which are off the pink radar.

However, this brings a real dilemma.  By raising awareness and highlighting signs which women should be aware of., this leads on to a greater demand for diagnostics and treatment.  However, high standards of medical treatment and facilities are not readily accessible to many.  Furthermore the costs of treatment is also beyond the reach of a great number of people.  So what does empowerment and awareness achieve if options are very limited, and someone is not able to access the treatment indicated?  Is awareness raising in fact more dangerous because it puts people in a situation in which they are worse off and more afraid?

There is no easy answer to this.  The ideal would be that hand in hand with awareness raising would be a move towards broad access to treatment and care.  I guess that is what we have to strive for.

So while the debate rages around pinkification, I have the aim of sharing a side which does not generally feature in the discussions.  The reality that for many women around the world the need for awareness and treatment is urgent and for whom the debate around pink October has no immediate relevance.

20 thoughts on “Where there is no pink pandemic

    • Lauren, your posts always take my breath away, and I learn much from them. Thank you for your kind words about mine 🙂

  1. What a superb piece of writing Philippa and such an important issue to raise. While full-on pinkification hasn’t quite penetrated here to us in Ireland, there is nevertheless plenty of it about and while I agree that women are more educated to the awareness of the signs of breast cancer, I also wonder, like you, if that message still hasn’t made it to certain communities. In the patient advocacy group I work for, we worked with our national adult literacy agency to produce a simple leaflet to explain the signs to look out for and this was in response to findings that women in disadvantaged areas were still not getting the message. Having moved from the city to a rural area, I have found there still exists a stigma around the big C, and imagine my area is not the only one where this is to be found. So, I think a balance is called for – as my own experience, and yours bears out, there are still pockets of areas where education around risks and signs are still needed, but equally the whole pinkification has gone way over board and I wonder if it is obliterating some of the message in a sea of pink?

  2. Marie, I have to thank you for the prompt and encouragement to develop this, thank you so much. I agree that the whole area of Awareness is very thorny, and in addition to pockets in more marginalised areas, I think that we tend to really take on full awareness when cancer touches us or someone near us. I also think that it is very sad that pinkification has hi-jacked what is a critical piece of work.

    Thank you 🙂

  3. Fabulous post Philippa. It is indeed very reminiscent and took me on a trip down the memory lane. For me, raising awareness is a two-fold process. First, the standard information for the general public; Second is the dissemination of more focused information for the target groups; and it needs to be customized for every society.

    There is no doubt, this awareness has brought positive results in US and other developed countries where population is managable, more educated, easier to reach across via the Internet, TV, Radio, Newspaper or Magazines, have a generic health benefit program and ready access to test and treatment centers. But in low and middle income countries, which still accounts for more than 70% of all cancer deaths, “pinkification” is nothing more than the buzzword in the minds of extremely dedicated volunteers and employees striving hard to make a difference against a range of seemingly unsurmountable factors – huge population, low literacy, inferior social status of women, lack of financial independence and non-availability of quality test and treatment centres.

    While Breast Cancer awareness has succeded in bringing together voices of millions and changing the social perspective on the disease, it will only serve its true purpose beyond the advertising glitz and media pomp, when the poorest in every country starts to benefit from it.

    • Thank you for your comment and your introduction – I had missed your post on Journeying Beyond Breast Cancer and was delighted when Marie pointed me towards it yesterday. The picture of Kanchenjunga jumped out at me – my husband is from Darjeeling and we have spent many years in Nepal and India.

      Your comment very much resonates with my thoughts too. I also believe that awareness and education have to be relevant and appropriate, as well as respectful. I was interested to see the distinction between mass awareness and more targeted work, a very useful distinction and one which lies at the heart of much of the debate on the topic.
      Thank you

  4. A very thoughtful and informative post. It is so important to expand conversations like this. Awareness is necessary for prevention but without available follow up care in a case where screenings diagnose cancer, it isn’t enough. That is why I supported LIVEStrong’s global initiative this summer creating a call to action to global leaders. My work in survivorship has revealed similar challenges. Many survivorship programs highlighting issues, most of which survivors are well aware of, but no on the ground tools offered to address them. Awareness is a first step…not the only step.

  5. A very interesting and thought provoking piece Philippa. And your reflection there – maybe we only really take on full awareness when cancer touches us… yes, maybe that’s true.
    In the UK the proliferation of pink products is certainly nothing like the photos I have seen in the US, nor are the pink events so prolific or so large. However – it is there – the cheery positive pink culture.
    Even with the ‘awareness’ we do have, the reality of breast cancer is not accurately being portrayed within this culture. And, equally, as you point out – whether it’s pink or not – how do we realise awareness – and reality – without bringing fear into the discussion?
    It is interesting to see, from your perspective, that even without pink it’s still a difficult challenge.
    Thanks for this view, Sarah

    • Thank you for your thoughts Sarah, and I particularly think your point about how to raise awareness without bringing fear into the discussion which in itself blocks awareness. It is very complex and emotive. Just like us all really! I think that the pink has an under recognised role in the experience for our family and friends, bringing a constructive focus. But as you say, this turns too easily into too much cheer and positivity.

  6. Thanks for suggesting I read this Phillipa, after my posting earlier today on Being Sarah’s blog. We certainly do get all western-centric about ‘awareness’ and ‘pink’ – and I recognise that the awareness to even call it cancer and acknowledge what is happening is a real challenge in large parts of the earth. So what you’re doing is really important, as is what Marie talks about in rural Ireland. To get proper information and educated discussion and decent treatment going, as quickly as you can.
    Also, though, I think the discrediting of the pink wash approach, can only help you in the long run. Otherwise, could be you end up with a pink ‘we’re all sorted myth’ getting in the way of the educated discussions you are promoting.

    • Thanks for your comment and thoughts, Ronnie. It has been really interesting to hear of the different levels of pinkness and awareness from different places. I do wonder how and whether it is possible to get a balance. There is a huge job to do…….

  7. You go, girl, on getting out the proper awareness we need for the cause. Today is the start of pinkification, but we don’t have to have a repeat of prior years. We have power in our numbers, numbers of people who have seen this disease up close and personal and don’t want others to have to endure the same things.

    • Thanks Jan, I do hope that we can take lessons from other experiences. Can we have awareness in less touched places, without commercialisation and trivialisation taking over, I wonder?

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  10. Thank you so much for this post. We sometimes get so wrapped up (tangled up?) in our pink ribbons that we forget about places that still need cancer awareness — not just breast cancer awareness. I enjoyed reading about October from your perspective!

  11. I am enlightened by this post.

    A doctor in Singapore pointed out that Singapore has relatively high incidence of cancer because of dietary habits. It is natural that some untouched areas have high incidence of all forms of cancer among men and women, but goes undetected.

    The blood test for cancer markers is one service that third-world governments can provide in the rural health centres. Thereafter those diagnosed can move up the chain and seek help in secondary and primary medical facilities.

    The blood test, and a primary public facility for cancer and related treatment should exist in all countries. Both of these are possible in every country. The rich people do find the tests and the oncologists in their own country. The govt should, therefore, organise services for the general public. This was done across asia to fight Cholera and Tuberculosis. Now it time to deal with cancer.

    • Thanks Z – yes this is something I have been thinking of a lot recently, and on Friday I ran a session on Breast Awareness for colleagues. It was humbling and eye opening. It is useful that you highlight cost effective ways of screening and the need for adequate heath provision in the event of diagnosis. We have so incredibly fortunate.

  12. Pingback: Tangled Up In Pink | Dispatch From Second Base

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