Pakistan Is Missing the Pink Ribbon

October was Breast Cancer Awareness Month internationally. The sight of pink ribbons the past few weeks reminded me of an article about a troubling statistic I read earlier this year: Forty thousand women die of breast cancer every year in Pakistan. To put that in perspective, about the same number perish in America due to the disease, yet the population in the United States is double the size of Pakistan’s. One in nine women is at high risk of developing breast cancer in Pakistan, a significantly higher rate than those affected by militancy or terrorism.  Despite Pakistan registering the highest rate of the disease in all of Asia, the topic has been seen as too taboo for public discourse for some time now, leaving much of the population ignorant about preventative and screening measures.

In the socially conservative South Asian country, discussion of breast cancer has been nearly non-existent due to social stigma. Pink Ribbon Pakistan, an NGO founded in 2004 that provides public awareness and mobile screening services, had to use the term "cancer of women" during a presentation at a university last year regarding mammograms and checking for lumps. The word ‘breast’ is viewed as a sexual term and therefore unfit for public discussion.  In many regions, societal norms have dictated that breast exams and screenings are immoral.

Due to the absence of public education on breast cancer, many women are not aware of their risk and need for regular self-exams.  Those who are diagnosed often do not tell their families or spouses.  Most cases of breast cancer in women in Pakistan are discovered late stage, when the rate of survival is drastically lower.  Often Pakistanis will seek treatments from a traditional or spiritual healer first; by the time they see an oncologist, the tumor is stage III or IV, more likely to spread, and more difficult to treat.

The shortage of women physicians and specialists further complicates matters. Although a record number of women are graduating medical school in Pakistan, most are pressured by family members to get married and not to pursue the profession upon graduation. The medical degree, instead, is valued for boosting a woman’s marriage prospects. This shortage of women physicians and specialists is damaging — many families do not want their wife or daughter examined by a male doctor.

Luckily, the tide is starting to change and Pakistanis are learning more about the prevalence of breast cancer in their country. The Pakistan Monument, which sits atop Shakarparian in Islamabad, was illuminated with pink lights in honor of ‘Pinktober.’ Recently a breast cancer clinic opened at the Holy Family Hospital in Rawalpindi. Pinktober was marked this year, with a fair at a Karachi mall providing information on self-examinations. One booth visitor, Erum Amir said: "Even though this disease is killing so many Pakistani women every year, there is a strong perception in our society that it is a stigma, and that sadly marks the end of the story for us."

As highlighted by the Nobel Committee’s awarding Malala Yousafzai the Peace Prize recently, education and access to information for women and girls is paramount for creating a healthy and functioning society.  Empowered and educated woman will not only help themselves, but also one another and society at large. In the case of breast cancer, it starts with honest, public discourse and prioritizing access to screening and detection services.  Kudos to the organizations and cancer survivors, such as former Speaker of the National Assembly Fahmida Mirza, working to break social taboos and create an environment where women no longer have to die due to a stigma or shame.

Kelsey L. Campbell is a member of the Truman National Security Project.  She has lived and worked in Pakistan.