I attended a session of a young Iranian male who said that community development in Iran is coming from the villages and the young people have fled the villages for the cities leaving only older people to run the cities;women cannot speak up because their husbands will not let them and the women are mostly illiterate because in times past, women were not formally educated. So he is working to try to get several leadership positions promised for women in each village and then he will help these women go through some leadership training. I was struck by the earnestness of these young people to create a better community. Of course, the theme was community development for a sustainable future, so I would guess these young people are already thinking that way.
There was a whole section in the afternoon dedicated to cancer and how various countries were approaching awareness and help for the communities. Sharan and Maznah talked about their research on the faith healers (bohomos) and that prelimilarily, the bohomos that appeared less cooperative and provided less information and relied more on chants and potions were less educated. They told of one woman who was a mother of 5 children, was older and found a lump. She wanted to go to the hospital for treatment but her husband would not support that. Instead he took her from bohomo to bohomo and spent 8000 ringgets (divide by 3 for US dollars) on a special potion. She took it and the tumor grew until it burst. By the time he did take her to the hospital she passed away. These stories are not unusual here. In the audience was the Minister of Health (or a deputy minister - not sure) but she spoke with authority and said that when their research is ready to be published, she would hope that there could be a coming together of the spiritual leaders and the doctors in Malaysia because women need both - which is certainly the truth. She spoke to me after my remarks the day before and talked of a new cancer center opening up. I might have been a tad critical of the government who does not seem to provide enough support for women to get tested for breast cancer.
As we were drinking tea and eating some delicious pastries after the conference, Maznah brought a young Malaysian woman up to talk with me. She was very shy and smiling but also shaking when she shook my hand. Not all women shake hands, many just pass their hand over yours or give a very limp handshake. She started talking to me in English and I thought she said her mother was dying of breast cancer. I said how sorry I was and it turns out her mother died 2 years ago at 54. She had tried to get her mother to accept medical care but it was uncertain to me whether she said she had some medical care or started care and then quit but she told me she died a very painful death. Nevertheless, she wanted my advice on the kind of care she should have. I suggested she go for an exam and follow up with a mammogram. We talked about that for a while and she said that she did not want anyone to touch her and she had heard that a mammogram is very painful. She also said that when her mother was getting care from a doctor, he wanted her, this young woman, to have a mammogram but she was too frightened to get one then.
Apparently when I mentioned the statistics in my session and in my keynote address of the very bleak future for women in Malaysia that get breast cancer, it upset her a lot. So after about 20 minutes, she agreed she would go get a checkup and would not worry about the pain of a mammogram. I found Maznah and suggested this woman go see Dr. Yip Char, a terrific surgeon for breast cancer; and she is a woman - a requirement for Muslim women who are not allowed to be touched by a male doctor.
Maznah asked where she lived and then said she would not be allowed to see Dr. Yip because she did not live in the right district and Dr. Yip is a surgeon. Maznah told her where to go and then said that she didn't believe there is any mammography equipment available in that district and they are not allowed to go to other districts so she would have to be satisfied with just a breast exam. So they talked about where she grew up and Maznah said another option was for her to go back to her village and get a mammogram there - but it also seemed that wouldn't work either. So we left her with an address of a clinic where they would examine her and hopefully wouldn't find a lump. If one was found, it had to be a certain size before she could go out of her district to get a mammogram. The readings of the mammogram take a while and then there is the biopsy results that take a while. Time is so important here, that I pray this woman does not have a lump.
She is really on my mind this morning. I don't know if she will have any better future here because of lack of resources like mammography equipment, shortage of doctors who handle breast cancer paptients, extreme shortage of oncology nurses who care for these women and these services availabe if the women over come their fear and actually go to a clinic in the first place. The words, "If it is God's will . . ." are more prevelant than any good assessment options for many of the women here. I also think about the woman in the jungle that came up to Sharan because Sharan was a doctor and asked Sharan why she was having such pains in her stomach and why she hadn't had any periods for 8 months. To see a doctor, she would have to travel about 6 hours out of the jungle and face the 2nd biggest killer of women here, cervical cancer.
I keep thinking of my girls and John's daughters and how fortunate we are to have the health care system we do in the US, even with it's flaws, I know we can see doctors who will care for us. This experience has brought me full circle and I remember why I am here and it isn't to see wild reptiles, it is to encourage young women to go get their examines and to catch the tumors early so they can survive. But as you can tell, it is never that easy or simple - but maybe saving 1 woman who can then encourage her sisters to get examined, is what it is all about after all.
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