Systemic Barriers

Reflections From World Health Day: Bridging The Gap in Cancer Across The Globe

On World Health Day, April 7th, we came together under the banner of “My Health, My Right,” echoing a fundamental truth: access to quality healthcare is a basic human right. However, as we reflect on the day’s theme, it’s clear that this right is far from being universally realized, as disparities persist not only on a global scale but also within communities, even in countries like the United States, Canada, Scotland, and across Central America and Africa.

The fight against cervical cancer serves as a poignant example of the multifaceted challenges in healthcare accessibility. In Africa, the lack of resources, including broken machines and long waits for vital screenings, creates barriers to early detection and treatment. Despite the personal choices individuals may make regarding their health, they are often hindered by the absence of necessary tools and infrastructure. Jane was a patient seeking care for a routine physical. She happened to find a free screening clinic being offered at her local hospital. Her cervical cancer was detected and treated early due to access and timely screening. 

In the Caribbean, where the scenery is picturesque, the reality is harsh: limited access to comprehensive treatment options forces individuals to endure costly and emotionally draining journeys for essential treatments like radiation therapy. Countries like St. Lucia face the added burden of relying solely on chemotherapy, necessitating patients like Nymphia to seek radiation treatment abroad, adding layers of complexity to an already challenging situation.

Even in countries like Canada, where universal healthcare is a cornerstone, significant barriers persist, particularly for marginalized communities. Poverty, homelessness, and racism contribute to late-stage cancer diagnoses, resulting in poorer outcomes. Addressing modifiable barriers such as housing instability and limited health literacy is essential to ensure timely access to treatment for all Canadians.

Similarly, in Central America, including countries like Honduras, World Health Day serves as a reminder of the inherent right to healthcare. Despite recent progress, many barriers continue to hinder vulnerable groups and rural communities from accessing essential cervical cancer screenings. Challenges such as lack of awareness, stigma, financial constraints, and inadequate family support contribute to low screening rates, highlighting the need for targeted interventions. Karla is a cervical cancer survivor and patient advocate working to change the narrative.

Even in Scotland, a country with a robust healthcare system, cancer inequalities persist, with higher incidence and mortality rates in deprived areas. The disparity is stark, with cancer death rates being 74% higher in the most deprived populations compared to the least deprived. Urgent action is needed to dismantle barriers to early diagnosis and ensure equitable access to high-quality care across all communities. Cara was diagnosed with stage II cervical cancer after several doctors appointments originally addressing gastrointestinal and stress-related symptoms.   

As we reflect on World Health Day 2024, it’s evident that the journey towards equitable healthcare is ongoing and multifaceted. It requires not only addressing systemic issues but also dismantling barriers rooted in social determinants of health. Together, we must continue to advocate for universal access to quality healthcare, ensuring that “My Health, My Right” is a reality for all, regardless of geography or socioeconomic status.

To get involved and make a difference, community members and allies can:

  1. Advocate for policy changes that prioritize healthcare equity and address social determinants of health.
  2. Support organizations like Cervivor and initiatives working to improve access to healthcare services for underserved communities.
  3. Educate others about the importance of health equity and the impact of social determinants on health outcomes.
  4. Engage in community outreach and support initiatives that address healthcare disparities and promote wellness.
  5. Stay informed and involved in local and global health issues, amplifying the voices of marginalized communities.

Together, we can create a future where everyone has equal access to the healthcare they need and deserve. Let’s work towards a healthier, more equitable world for all.

Cultural Perspectives: Understanding the Impact of Cervical Cancer on Black Women

Cervical cancer is a global health concern that affects women of all races and ethnicities. However, when we look into the cultural nuances surrounding healthcare, it becomes evident that certain communities face unique challenges. 

Black women, despite advancements in healthcare, continue to face disproportionate rates of cervical cancer. The reasons behind these disparities are complex and rooted in a combination of socioeconomic factors, healthcare access, and cultural considerations. To truly understand the impact, we need to listen to the stories of Black women who have faced the challenges of cervical cancer head-on.

