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23 October 2020 | Story Nombulelo Shange and Lesego Bertha Kgatitswe | Photo Pixabay
It is #BreastCancerAwarenessMonth, and women in rural areas struggle to receive and understand the life-saving messages, as much of the awareness is predominately in English, while cancer centres and health facilitates are mostly located in urban areas.

It is Breast Cancer Awareness Month, and questions around the reach of awareness are important to ponder. Who is the awareness really for? Much of the awareness is predominately in English, while cancer centres and health facilities are mostly located in urban areas. The result – women in rural areas struggle to receive and understand the life-saving messages. Accessibility remains a huge challenge when it comes to both diagnosis and treatment. Once diagnosed, black women must contend with many other socio-economic challenges that limit them from receiving treatment, even if it is free and provided by public healthcare institutions.

Overwhelming number of black women is poor and marginalised in SA

Women in the Northern Cape and parts of North West, for example, have to travel to Kimberley to access breast cancer treatment facilities. Kuruman has a satellite facility, but with limited resources and staff. Northern Cape is the largest province in South Africa when it comes to land mass, and most poor rural black women cannot afford the cost of travelling to Kimberley because of extreme poverty. A 2019 study conducted by the Pietermaritzburg Economic Justice and Dignity Group shows that 55,5% of the South African population survives on R40,90 per person per day. South Africa is also the most unequal society in the world, with those historically marginalised by colonisation and apartheid still being the most oppressed even today. Black women make up an overwhelming number of the poor and marginalised in SA. When black women are diagnosed with breast cancer, they have the burden of having to pit their bread and butter issues against their health concerns. Transport, food, and other travel costs have the ability to push these women and their families deeper into poverty when important healthcare institutions are far and inaccessible. 

Breast cancer awareness and education needs to be scaled up in the black communities to also consider these socio-economic limitations. Greater focus on primary healthcare is also needed with regard to speedy referral for screening and diagnostic tests. These interventions are still largely lacking in black communities, partly because of the myths around who is affected by cancer. The misconception is often that cancer is a disease that only affects white people, and it still persists despite the growing incidences of cancer among black women. One of the reasons influencing this racialised idea of the illness might be the fact that there are seemingly higher incidences of breast cancer among white women than among black women.

In 2011, the National Cancer Registry reported that the overall risk for breast cancer in South Africa is 1 in 29 women, and further estimated that the lifetime risk is 1 in 12 among white women and 1 in 50 among black women. These figures, however, do not account for the black women who might never receive a proper diagnosis. Current and accurate research is not available on how these figures might have changed over the past 10 years. The 2017 Breast Cancer Prevention and Control Policy, however, attributes lower incidence of breast cancer among black women to multiple socio-cultural factors, such as universal and prolonged lactation, low use of hormone replacement therapy, late menarche, early age of first birth, and a diet low in fat and high in fibre. However, due to rapid urbanisation and lifestyle changes, there has been a significant decrease in these protective factors, making black women vulnerable to increased incidences of breast cancer and mortality.

Public healthcare system had to prioritise simultaneously 

Historically, cancer, along with other non-communicable diseases, have been understood as diseases of affluence, as they are related to economic development, consumption, and lifestyle. In contrast, infectious or communicable diseases were understood as diseases of poverty and impoverishment. These crude categorisations were central in explaining global health inequalities, but the epidemiological transitions of the past few decades have forced us to think more critically about these issues. South Africa as a middle-income country is a case in point, with a disease burden of both communicable and non-communicable diseases, which the public healthcare system had to prioritise simultaneously. Breast cancer has thus been declared a national priority, as highlighted by the Breast Cancer Prevention and Control Policy of 2017.

The policy notes that women who live in rural areas are at a disadvantage regarding access to information and services; however, little is said about the intersections of race, class, and gender in understanding the structural barriers to breast cancer awareness and knowledge. The poor or inadequate breast cancer awareness and knowledge among black women should be a call for concern.

Poor knowledge and awareness of breast cancer leads to delayed detection, presentation, diagnosis, and treatment. This results in a late stage of cancer upon diagnosis, aggressive cancer treatment, severe side effects, poor quality of life, or worse – mortality. As public health specialists often say, ‘equity in healthcare begins with equity in health education’. Sociological analysis and theorising are thus important for us to understand these structural barriers, starting with how black women’s bodies are seen and treated. Researchers around the world have highlighted how the healthcare system treats black women differently as a result of implicit racial bias, discrimination, and racism.

American critical race theorist and feminist scholar, Patricia Hill Collins, attributes the discrimination experienced by black women to vectors of oppression that intersect in black women’s lives. Poverty, lack of representation in healthcare systems/leadership, discrimination along racial and gender lines – all these vectors come together and make access to healthcare a huge challenge for black women. Systems marginalise black women for economic gain or to maintain patriarchal dominance, making even the most basic rights and institutions inaccessible to black women.

