October is probably the most well-known of all cancer awareness months and the pink ribbon the most widely recognized symbol of the fight against cancer. The rise of Breast cancer activism and the pink ribbon movement in Kenya can be credited to the late Mary Onyango. Mary bravely led the breast movement for several years until she succumbed to the very disease she spent decades fighting.
October breast cancer month is marked with numerous activities. From wearing pink ribbons to discounted or free screening offers as well as cancer talk shows on radio and television. Yet breast cancer cases continue to rise and survival is no better than it was 15 years ago when I joined the cancer advocacy movement. Clearly there is something fundamentally wrong with confining cancer to a four week once a year ritual. The greatest danger with this month-long cancer extravaganza is that it is rapidly taking the form and shape of Christmas: Heavily commercialized and promptly forgotten until next year. Though we have not reached the North American levels of commercializing everything around breast cancer, there is a very gradual but relentless effort to merchandising of this serious disease. Breast cancer is now becoming a darling of the media and major corporates in Kenya using the pink ribbon to boost their image.
Reducing deaths from breast cancer will take more than pink ribbons and cancer talks. Creating ‘awareness’ without accessible cancer treatment infrastructure is in itself myopic. Well-meaning community based organizations spend an incredible amount of time and resources spreading the cancer message in schools, churches and other social places. But without well-equipped referral channels to enable those with suspicious lumps or early stage disease get prompt diagnosis and treatment then these efforts will not contribute to reducing deaths.
A diagnosis of cancer brings unexpected confrontation with mortality. The fear, pain, emotional and financial distress are very real. Thus classifying patients as ‘survivors’ and ‘warriors’ sometimes gives an unfair insinuation that those who die from cancer give up the fight too soon. The metaphor of ‘fighting cancer’ or the ‘war on cancer’ is somewhat misplaced compared to the ‘war on terror’ or the ‘war on drugs’. It would be very simplistic to describe cancer cells as the only enemy in the war. Cancer cells are a product of nature from the same linage as normal cells. The disease is thus much more complex and multifaceted. Unlike drug lords and terrorists, cancer is not exactly malicious. Sometimes cancer just happens even to people with no known risk factors affecting the poor and the rich, the educated and the illiterate alike, no one actively seeks to get cancer save for tobacco users. Broader policy and legislative issues around cancer causation that must be part of the ‘cancer war’ include funding of local research and enforcement of laws that target reduction of environmental carcinogens. There is a very strong case for legislation to ban advertisements of unhealthy diets and drinks along with a permanent ban on growing, processing and using tobacco and its products.
A pink ribbon means nothing to a breast cancer patient who cannot even raise bus fare to a treatment center. The disparities that exist in breast cancer outcomes in this country must be acknowledged. The economically marginalized suffer disproportionately more and are more likely to die even with a diagnosis of early breast cancer. The mobile platform fundraising for teachers recently launched by politicians would probably have received more public sympathy if it was to enable poor breast cancer patient’s access treatment during this pink month.
The writer is the Chairman of the Kenya Network of Cancer Network Organizations (KENCO) and Manager of the Cancer Programme at the Aga Khan University Hospital. dkmakumi@gmail.com
