On Breast Cancer: Stay Well Until October

Piše Sanja Hajdukov

October is the month of books, libraries and pink ribbons.
A long time ago, we would get up early on Saturdays, to catch the cult radio show “Primus”, in which the boys from the “Top Lista Nadrealista” (The Top List of Surrealists) used to amuse us to tears.
One long-past October, the topic was the then event “October Days of Culture”, where they asked a library employee: “Will you be able to remain cultural until the end of October?”
Since there are more and more medicine and medications, and less and less health, Bosnia and Herzegovina have taken the lead in Europe in breast cancer mortality. At the very top of this list, we are competing with Serbia and Albania, which have, nevertheless, significantly surpassed us in prevention, because they have a more or less functioning system of inviting women for preventive examinations.
Scandinavian countries have contained the incidence of this disease to less than 10 per cent, all by prevention. Maybe by healthy lifestyle, maybe by cleaner air, but definitely by preventive screening.
Patients Make the Healthy Aware
If we were to ask the citizens of Bosnia and Herzegovina if this kind of prevention exists in our country, they would probably, without too much ado, say that it does, that it is being worked on, but in fact, absolutely nothing is being done. A problem cannot be solved by a month of fighting, but by the establishment of a functional and continuous system that deals with it.
In Bosnia and Herzegovina, this problem is discussed a little more in October than before. That story results in members of associations of ill and healed women putting pink ribbons on their lapels as a token of support. It is these women, who should, in fact, be the least responsible and obligated, who make the healthy aware, go out to the squares, selflessly share their experiences, give advice, find medications…
But, really, why would this be their obligation? Is it not the interest of still-healthy women to take this matter over? Moreover, isn’t the only and true obligation of this society to establish a system for prevention? Also, are women, if not all, then at least the educated ones, women from cities, where everything is more accessible, organized in the fight for the establishment of a prevention system?
Breast cancer is the leading malignant disease in women in Bosnia and Herzegovina and the region, and not just women, for that matter. It can be cured in 90 per cent of cases if discovered in time. Women are advised to self-examine to diagnose the beginnings of this disease, but the matter of fact is that breast cancer, when in stage suitable for lay palpation, is already in the third of the four stadia of the development of this disease, and may be treated in the first two. The only comfort is that a smaller percentage of cancer is malignant when palpable.
Consequences of Emigration of Professionals
The only way to fight for the population, for women’s health and for conscientious management of the funds of the Institute for Health Protection is early detection, because then it is efficient and cheap, as opposed to expensive, difficult and unreliable treatment methods.
The other day I was unable to undergo a breast mammogram because no technicians were working on this device at the healthcare centre. They are all on sick leave or already getting a one-way ticket to Germany. We are substantially suffering from the consequences of the emigration of qualified professionals, especially medical staff and, of course, this phenomenon of insufficiently coordinated employment of new staff.
We know that employment procedures are long-lasting and that our politically elected managers of health institutions do not have managerial knowledge and qualifications, so employment is in a complete disparity with vacancies incurred as a result of the exodus of professionals.
And I wanted to honour October.
The problem, as all problems of disordered societies with immature democracy, is multi-layered. The fight against breast cancer is led, in fact, by the healed and the diseased women, going out on city squares and sharing pink ribbons. In fact, no one deals with the prevention, nor are healthy women requesting it.
Health Is for the Rich
It all comes down to waiting or suppressing the thoughts; and reasoning that is so characteristic of us - it is happening to someone else…
Prevention requires a stable and clear system, which someone needs to develop, which should cover all women. Those who need to work on the development of the system are in the ministries and governments, obsessed with senseless egoism, dealing with themselves, of course, and believing that this problem does not concern them. Some do not know, and some are simply tired and overwhelmed.
Tolstoy wrote about the prisoners cast out to the Siberian taiga who, being left there to a callous struggle for life, began to eat each other.
“Cannibalism doesn’t begin in the taiga, but in the ministries and departments, it actually ends in the taiga!” (Resurrection, L.N. Tolstoy)
In Bosnia and Herzegovina, every eighth woman falls ill. The other day, 16 of us listened to a lecture on the early diagnosis of breast cancer, because – it’s October. Of the 16 women in the room, two were already statistically ill. Of course, the women who undergo examinations on their own initiative will get an appointment in six months, a year, or even later. The number of women who take the warnings seriously and who have the money will undergo an examination outside the public healthcare system and pay for it with their own money. Health is for the rich!
Prevention Is Cheaper Than Cure
Having failed to get a mammogram, I wonder if I will be able to remain conscientious and scared until the end of October?
As with everything, prevention is considerably cheaper than treatment. Prevention is left to the citizens and associations of those who have already gone through this ordeal. How to reach rural women and those who live in small towns, when there are no mammographs even in larger ones, and now there is no staff to utilize them. Why don’t we and when will we have mobile mammographs? Maybe when the first cases of “cannibalism” befall?
Tolstoy also said: “If you don’t know how to deal with people, sit in peace, deal with yourself, deal with things, deal with anything, just don’t deal with people”.
Also, what does a woman do when she is scared of all knowledge, threats and dangers, except to pat herself on the shoulder and say: “Stay well until October, then we’ll get to it…”

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