The exclusion of black women

Beyond awareness, these challenges also speak to the exclusion of black women in public spaces, in senior positions within healthcare, in leadership, and in important decision-making that can impact how they navigate the world. The lack of representation affects even the personal aspects of black women’s lives, such as how they experience illness.

Feminists tackle this challenge by turning the personal into the political. Politicising the personal is forcing the challenges that women are faced with into the public space, compelling institutions and leaders to address these challenges. Breast cancer awareness does this in part, which is one of the things that makes the movement so important. But is it leaving black women behind?  

While awareness might be lacking for black women with breast cancer, it is important to note that some women have exercised their agency to advance breast cancer awareness. Mama Lillian Dube, for example, used her public platform to talk about her experiences of breast cancer, demystifying the illness, and advocating for quality healthcare services for women. We also need to tap into existing structures and initiatives; community healthcare workers have done great work in the past to create awareness around HIV/AIDS. Similar strategies should be considered for breast cancer awareness to ensure that no woman is left behind.  

Opinion article by Nombulelo Shange, Lecturer in the Department of Sociology, University of the Free State, and Lesego Bertha Kgatitswe (Lecturer in the Department of Sociology at Sol Plaatje University)  

 


News Archive

During 2011: Appointments
2011-12-01

Dr Lis Lange: Senior Director: DIRAP

Description: 2011 Appointments_Lis Lange Tags: 2011 Appointments_Lis Lange

Dr Lis Lange, an Argentinean by birth, immigrated to South Africa twenty years ago – a few weeks after Nelson Mandela had walked through the gates of Victor Verster. For the past ten years, she has been involved in quality assurance for higher education institutions at the Council on Higher Education at national level.

She is assisting our university in the areas of quality assurance and academic planning, contributing to the development of deep intellectual debate and multi-disciplinary research.


Prof. Charles Dumas, Department of Drama and Theatre Arts

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Prof. Charles Dumas, Extraordinary Professor in our Department of Drama and Theatre Arts, will be spending three months per year for the next three years at our university to help develop filmmaking, specifically focusing on the development of the Video Unit Planned for the Department.

Prof. Dumas started the year off with the production, Our Father’s Daughters, which was produced during the Mini-festival as well as at the Reitz Four reconciliation meeting. The production was also turned into a short film. Prof. Dumas gave film-acting classes to the third-year drama students. He directed multiple productions, such as the third-year module production Ipi Zombi, the Grahamstown Festival production, Seven Guitars and the Dance/drama production, Race, Reconciliation and the Reitz Four.


Prof. Daniel Plaatjies, UFS Business School

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Prof. Daniel Plaatjies is the former Director and Head of the Graduate School of Public and Development Management at the University of the Witwatersrand. He was mainly responsible for the leading, directing and managing of strategic academic programmes, teaching, research, governance, service management and monitoring. Prof. Plaatjies, who was appointed as Visiting Professor at our Business School this year, will as part of his new duties at our Faculty of Economic and Management Sciences, be lecturing part-time and supervise our PhD students.


Prof. Johann Neethling, Department of Private Law

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Prof. Johann Neethling’s career is now completing its full circle with his appointment as Senior Professor in our Department of Private Law. In 1965 he was a first-year at this university. With his nine law text books and nearly 200 articles, together with 40 years’ experience in academic training he is of inestimable value to this Department. His publications contribute to the establishment of our university as a research institute.


Prof. Hussein Solomon, Department of Political Science

 Description: 2011 Appointments_Hussein Solomon Tags: 2011 Appointments_Hussein Solomon

Prof. Hussein Solomon joined our university this year as Senior Professor in the Department of Political Science. Formerly he worked in peace NGOs, advised diplomats and acts as a serving officer in the South African Air Force.

His area of research expertise includes conflict and conflict resolution in Africa; South African Foreign Policy; international relations theory; religious fundamentalism and population movements within the developing world. He is also the author of a number of books, including one on global jihad and one on India's secret relationship with apartheid South Africa.

He is also member of the internationally renowned Our Humanity in the Balance (OHIB) organisation, where his role is to bring these disparate communities together and to focus energies on a common project.


Prof. André Keet, International Institute for Studies in Race, Reconciliation and Social Justice

Description: 2011 Appointments_Andre Keet Tags: 2011 Appointments_Andre Keet

Prof. André Keet, our Director of the International Institute for Studies in Race, Reconciliation and Social Justice, joined the University of Pretoria on a part-time basis in 2008, whilst being a Commissioner on the Commission for Gender Equality. Later he left the Commission and joined the University of Fort Hare. “I was happy to join academia and now also serve on the Stellenbosch University Council; therefore I am very aware of the challenges facing higher education,” he said.

His vision for the Institute is to support higher-education transformation, promote non-discrimination, reconciliation and human rights, build national, regional and international networks, and developing ‘new’ languages, knowledge and discourses for reconciliation and social justice, all to the benefit of our university and South Africa.”


