Research Critique III-- Field Experience
On May 23rd, 2018, we visited a rural village approximately forty miles from the Public Health Research Institute of India (PHRII), geared with two vans full of medical supplies to prepare for a day of screenings of the cervix. For many of the women who attended the screening camp, medical centers and hospitals are too far for them to travel on their own, as well as too expensive to attend. We began with the set-up of the camp, placing mats on the floor in specific areas for the women to rest and wait for their screening by Dr. Vijaya Srinivas, a woman with more than twenty years of experience in working in women’s health. Prior to the screening, women began with a counseling session in which they were explained the pap smear procedure, as well the VIA technique to test for cancerous lesions and the symptoms associated with cervical cancer. The women were then brought into a private room where they were to give personal information to be recorded for PHRII records, including marital status, knowledge of HPV/ HIV diagnoses, and various other aspects of their medical history. Finally, the women were brought into a cool room in which they were given the pap smear and explained what they were to do following the procedure. Women who were not given a cervical cancer diagnosis were given a paper informing them to return to PHRII in three years for a follow-up, and women who were found with lesions, a paper informing them to return within a month.
This field experience day was very significant and stood out to me most of all the days spent in India, as it seemed to be the most beneficial to women who are in desperate need of cervical cancer screenings. Many women are unable to undergo cervical cancer screenings due to cultural beliefs, money, daily responsibilities, fear, or disbelief of their need for a screening. We were able in our five and a half hours in this camp to screen almost a dozen women.
The status of women’s health in India is regarded much differently than women throughout the rest of the world, causing many challenges when considering their reproductive health. For example, it was noted during the moments of sharing their medical histories that women are not to disclose their sexual history or current sexual status, as it is against their cultural norms to disclose such private information. We were then only permitted to ask the women if they are married and the duration, to know whether or not the women were indeed sexually active. There are also various stigmas present when mentioning a woman’s menstrual cycle, with many women being uncomfortable with answering the question at the camp. This stems from the way in which women are treated from their first onset of menstruation, with many women leaving school and not being given the proper materials to combat the menstruation.
Women being unable to attend cervical cancer screenings is one of the biggest challenges to face in this health phenomenon. Chan and So (2016) mention that ethnic minority populations with lower literacy levels and lower socio-economic status are less likely to undergo screenings that are pertinent to their health. The lack of education on one’s reproductive health causes a health disparity that has traveled throughout most of India. There are also women with household responsibilities, including but not limited to, cooking, cleaning, and taking care of the children. This causes women in rural areas, such as the one we visited, to be unable (even if educated on the importance of cervix screenings) to attend the screenings. During the time we spent in the camp, five women had to leave because of responsibilities that needed to be completed prior to their husband returning home. This has been supported by research throughout the years, with doctors and researchers being unaware of the reasoning for cervical cancer to be one of the biggest causes of death in India, but no governmentally funded programs being created to combat rising numbers of diagnoses. In 2008, cervical cancer was accountable for “9% (529,800) of the total new cancer cases and 8% (275,100) of the total cancer deaths among females, worldwide. More than 85% of these cases and deaths occur in developing countries.” (Hiremath, Hiremath, Kulkarni, Yatnatti, & Ghattargi, 2013)
Throughout the world, health disparities relating to women’s reproductive health exist, and have existed for many years. Not only in India, but many areas in the United States, women are not given the appropriate education and resources to combat cervical cancer and other aspects of their reproductive health. Race and socioeconomic status tend to cause the differences in trends seen throughout the US. Recent studies have shown that “black women continue to have higher cervical cancer incidence rates than whites (10.4 vs. 7.8 per 100,000 persons)” and “black women continued to have the highest cervical cancer mortality rate (4.3 per 100,000 persons) than any other racial/ ethnic groups from 2000-2009.” (Yoo, Kim, Huh, Dilley, Coughlin, Partridge, Chung, Dicks, Lee, & Bae, 2017) There are not many places in the US where free cervical cancer screenings are given, and one of the main programs where women are given those screenings (Planned Parenthood) is near being defunded because of America’s lack of understanding of women’s health. Being a non-profit and located in many areas of low socioeconomic status, this organization is very beneficial to the many women who are not given the proper tools to engage in proper reproductive health.
