Breast cancer: raising awareness

By: Nadia Agha

Recently I visited an institute of radiotherapy in northern Sindh for organising an awareness-raising seminar on breast cancer. I was overwhelmed to see the place specifically made for cancer related issues where a large number of women were making their way for breast cancer detection and diagnosis, but at the same time seeing these rural women in miserable condition was an agonising experience. On one hand, there were the women suffering from breast cancer. On the other hand, there were the men, belonging to low socioeconomic status, begging the staff for the financial support for their wives’ treatment.

 Every year October is observed as the month of raising awareness against breast cancer around the world. Since the month is here, a number of activities are taking place for raising breast cancer awareness. Yet, the number of the women who lose the battle against breast cancer has increased alarmingly in Pakistan.

Generally speaking, cancer causes a great deal of stress around the patients and their families, but it becomes a fraught issue when it has to do with women and their sexuality. Pakistan is said to have the highest incidence of breast cancer occurrence in Asia. It has been stated that one in nine women is likely to suffer from it, every year about 90,000 new cases of breast cancer are reported and 40,000 women die from it. New research studies reveal that Pakistani women are more prone to having breast cancer at a younger age as compared to their counterparts in western countries. Nevertheless, there is a lack of research on how women suffering from breast cancer cope with socio-psychological effects and deal with the people who look down upon them.

The alarming statistics on breast cancer make it essential for the state to introduce well-integrated and improved programmes for raising awareness as well as countering stigma against breast cancer. Currently, there is a strong rural-urban divide when it comes to raising awareness against breast cancer; knowledge about this fatal disease is highly deficient in rural areas. Most of the activities that raise awareness are concentrated in cities or towns targeting youth in educational institutions whereas those who belong to rural areas are unaware about prevention and cure of the disease. Sadly, there is a great deal of stigma associated with breast cancer. Women in our parts of the world feel ashamed of seeking help unless it gets compulsory. This stigma may often lead to denial from the diagnosis as well. Lack of awareness and low socioeconomic status add more to the problem. Such problems worsen in rural areas where people have low levels of literacy, less exposure to media and lack of access to modern facilities to treat the disease. Also, rural Pakistani households are extremely patriarchal where all decisions of women’s lives are taken by men. Even when women want to see doctors, their access to the specialist is conditional upon the wish of their men in the family. It is unfortunate to say that the appearance of any lump is often ignored and women are only taken to the hospitals when it is too late to cure the cancer.

Pakistani women can be empowered to control their health issues if they receive timely support, but unfortunately there is no awareness at family or community level in rural areas. If a woman is diagnosed with cancer, she not only has to fight against cancer but also against social attitudes around it let alone seeking psychological support on trauma of losing one or both breasts.

It has become imperative for Pakistan to develop effective practices to combat the disease. In this context, the problem of the prevalence of breast cancer needs to be dealt with taking local culture and social attitudes in consideration. Therefore, all strategies must also target rural and remote areas and involve wider audience. Breast cancer is curable with early detection which is only possible when awareness raising activities and healthcare facilities are extended to every nook and corner and involve families, in particular men.

The Express Tribune

Three women, our politics

By: Wajid Shamsul Hasan

Pakistan’s history without three women being mentioned as catalyst would remain incomplete. First was Madre Millat Mohtarma Fatima Jinnah — sister of founder of the state Quaid-i-Azam Mohammad Ali Jinnah. Hers was a life devoted to the well-being of her iconic brother who was consigned by providence to create history single-handedly leading an essentially peaceful democratic struggle to establish a state for his nation by vote — a state that would guarantee equality to all-irrespective of caste, creed, colour or gender and where religion shall have nothing to do with the business of the state.

Despite having not much to do with practical politics; Mohtarma Fatima Jinnah had learnt her bit of politics from the close company of one of the greatest leaders of all times. She knew the pristine values that were dearest to her upright brother and what was to be good for Pakistan. She believed that her brother had rightly chosen a democratic, secular and progressive future for his country. And when she realised that President Ayub Khan was putting her brother’s vision asunder in sixties she took the challenge when there was paucity among male leaders to take on the bull by the horn. Had she not contested the presidential elections and challenged the dictator, self-styled Field Marshal, course of Pakistan’s history would not have changed after 1965.

Twelve years later yet another fragile woman — Begum Nusrat Bhutto — with strong nerves was rightly selected by her incarcerated husband Zulfikar Ali Bhutto to lead his party — Pakistan People’s Party – that he had sprung in the national political arena in the face of strongest opposition by the forces of status quo — to harness dynamics of socio-economic and political change that he had ushered in — to defy country’s worst possible and history’s most ruthless dictator General Ziaul Haq.