Prof. Helene Strauss, Department of English

Description: 2011 Appointments_Helena Strauss Tags: 2011 Appointments_Helena Strauss

Prof. Helene Strauss completed her PhD at the University of Western Ontario, London, Canada, where she taught courses on Film Studies, Children’s Literature and South African Literature and Culture. “I was subsequently appointed as an Assistant Professor in the Department of English and Cultural Studies at McMaster University, Hamilton, Canada.” She joined our Department of English this year.

Prof. Strauss has an on-going preoccupation with questions concerning social justice, race, gender and ethical interpersonal interaction in South Africa and beyond.


Prof. EC Ejiogu, Centre for Africa Studies

Description: 2011 Appointments_EC Ejiogu Tags: 2011 Appointments_EC Ejiogu

After 22 years in the United States of America, Prof. EC Ejiogu decided to return to Africa – to his roots – to join our university’s Centre for Africa Studies at the beginning of 2011.

Before joining the Centre, he was Assistant Research Professor in the Centre for Innovation at the University of Maryland, College Park. As Senior Researcher at the Centre, he has already helped with the streamlining of the academic programme, restructuring it to enable students to gain skills necessary to deliver a research proposal towards a dissertation after their three years of study. He has also taken up PhD and Master’s supervision.

His latest publications include a book published in March 2011 with the title, Roots of Political Instability in Nigeria, and a book co-edited with Prof. Kwandiwe Kondlo, Director of the Centre for Africa Studies, Africa in focus: Governance in the 21st century, published in April 2011.


Pura Mgolombane, Vice-Dean: Student Affairs

Description: 2011 Appointments_Pura Tags: 2011 Appointments_Pura

Bringing with him a decade of experience in Student Affairs our new Assistant-Dean for Student Life and Leadership, Pura Mgolombane, has big plans for student development. He says his office wants to help Kovsies increase its throughput rate and produce socially well-adjusted and employable graduates in South Africa, the continent and anywhere in the world.

Before joining Kovsies, he was employed as Director: Student Life, Governance and Culture at Walter Sisulu University. Pura, who has a background in Human Resources, Business Management and Corporate Law, says his academic training has empowered him with skills to ensure that the Student Life and Leadership is properly led, governed and managed.


Prof. Hasina Ebrahim, School for Social Sciences and Language Education

Description: 2011 Appointments_Hasina Ebrahim Tags: 2011 Appointments_Hasina Ebrahim

This former academic from the University of Kwa-Zulu Natal was appointed as Associate Professor at our School for Social Sciences and Language Education in the Faculty of Education. Amongst others, she is the project coordinator for the Faculty’s Early Childhood and Foundation Phase Teacher Education Programme and the MEd and PhD supervisor in the programme.

Prof. Ebrahim is also the Deputy-President of the first South African Research Association for Early Childhood Education (birth to nine). “This is certainly a milestone to profile the university in terms of its thrust towards excellence in research,” she says. One of the main aims of the association is to shape the research agenda for a marginalised field in South Africa. 


Prof. Corli Witthuhn, Faculty of Natural and Agricultural Sciences

 Description: 2011 Appointments_Corli Witthuhn Tags: 2011 Appointments_Corli Witthuhn

Prof. Corli Witthuhn, a former Bloemfonteiner, attained her PhD in Microbiology at our university. Therafter, in 1999, she was appointed as a lecturer at Stellenbosch University and later as Vice-Dean.

Currently she is our Vice-Dean in the Faculty of Natural and Agricultural Sciences. She hopes to sustain her research here at our University.

Her life motto? “Opportunities are presented in the form of obstacles,” she says.
 


Prof. Melanie Walker

Description: 2011 Appointments_Melanie Walker Tags: 2011 Appointments_Melanie Walker

Prof. Melanie Walker is a prominent South African scholar who has been working as Professor of Higher Education Studies at the world-leading University of Nottingham in the UK, where she been Director of Postgraduate Students and a Director of Research in the Faculty of Social Sciences. She will join the University of the Free State in February 2012 as Senior University Professor in the Postgraduate School.

She is a graduate of the University of KwaZulu-Natal and the University of Cape Town, where she completed her PhD, after teaching in disadvantaged secondary schools for a number of years. Prior to working at Nottingham she worked at the Universities of Sheffield, West of England and Glasgow, as well as the Universities of Cape Town and the Western Cape. She is also a Fellow of the Human Development and Capability Association. She is currently Director of Research Training and a senior researcher in the EU-funded Marie Curie EDUWEL project, which includes senior researchers from eight European countries and 15 early-stage researchers.

With a long-standing commitment to social-justice research and equality practices, she is currently widely recognised internationally as leading in the application of the capability approach and human development to higher education policy and practice. Among others, she has led or participated in research projects funded by the NRF (South Africa), the Higher Education Academy (UK), HEFCE (UK), EU, and ESRC/DfID, which funded the Public-Good Professionals’ Capability Index research project. 
 

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