It’s crucial that light is being brought to these issues throughout the world, as women and their reproductive systems are stigmatized every single day. This includes embarking on various campaigns to bring awareness of the necessity of proper education being given to girls and women of all ages, starting at a young age. Menstruation can begin at as early as 8 years old, and women not being aware of their own bodies can only further the problem and deepen it into our core belief systems. It seems realistic, as the feminist movement is having a larger impact on our society, and has seen improvement in even the last year. I have always had a strong opinion on women’s rights and their rights to have healthy discussions on their reproductive health. Research has shown that these stigmas are not only transferred through generations by word of mouth, but various other “cultural artifacts,” such as advertisements, play a role. “Ads for menstrual products have have contributed to the communication taboo by emphasizing secrecy, avoidance of embarrassment, and freshness.” (Johnston-Robledo & Chrisler, 2013)
It is crucial for this stigma to be lifted from women throughout the world. Not only is it leading to a lifetime of holding shame of one’s own body, but is causing hundred of thousands of deaths throughout the world. Without a proper education on one’s body, women are subjected to confusion and a misunderstanding of how to handle themselves. When exactly women are going to be understood as human’s with specific health needs is unknown, however the future seems bright with more and more people coming to terms with the problem at hand.
References
Chan, D. N., & So, W. K. (2016). Strategies for recruiting South Asian women to cancer screening research and the lessons learnt. Journal Of Advanced Nursing, 72(11), 2937-2946. doi:10.1111/jan.13068
Hiremath, L. D., Hiremath, D. A., Manjula, R., Kulkarni, K. R., Yatnatti, S. K., & Ghattargi, C. H. (2013). Study of Socio Demographic and Microbiological Profile of Inflammatory Pap smear of Married Women in Urban Field Practice Area Bagalkot- a Cross-sectional Study. Medica Innovatica, 2(2), 51-55.
Yoo, W., Kim, S., Huh, W. K., Dilley, S., Coughlin, S. S., Partridge, E. E., & ... Bae, S. (2017). Recent trends in racial and regional disparities in cervical cancer incidence and mortality in United States. Plos ONE, 12(2), 1-13. doi:10.1371/journal.pone.0172548
On May 23rd, 2018, we visited a rural village approximately forty miles from the Public Health Research Institute of India (PHRII), geared with two vans full of medical supplies to prepare for a day of screenings of the cervix. For many of the women who attended the screening camp, medical centers and hospitals are too far for them to travel on their own, as well as too expensive to attend. We began with the set-up of the camp, placing mats on the floor in specific areas for the women to rest and wait for their screening by Dr. Vijaya Srinivas, a woman with more than twenty years of experience in working in women’s health. Prior to the screening, women began with a counseling session in which they were explained the pap smear procedure, as well the VIA technique to test for cancerous lesions and the symptoms associated with cervical cancer. The women were then brought into a private room where they were to give personal information to be recorded for PHRII records, including marital status, knowledge of HPV/ HIV diagnoses, and various other aspects of their medical history. Finally, the women were brought into a cool room in which they were given the pap smear and explained what they were to do following the procedure. Women who were not given a cervical cancer diagnosis were given a paper informing them to return to PHRII in three years for a follow-up, and women who were found with lesions, a paper informing them to return within a month.
This field experience day was very significant and stood out to me most of all the days spent in India, as it seemed to be the most beneficial to women who are in desperate need of cervical cancer screenings. Many women are unable to undergo cervical cancer screenings due to cultural beliefs, money, daily responsibilities, fear, or disbelief of their need for a screening. We were able in our five and a half hours in this camp to screen almost a dozen women.
The status of women’s health in India is regarded much differently than women throughout the rest of the world, causing many challenges when considering their reproductive health. For example, it was noted during the moments of sharing their medical histories that women are not to disclose their sexual history or current sexual status, as it is against their cultural norms to disclose such private information. We were then only permitted to ask the women if they are married and the duration, to know whether or not the women were indeed sexually active. There are also various stigmas present when mentioning a woman’s menstrual cycle, with many women being uncomfortable with answering the question at the camp. This stems from the way in which women are treated from their first onset of menstruation, with many women leaving school and not being given the proper materials to combat the menstruation.
