LETTER | Women in rural S'wak need access to breast cancer screening urgently

LETTER | As we mark Breast Cancer Awareness Month this October, I call on the Sarawak state government to ensure that all women in rural Sarawak have access to breast cancer screening urgently.

As a mother of five, and a Sarawak healthcare campaigner, this is an issue that is particularly close to my heart. Having lost my own mother due to maternal healthcare complications and inadequate healthcare access in rural Sarawak, I understand the pain and suffering that is faced by our local Sarawakian women, particularly in the Ulu.

According to the National Health and Morbidity Survey (NHMS 2019), the breast screening rate in Malaysia is extremely low, and three in four women aged 40 and above have never had a mammogram. The situation in Sarawak is likely to be even worse, but we do not have clear up to date statistics to show home many women in rural Sarawak participate in breast cancer screening.

What we do know though is that nearly half of breast cancer cases in Malaysia are diagnosed late ( stage 3 and stage 4) according to the Malaysian National Cancer Registry Report and as a result, the five-year survival rate for breast cancer is only around 66.8 percent according to the Malaysian Study on Cancer Survival (MyScan).

This is a real tragedy, especially as breast cancer is a highly treatable disease if detected early. In rural Sarawak, however, breast cancer awareness is extremely low, and we often hear very sad accounts of how women have hidden breast lumps for months and sometimes even years due to ignorance, fear and stigma.

We often hear of friends, neighbours and family in the villages and longhouses who are diagnosed with very advanced fungating breast tumours and by the time they seek medical help, the cancer has spread to other parts of the body, and they sadly pass away soon after.

There are many barriers to accessing cancer care amongst Sarawakians in rural Sarawak. Firstly is the issue of education and awareness. Many women simply are not given education and support about the importance of regular breast examinations and what to do if they find a lump.

Training community women as healthcare champions and ensuring patient information is available in local languages is an essential step to educating women on breast health.

Secondly, Sarawakians face huge healthcare access issues when trying to access clinic or hospital services for further investigations and diagnosis. Village clinics do not have the facilities for a breast ultrasound or mammogram for screening and early detection.

Hence there is an urgent need for mobile mammogram units to bring breast cancer screening facilities to every village and longhouse throughout Sarawak. Some women may live many hours from a district or specialist hospital, and the journey to town may be too expensive, costing RM200-300. If they do manage to make it to a hospital for initial assessment and biopsy, they may not be able to afford to return for their results and treatment.

Thirdly, for those diagnosed with cancer, they and their families may face financial catastrophe if required to pay for hospital visits and any additional treatments not covered by the government.

During our community outreach programmes, we have found that the majority of cancer patients in rural Sarawak are unaware of My Salam and other welfare benefits that may help them throughout the course of their cancer treatment. Dedicated social worker teams are urgently needed to help these patients access the support and benefits they are entitled to.

On behalf of all women in Sarawak, we urge the state government to urgently implement a dedicated statewide breast screening programme with a community education campaign, mobile mammogram units, rapid access assessment clinics and enhance our cancer treatment services in Sarawak. We cannot wait any longer whilst our women, wives, sisters, mothers and children die quietly in our longhouses and villages of breast cancer.

AGNES PADAN is Sarawak PKR Women chief.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.