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Using theatre to combat
breast cancer
Linda Dias, an African Indian,
was diagnosed with breast cancer in 2002, shortly after losing
her mother to cancer. The first thing she discovered when
seeking medical help was the lack of awareness and paucity of
information available among immigrant communities in Canada on
breast cancer or how to access health services.
Linda, who
immigrated to Canada in 1986, had an advantage over other
refugee women. Having acquired a university education and
being an outgoing, articulate person, she
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had access to valuable information about
health care services available to women diagnosed with breast
cancer. "But there are so many less fortunate immigrant and
refugee women, who have left their countries and cultures and
don't speak English and aren't aware of existing facilities
and resources here," she remarked.
Drawing from her own
experiences of working within the system and advocating breast
cancer issues as a survivor, Linda realised how daunting such
a process would be for women wanting to avail of health
services and yet being unfamiliar with the language and
prevailing institutions in Canada. So when the Working Women
Community Centre, a Toronto-based voluntary organization,
started an innovative "Breast Cancer Education Project for
Immigrant and Refugee Women", she immediately enrolled herself
as a volunteer.
The project has worked with a script
development team consisting of staff, community workers,
professional scriptwriters, breast cancer survivors and a very
dedicated group of participants/performers to bring a play to
life.
The play provides information on breast cancer,
early detection diagnosis and coping and support issues to
newcomer women and their families, says Ms Marcie Ponte,
Executive Director of the play.
The play, entitled
"Tomorrow's Time", draws upon the personal stories and
experiences of immigrant women who have bravely struggled
against the disease. The courage, passion and spirit of the
protagonists emerges powerfully, whether it is Marjeiry from
Guyana who didn't know there was support available when she
was diagnosed in 1991, or Christine from Trinidad who became
involved after watching her sister battle breast cancer and
yearned for more information so she could help her sibling
cope with the physical and emotional trauma exacted by the
disease.
Some like Vanita Sabharwal (who came from India in
1998) wanted to participate in the play because she realized
that more breast health awareness is needed in her community
as she finds its still difficult to get women to go for their
check-ups.Others like Lucy Frankel, who came from England five
years ago, was drawn to this project as she is committed to
promoting women's health through popular education. The
project is especially dear to her heart because she has two
family members who have been diagnosed with breast
cancer.
Yoseline Aparicio, originally from Venezuela, has
been working for the Working Women Community Centre for two
years as a volunteer facilitator. This 31-year-old mother of
two boys was drawn to the play because she wanted to lend her
energy and voice to a worthy cause. And what can be a more
worthy cause than promoting breast cancer awareness among
women, especially as this disease ultimately affects not only
women but their families and the community around them.
As
Linda Dias says, the play deals not just with giving
information about breast cancer but it goes into all the
socio-cultural and psychological aspects of the illness. "It's
geared towards marginalized women. It's about self empowerment
and about de-mystifying myth and taboos surrounding breast
cancer," she pointed out.
Linda and Marcie spoke about
their project at a workshop organised during a recent World
Conference on Breast Cancer held in the coastal town of
Halifax in the Nova Scotia province of Canada. A video of the
play was screened at the seminar, and it was followed by an
animated discussion among the audience on important health and
social issues.
"This health promotion project creates
dialogue that aims to bring about change in medical care,"
explained Marcie. "The play also offers opportunities for
collaborative work with health care professionals and
educators committed to equal access and quality cancer care
for immigrant women and men."
The five-day conference from
June 8-12, 2005, organized by the Canadian-based World
Conference on Breast Cancer Foundation, brought together
650-odd delegates from 60 countries to share information on
all aspects of breast cancer.
The Working Women Community
Centre project assumes added importance in view of a recent
study conducted by the Institute for Clinical Evaluation
Sciences in Toronto which cites cultural and language barriers
as the two reasons why women in low-income, high-immigrant
areas of Toronto have the lowest rate of breast cancer
screening.
According to Dr Richard Glazier, author of the
study, multiple factors for women, health care providers and
within the health system are most likely responsible for the
differences seen in mammogram rates in different areas of the
city.
The study looked at census data of more than 113,000
women aged 45 to 64 years to determine mammography rates in
various areas.
On an average, only 24 per cent of women in
that age group, who are advised to have a mammogram every two
years, were tested in 2000.
The proportion dropped to 21
per cent in low-income, high-immigration areas, and was 27 per
cent in high-income, low-immigration areas. Dr Glazier says
the study showed that low-income immigrant women often face
cultural and language barriers in getting needed health care
services.
Linda has experienced first hand many of the
study's findings. A big hurdle in her community, she says, is
the lack of family physicians and many of the women she has
encountered, during the course of her treatment and while
advocating breast cancer awareness, don't even know what a
mammogram is.
The study highlights the fact that disrobing
and breast examination are also sensitive issues in some
cultures. Agreeing, Linda says that as a part of her cultural
conditioning she could never imagine touching or examining her
own breasts, so the question of a machine looking at her
breasts was totally alien to her.
The study, an eye opener
for both immigrant women as well as health care professionals,
recommends that doctors adopt a system for making mammogram
referrals and following up with patients. Information should
be published in various languages and reading levels, while
flexible hours at radiology clinics would help women who can't
take time off from work, it adds.
"One of the things we
discovered is that a lot of new communities live in areas
where there is no major community health center," observed
Linda. "So these communities tend to use a drop-in doctor, and
so they don't have continued supervised medical care".
Through the play, Linda and her co-volunteers are trying
to reach out to the different stakeholders and to forge
relationships between health professionals and breast cancer
patients and their families.
"There are huge disparities
in information, research, access to and quality health care,"
she stated.
"Our play addresses these issues. The
encouraging fact is that more men have started to get
involved, and accompany their wives and other women relatives
to the play.""During one session, a man asked me if there was
a link between breastfeeding and breast cancer while another
man wanted more information about the environmental links with
the disease", she recalls.
The bottom line, she rightly
asserts, is that the community as a whole is taking women's
health issues seriously and this is a major hurdle that has
been crossed. This passionate breast cancer activist plans to
continue participating in the play, staged in different
community centers across major Canadian cities, seeing in her
contributions to the community a crucial step to her own
survivorship.
Grassroots Features
If the
article is reproduced it may please be credited to Grassroots
Features and a clipping sent to the Press Institute of India,
Administrative Block, Jamia Millia Islamia, Jamia Nagar, New
Delhi-110025
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Nitin Jugran Bahuguna
Halifax,
Canada
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