Women being unable to attend cervical cancer screenings is one of the biggest challenges to face in this health phenomenon. Chan and So (2016) mention that ethnic minority populations with lower literacy levels and lower socio-economic status are less likely to undergo screenings that are pertinent to their health. The lack of education on one’s reproductive health causes a health disparity that has traveled throughout most of India. There are also women with household responsibilities, including but not limited to, cooking, cleaning, and taking care of the children. This causes women in rural areas, such as the one we visited, to be unable (even if educated on the importance of cervix screenings) to attend the screenings. During the time we spent in the camp, five women had to leave because of responsibilities that needed to be completed prior to their husband returning home. This has been supported by research throughout the years, with doctors and researchers being unaware of the reasoning for cervical cancer to be one of the biggest causes of death in India, but no governmentally funded programs being created to combat rising numbers of diagnoses. In 2008, cervical cancer was accountable for “9% (529,800) of the total new cancer cases and 8% (275,100) of the total cancer deaths among females, worldwide. More than 85% of these cases and deaths occur in developing countries.” (Hiremath, Hiremath, Kulkarni, Yatnatti, & Ghattargi, 2013)
Throughout the world, health disparities relating to women’s reproductive health exist, and have existed for many years. Not only in India, but many areas in the United States, women are not given the appropriate education and resources to combat cervical cancer and other aspects of their reproductive health. Race and socioeconomic status tend to cause the differences in trends seen throughout the US. Recent studies have shown that “black women continue to have higher cervical cancer incidence rates than whites (10.4 vs. 7.8 per 100,000 persons)” and “black women continued to have the highest cervical cancer mortality rate (4.3 per 100,000 persons) than any other racial/ ethnic groups from 2000-2009.” (Yoo, Kim, Huh, Dilley, Coughlin, Partridge, Chung, Dicks, Lee, & Bae, 2017) There are not many places in the US where free cervical cancer screenings are given, and one of the main programs where women are given those screenings (Planned Parenthood) is near being defunded because of America’s lack of understanding of women’s health. Being a non-profit and located in many areas of low socioeconomic status, this organization is very beneficial to the many women who are not given the proper tools to engage in proper reproductive health.
It’s crucial that light is being brought to these issues throughout the world, as women and their reproductive systems are stigmatized every single day. This includes embarking on various campaigns to bring awareness of the necessity of proper education being given to girls and women of all ages, starting at a young age. Menstruation can begin at as early as 8 years old, and women not being aware of their own bodies can only further the problem and deepen it into our core belief systems. It seems realistic, as the feminist movement is having a larger impact on our society, and has seen improvement in even the last year. I have always had a strong opinion on women’s rights and their rights to have healthy discussions on their reproductive health. Research has shown that these stigmas are not only transferred through generations by word of mouth, but various other “cultural artifacts,” such as advertisements, play a role. “Ads for menstrual products have have contributed to the communication taboo by emphasizing secrecy, avoidance of embarrassment, and freshness.” (Johnston-Robledo & Chrisler, 2013)
It is crucial for this stigma to be lifted from women throughout the world. Not only is it leading to a lifetime of holding shame of one’s own body, but is causing hundred of thousands of deaths throughout the world. Without a proper education on one’s body, women are subjected to confusion and a misunderstanding of how to handle themselves. When exactly women are going to be understood as human’s with specific health needs is unknown, however the future seems bright with more and more people coming to terms with the problem at hand.
References
Chan, D. N., & So, W. K. (2016). Strategies for recruiting South Asian women to cancer screening research and the lessons learnt. Journal Of Advanced Nursing, 72(11), 2937-2946. doi:10.1111/jan.13068
Hiremath, L. D., Hiremath, D. A., Manjula, R., Kulkarni, K. R., Yatnatti, S. K., & Ghattargi, C. H. (2013). Study of Socio Demographic and Microbiological Profile of Inflammatory Pap smear of Married Women in Urban Field Practice Area Bagalkot- a Cross-sectional Study. Medica Innovatica, 2(2), 51-55.
Yoo, W., Kim, S., Huh, W. K., Dilley, S., Coughlin, S. S., Partridge, E. E., & ... Bae, S. (2017). Recent trends in racial and regional disparities in cervical cancer incidence and mortality in United States. Plos ONE, 12(2), 1-13. doi:10.1371/journal.pone.0172548