….but we are all fabulous.
I attended my first medical conference a few weeks ago – the IFCPC 15th World Congress for Cervical Pathology and Colposcopy. This was a large international conference with 1000+ delegates from across the world attending. I had an e-Poster**, which was a bit of a non-event, but I also gave a talk about the levels of knowledge and awareness of the human papillomavirus (HPV) and cervical cancer in younger and older women*.
The whole experience was a complete eye-opener for me. On a personal level, giving the talk was very different from giving talks at conferences to cognitive psychologists. At these conferences, you present your data and theoretical interpretations before often having them challenged in quite a combative manner – with the intention of the challenger to be to push their theoretical interpretation over yours or to query the validity of your findings. Since this was all I had known, and since it mirrors the peer review process that accompanies submitting your work to journals, I thought nothing of it. Until attending my first medical conference…
At the IFCPC, I observed several talks before I gave mine, and the style of questioning was always the same – a very lovely thank you and acknowledgement of the talk, followed by genuine interest in the research that had been presented. “Can you tell us more about how you did x?” “Did you have any problems doing y?” “In our clinic we have z problem, how did you deal with this?” The delegates were all here to work collaboratively to improve the lives of women across the world and that felt wonderful. Even my talk, which was not clinical but rather psychological, was met with rigorous but generous questions, with audience members open to the suggestions proffered. I came away enthused and very much wanting to be a bigger part of this.
It also re-opened my eyes to the issue of global health inequalities.
The NHS is always in the news – people are always knocking it down, talking about how poor it is, how standards are failing and today, the Guardian led with a story about how it “could collapse within 5 years” http://www.theguardian.com/society/2014/jun/28/cameron-warned-nhs-in-danger-of-collapse. Whilst it is undeniable that things could be better – better managed, better funded, and there have certainly been some chocking scandals, it is easy to forget the good that the NHS does and how fortunate most of us are to have access to not just basic but advanced health care. We must not let it collapse in 5 years, 10 years, or ever.
In Africa, 38 countries do not have access to opioids, so no pain relief for cancers and other moderate to severe pain. At least one country in Africa only has 1 pathologist, which means diagnosing what biopsies have found is virtually impossible. These were just two of the facts that stood out from a wonderfully energetic talk given by Professor Lynette Denny who was awarded the BSCCP’s Founders Medal. She also commented that in her work in South Africa, she meets so many people who are HIV positive, that she is surprised when someone isn’t. I came away from her talk excited about all the people working to make a difference and almost speechless with horror about the conditions elsewhere in the world.
I say it ‘re-opened my eyes’ because of course I was already aware that elsewhere in the world, things are very different, but it is not visible on a daily basis, and because it is just through words on a page or short-lived media coverage of a fundraising campaign that we are made aware of suffering elsewhere, it becomes part of the background noise of unpleasant news stories. There are so many worth stories out there, so many tales of horror and heartbreak that you would be overwhelmed if you became personally affected by them all. But hearing these fantastic clinicians talking through personal experience cut through the background noise.
There are health inequalities in our own country: life expectancy at birth for men in the Calton neighbourhood of Glasgow is 54 years, 28 years less than that of men in Lenzie, a few kilometres away (WHO, 2008).
There are health inequalities across different strata of society: the prevalence of long-term disabilities among European men aged 80+ years is 58.8% among the lower educated versus 40.2% among the higher educated (WHO, 2008).
But since my personal interest is in women’s health, I thought I would just round up just an illustrative few facts about women’s health inequalities across the world:
The lifetime risk of maternal death during or shortly after pregnancy is only 1 in 17,400 in Sweden but it is 1 in 8 in Afghanistan (WHO, 2008)
Cervical cancer is the 7th most common cause of cancer death in Europe for females, with around 24,400 deaths from cervical cancer in 2012 (3% of female deaths). UK cervical cancer mortality rates are estimated to be the 9th lowest in Europe.
Cervical cancer is the 4th most common cause of cancer death worldwide for females, with more than 265,000 deaths from cervical cancer in 2012 (7% of female deaths). Cervical cancer mortality rates are highest in Eastern Africa and lowest in Australia/New Zealand (Cancer Research UK).
Approximately 84% of cervical cancer cases in 2012 occurred in less developed countries (World Cancer Research Fund International).
According to the latest (2008) WHO and UNAIDS global estimates, women comprise 50% of people living with HIV.
In sub-Saharan Africa, women constitute 60% of people living with HIV.
Violence against women (physical, sexual and emotional), which is experienced by 10 to 60% of women (ages 15-49 years) worldwide, increases their vulnerability to HIV.
Forced sex can contribute to HIV transmission due to tears and lacerations resulting from the use of force.
More than 125 million girls and women alive today have been cut in the 29 countries in Africa and Middle East where female genital mutilation (FGM) is concentrated (UNICEF, 2013).
Procedures can cause severe bleeding and problems urinating, and later cysts, infections, infertility as well as complications in childbirth and increased risk of newborn deaths.
3 million girls are at risk every year in Africa.
20,000 girls in the UK are at risk of FGM every year.
101 million girls aged 10 and above in Africa have undergone FGM (Plan-UK)
Obviously no one person can do something about all the problems in the world, but we could all pick one issue dear to our hearts to champion – by fundraising, writing letters, organising petitions, volunteering, or in the case of the clinicians I met at the IFCPC, by working to make a difference.
*Sherman, S. M., Minshall, C., Nailer, E., & Redman, C. W. E. (May, 2014). Knowledge of cervical cancer and HPV in younger and older women. Paper presented at the 15th World Congress for Cervical Pathology and Colposcopy, London.
**Sherman, S. M., Nailer, E., & Redman, C. W. E. (May, 2014). Disclosing the results of the invasive cervical cancer review to patients: a survey of lead colposcopists. Poster presented at the 15th World Congress for Cervical Pathology and Colposcopy, London.