The Winds of Change

The winds of change are definitely in the air.  The days are becoming drier, more sunny and very hot.  There is still a good amount of rain, some torrential, but the skies are looking different.  There are swathes of blue, punctuated by white, grey and inky black cloud formations. It is a beautiful time of year, the vegetation lush and rich from the rains but now set amidst bright sunshine and clouds with character and feist.

As I discussed in my last post too, it another season is newly underway.  Personally, it is my anniversary season.  In only two days time I will silently and sombrely recall the words which changed life forever for me and those close to me.  The “this is highly suspicious of cancer” words.  Those days were followed rapidly by surgery, pathology reports, chemo and all the attendant extras that these entail. It is a rough and stormy season and one which I will be glad to be on the other side of, just like a rough storm indeed.

It is also a season which is becoming increasingly divisive within what is a close and highly supportive online (and offline) community of breast cancer veterans.  (Hmm – apart from the war and fighting associations – I think I might prefer veteran to survivor as a term?  A veteran being anyone who has crossed over the “you have cancer” line….  just thinking out loud here).  The season is of course Breast Cancer Awareness Month (BCAM) – often called Pink October.  I personally believe, looking at this from a global perspective, that there is no right or wrong in terms of BCAM.  The context varies wildly and we cannot prescribe for another situation.  I very much disagree with hijacking a cause or issue for profit, but will never tire of trying to highlight the very different context here and the challenges for, particularly women, in the developing world.

Many winds and crosswinds are blowing during October.

So while these serious winds of change are sweeping through our lives, what better time to step back and refresh the visual image backing the blog.  This time I have selected an image from my travels again, but the elements which I wish to share are ones which are universal.  A sinking sun against a sky scattered with cloud formations, reflected on the water.  Foliage silhouetted against the darkening sky.  The mood of the sky captures the winds of the changing season and the promise of dry days and retreating rains.

This is the complete image, and very shortly (as connectivity allows) the image will appear as the background for the next few weeks.

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.