Impactful Stories of Black Cervical Cancer Survivors

Shondria’s Journey: Navigating Societal Norms: “Giving up my dream of having children with the man I loved and giving Romeo a sibling was one of the hardest things to deal with. After Matt and I got married, people automatically asked when were we going to have a baby. My son was from a previous relationship and Matt didn’t have any kids and I was hoping that later down the line if we were still together we would be able to have a child or 2. I even told my doctor that I didn’t want to give up my reproductive rights but I still chose the supposed better option. On March 27, 2008, I had my radical hysterectomy where they removed my cervix, the top part of my vagina, my uterus, my Fallopian tubes, and about 20 lymph nodes. I requested a copy of my surgery report that showed that the cancer was about 1 cm. Everything else was negative for cancer. Raising awareness is so important and I don’t know how many times at work I hear my female coworkers say they don’t think they need a Pap or they’re too afraid to find out if it’s bad news. Also, knowing your family’s medical history is so important! My mom never told me that other women in our family have had cervical cancer, ovarian cancer, and vulva cancer, which is extremely important to know. Knowledge is power!”

Urika’s Story In Overcoming Systemic Barriers: “Before starting my chemo treatments, my doctor at the time was having issues with my insurance to get my treatment started. She was beginning to get frustrated with my health insurance company because she wasn’t able to begin my treatments without approval. I received a call one day from my doctor saying, “Ms. Fraser. you are young and you have three kids to live for. I can no longer wait for your insurance to be approved. So my next step is to have you come into the emergency room and be admitted into the hospital.” At this point, I had no other choice but to believe in my doctor and do as I was told. I was checked in and admitted. I was mighty scared. My doctor came in and explained to me my chemo plan. She informed me the only way for me to begin treatment was for her to keep me in the hospital and bill my insurance later. After talking to me about my treatments, she brought in the doctor who would be doing my radiation treatments and he informed me he would be doing my radiation treatments for free. I stayed in the hospital for over a month and a half. I even celebrated my birthday in the hospital all while doing chemo and radiation. Eventually, I was released from the hospital and able to go home – not to my kids but instead to a family member’s house because my house was over an hour away from the hospital. I continued my treatments and eventually the tumor was no longer there. However, the cancer had spread to my lungs. I had to have a small piece of my lung removed and started chemo all over again – and this time I lost my hair.”

Felicia Fe Fea’s Advocacy: Empowering Through Education: “I had been experiencing heavier periods for numerous years, but thought nothing of it until in 2017 when the bleeding turned into flowing out like a water fountain and giant blood clots that would randomly fall out. I had gotten to the point of having to wear Depends. I was pale and weak. I kept advocating for myself by asking questions to my OBGYN and my advocating and questioning were ignored and minimized. I was told it may be hormonal and I might be going through menopause. Even though I had been with the same OBGYN for over ten years, who knew my history of abnormal paps and who had performed two LEEPs on me which supposedly burned off the precancerous cells, had never checked for cervical cancer. Instead, they told me to eat rare steak and liver to raise my iron levels, shot me up with hormones, and conducted an ablation on me going straight through my cervix. During my ablation, the OBGYN talked about how she had not seen anyone bleed so much during this procedure but when I questioned her she stated how much experience she had and how she had done 100’s of these. As I bleed I was sent home with no answers. I continued to basically hemorrhage for months. I couldn’t work because large blood clots would just fall out randomly and the Depends could not even hold them. The doctor kept trying to force me back to work and kept suggesting a hysterectomy with no real diagnosis other than the heavy bleeding. I was so weak and tired of wearing Depends so I decided to go along with the hysterectomy. I had labs done and my numbers were so low I had to have a blood transfusion before I could have surgery. Not once did my OBGYN say “Let’s check for cancer”; even knowing my history, as if I were an experiment (much like the Mothers of Gynecology Anarcha, Lucy, and Betsey). I had my transfusion and was off to surgery in March 2018. The surgeon contacted me and stated she would be sending my cervix and uterus to pathology because it was “torn up”. After that, I got the ‘you have cancer’ call. My entire cervix was a tumor and I had stage 2B cervical cancer that had moved into my uterus.”

Moving Forward

Understanding the impact of cervical cancer on Black women requires a holistic approach that addresses cultural, social, and systemic factors. It’s crucial to amplify these stories, cultivate open dialogue, and promote education within communities. By acknowledging the unique challenges faced by Black women, we can work towards creating a healthcare landscape that is inclusive, equitable, and supportive for all. We can break the barriers and ensure that no one is left behind in the fight against cervical cancer.

Are you a cervical cancer patient, survivor, or thriver that identifies as Black? Share your story at Cervivor.org! Then join our private group, Cervivor Noir to gain support and learn how your story can create change.