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Rima Dandachi, Head of the May Jallad Foundation with SCEME’S Jessica Sarhan |
At present, breast cancer is the leading cancer among women in Lebanon and constitutes 21% of all cancer cases. However, despite relentless awareness campaigns taking place throughout Lebanon and the Arab world, there still exists a culture of shame surrounding breast cancer, especially in rural communities. Rima Dandachi, President of the May Jallad Foundation, explained that this stigma is part of a difficult cultural mentality; “People just don’t talk about it. They used to call it The C Disease or The Other Disease, they couldn’t even mention it.” Nancy G. Brinker, founder and CEO of Susan G. Komen for the Cure urged that whilst the U.S faced a culture of shame and silence regarding breast cancer thirty years ago, “this problem is still a very grave and intricate one in the Middle East.”On asking breast-cancer patients if they would be confortable speaking about their experience, many declined, insisting that they did not want their neighbors to know of their illness. One woman refused to speak publically as she had not yet told her mother that she had breast cancer.
If detected at the early stages, breast cancer survival rates are as high as 98%, however, vast numbers of women continue to live in fear of admission of their illness anddo not seek help until the later stages of the disease when it becomes fatal. Princess Ghida Talal of Jordan, an advocate of breast cancer awareness in the Arab World, explained that women are failing to open up about their disease for “fear of being ostracized by their society and even sometimes their own families. They decide instead to avoid or delay diagnosis or treatment with the inevitably tragic consequences for the woman and her entire family”.
On asked why she feels this taboo exists, Anne Frangie, President of Faire Face, a Lebanese organization that sets out to raise awareness and funds towards breast cancer, explained that; “There is a fear of mastectomy. Women feel that there will be no future for them without breasts. I think women in Lebanon and the Arab world are especially afraid that if they lose their breasts, maybe their husbands will not want them or will divorce them. And for young women, it is the fear that they will never get married.” Tragically, Dandachi concurred, stating that divorce is incredibly common amongst couples where the woman is a breast cancer sufferer.
In addition to cultural stigma, women continue to be reluctant to get treatment due to the severe financial burden that comes with breast cancer. The costs of cancer treatment, which can go on for years, are staggering. “It is an expensive disease, with an expensive and long treatment. Even in remission, you still have to take your medicine. It’s a big burden, emotionally and financially,” urges Dandachi.
Whilst the Ministry of Health does cover up to 85% of treatment costs, patients are expected to pay the remaining 10-15%, which can still be thousands of dollars, leaving women from impoverished backgrounds unable to fund themselves through their illness. “There are so many associations and NGO’s here in Lebanon, that work towards prevention and awareness but nobody is really working for those who already have the disease” explains Dandachi, “I have seen so many families forced to sell their cars and they take their children out of school – the way people are pushed into poverty by paying for cancer-treatment is unacceptable.” This is why the May Jallad foundation is committed to helping with the costs of treatment and work closely with the Makassed Hospital to ensure that patients get the care they need.
There remains the issue of myths surrounding mammograms. In 2006 it was reported that 71% of women over the age of 35 in Lebanon have never had a mammogram despite the recommended bi-annual check-up for all women over 40. Women remain under the false impression that mammograms are painful and many are simply in denial – scared to know the reality of whether they have the disease or not.“Though most women recognize the importance of early breast cancer detection, the vast majority are still reluctant to get a mammogram for various reasons including fear or difficulties in accessing a center” explained Dr. Salim Adib, a leading epidemiologist andmanager of public health at the Health Authority in Abu Dhabi.
However, despite these setbacks movements are being made towards breaking taboos and the death rate from breast cancer in women has been gradually decreasing since 1990. “This mentality is changing,” insists Dandachi. “It’s changing because people are accepting the facts and becoming more open about breast cancer.”
Faire Face prides itself on its Mobile Mammogramprogram. Organized by the Lion’s club and funded by Faire Face, this program allows a vehicle, containing all the necessary equipment to conduct a mammogram, to travel around rural parts of Lebanon and provide women with free-check-ups and almost immediate results. It has proved incredibly popular, with women from the most remote communities eager to make use of its facilities. In addition to this, Faire Face is continually organizing conferences and visits to medical centers where oncologists are committed to showing women the benefits of early detection and break the myths surrounding mammograms.
“The results are more and more encouraging,” explains Frangie, “because of television, the internet and the campaign, a dialogue is being created about breast cancer. Women who have breast cancer are now talking about their experiences and how important early detection is. So things are changing.”
In October, The Ministry of Health will commence a three month program that will provide half price mammograms in private hospitals and free ones in governmental hospitals throughout Lebanon. Hopefully with movements such as these, Lebanon and the Arab world can strive towards a society where breast cancer is free from any social stigma.
You can check out the Faire Face Website: http://www.fairefacecancer.org.lb/ And the May Jallad Foundation: http://mayjalladfoundation.com/