There is a Chinese proverb that a picture is worth ten thousand words. Indeed it is so if you see the picture of a fragile lady bleeding from her head and yet standing defiant. History has strange ways to be ironic and symbolic. That woman’s birth on March 23, 1929 was not just coincidental. When Nusrat Khanum was eleven years old Muslims of India had gathered in the historic city of Lahore under the dynamic leadership of the Quaid to charter an independent course for the nation and passed the Resolution on March 23rd that is now called Pakistan Resolution. If such coincidences have any significance, people were right that destiny had chosen a role for Nusrat Khanum as well.

It was a historic coincidence that the day General ‘Tiger’ Niazi had surrendered 90,000 cream of Pakistan army before Indian General Jagjeet Singh Arora in Paltan Maidan of Dhaka where in 1906 All India Muslim League that was to spear head later Pakistan movement was established — Begum Nusrat Bhutto (see photograph) was baton charged by General Ziaul Haq’s blood hounds. That picture of Begum Bhutto blood crawling on her face is, indeed, worth more than 10,000 words. It captures a long and sordid tale of her sufferings at the hands of the ruthless dictator. Zia’s unleashed his steel-tipped baton chargers on her head when the teeming thousands gathered to watch a test match at Gaddafi stadium on 16 December 1977, on seeing Begum Bhutto in their midst broke into a deafening crescendo of “Bhutto Zindabad!”

General Zia was not content by spilling her blood only. She was arrested in hospital when her deep head wound was getting stitched. She had just received 12 stitches when lady constables aided by 6 footer cops pulled her out of the bed and despite resistance by doctors frisked her away. Her wound had not been unattended properly immediately and did cause her loss of memory later in life. On great hue and cry in public she was confined to her house and held in isolation for 21 months.

Bhutto Sahib’s mock trial for fabricated plot for eliminating a political rival of no significance and his judicial murder on the orders of four judges from Punjab as against his acquittal by three judges from the smaller provinces — would remain infinitely an albatross around the neck of Pakistan’s superior judiciary to prove right Shakespearean observation — in another context — that the entire perfume of Arabia would not wash the innocent blood of Bhutto from the hands of those four judges and General Ziaul Haq.

The intent of this piece is not to recall Begum Nusrat Bhutto’s sufferings since her death anniversary came by the other day. It is to honour our women who stood by Begum Bhutto when most of the male leaders had preferred to indulge in the pleasures of life when politics had become a Herculean challenge to pursue under Zia. Begum Bhutto kept ignited the populist aspirations of her husband and his devoted followers by keeping aloft the flag of defiance against the dictator. Initially in this fight she was alone but later Bhutto Sahib’s “Dearest Daughter” joined her. And that is when the team of mother-daughter served as the catalyst that transformed their peaceful efforts into ultimate return of democracy.

While referring to Begum Nusrat Bhutto’s contribution towards galvanising opposition parties under the banner of MRD to take on dictatorship and also Benazir Bhutto’s unparalleled sacrifices culminating in her assassination by the retrogressive elements who acted as killer puppets on the chains of a dictator who had been their mentor — the lori langri (lame) democracy that we have today needs to be preserved at all cost as a tribute to all those who singed our path to it with their blood.

Obviously our political leaders are required to stand up to counter the plethora of challenges including that of massive corruption. Previous government — with all its faults and failings — did consolidate democracy by braving the media-orchestrated impediments of its inevitable demise the next hour, praetorian machinations et all — and survived to transfer power to the present elected government. Its other gigantic contributions that shall be written in letters of gold would be empowerment of the parliament, its 18th Amendment that — besides strengthening provincial autonomy — took away the lethal power resting with the president to dismiss an elected prime minister on his whims and quixotic allegations.

Prime Minister Nawaz Sharif must wake up to understand that his existence until this day is on account of the support that he received from the Parliament. Regretfully by his own conduct and by the behaviour of his ministers, their lack of interest and disrespect to Parliament — the ruling party has abdicated its democratic role and responsibilities. It is already too late but still an attempt could possibly be made to save it at the last minute by offering itself for transparent accountability to the Parliament. Ruling party must understand that by refusing to conduct itself democratically, it has already caused a vacuum that powers that be are itching to fill.

Author is former High Commissioner of Pakistan to UK, a veteran journalist and long-time adviser to former prime minister Benazir Bhutto.

The News