Dr. Vijay NarayananMBBS MD MA MPhil PG Dip Pall .care

Clinical Director, Cancer Care Kenya

What is Stigma?

“A mark of disgrace associated with a particular circumstance, quality, or

person“. (Oxford dictionary)

Who is a stigmatized person? A stigmatized person is a person whose social identity, or

membership in some social category calls into question his or her full humanity-the person is devalued, spoiled or flawed in the eyes of others .Crocker, Major and Steele (1998)

Stigma will lead to ‘Negative evaluation’ Negative evaluations may be “felt” or“ enacted”. A felt negative evaluation is internalised and may lead to shame

or guilt associated with having a condition and to the fear of being discriminated against on the grounds of social unacceptability because of that condition.

An enacted negative evaluation refers to actual discrimination.

Types of stigma

An abomination of body Blemishes of individual moral character Tribal stigma

Elements of stigma

The problem of Knowledge – ignorance The problem of Attitudes – prejudice The problem of Behaviour - discrimination

Consequence of stigma

Stigma / fear of being stigmatised can result in people with cancer not getting help and having reduced self-esteem or confidence.

They can become socially isolated and excluded from society – none of which helps them cope with their illness or recover.

Cancer and Stigma

The word ‘cancer’ was once considered unacceptable in the public sphere, and even today, euphemisms such as ‘the Big C’ are common.

Polls in the US and Europe find that at least half the population say they fear cancer more than any other disease.

Around a third to a fifth say they fear cancer more than other potential catastrophes, such as violent crime, debt, and losing a job

What others do :

OCTOBREAST PINK RIBBON Breast cancer awareness month-

BCAM BCAM- is an annual international

health campaign BCAM-organized by major

breast cancer charities every October

BCAM- helps to increase awareness of the disease and to raise funds for research into its cause, prevention, diagnosis, treatment and cure.

What others do:

Movember movement www.movember.com

The goal of Movember is to "change the face of men's health- esp. Prostate cancer, Testicular cancer

Movember challenges men to grow a moustache for the 30-days of November, thereby changing their appearance and the face of men’s health.

In October Mo Bros sign up at movember.com, and on the 1st November start their moustache growing journey with a clean shaven face.

What others do :

BEATING BOWEL CANCER

DECEMBEARD

BBC –extends support to patients living with bowel

BBC-provides a dedicated nurse helpline BBC –gives free informational material for

patients in hospital at different stages of their diagnosis and disease

What others do :www.baldcartoons.com

‘Bald cartoon movement’ Started in Brazil Started to help children

with cancer with their experience of undergoing chemotherapy and losing their hair.

The campaign centres on well-known cartoons from around the world that have been redrawn without any hair

The idea that “a child with cancer deserves to be seen just like any other child

Cancer in childhood:

Cancer ribbons

How to stamp out Stigma: Few suggestions

Health care professional Patient

Reduce stigma to yourself Share with those you trust Read about others

www.livestrong.org

Diagnosis and disclosure Information needs Support Raising awareness Expose frauds- Jicho Pevu

Oncology health care professionals’ attitudes to cancer:a professional concern

Regardless of gender, profession and clinical experience, all health care professionals display persistently negative attitudes towards cancer.

Need for radical change in the attitude of health care professionals towards cancer -to provide optimal care for this clinical population.

Changing these attitudes presents oncology health care professionals with a challenge that can no longer be ignored.

N Kerney, M Miller et al, Annals of Oncology 14: 57–61, 2003

Challenges

Political harassment Health care discrimination Poor welfare systems Banalization of sufferings Wearing down of families Gender inequality Human rights violation Donor/media discrimination Lack of knowledge, research and hope.

It is our responsibility to stamp out STIGMA of cancer

“Be the change that you wish to see in the world”

Mahatma Gandhi