October 23, 2006

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Cervical Cancer Remains Number One Killer of Women in Chiapas

By Maria Antonieta Gómez Álvarez

SAN CRISTÓBAL DE LAS CASAS -- Maria Sánchez, an indigenous woman from Chanal, Chiapas, battles against a huge, seemingly invincible monster. It planted itself inside her womb and spread roots thoughout her body. Now, this woman with earth-colored skin who lives in a tiny house with a dirt floor, is fighting for her life against the number one killer of women in Chiapas, cervical-uterine cancer.

Sánchez said she first knew something was wrong in 1994, when she began to feel a bit of pain. Her pap smears came back negative time and time again, yet the pain worsened. Doctors insisted that she was healthy and even called her husband into the clinic to tell him that she was fine and needed to stop worrying. Finally, she found a specialist who confirmed her fears. Sánchez was sick. There was a tumor growing in the neck of her uterus.

Now, once a month, she travels to a treatment center in Tapachula, eight hours away from her home where she receives radiation and chemotherapy.

Braving Cancer in Chiapas

In Chiapas, being diagnosed with cervical cancer means more than medical hardship. For Sánchez and thousands of others, the high cost of medical attention and long distance transportation to and from treatment centers means many sick women must choose between food and medicine.

Sánchez pays $6,920 pesos (692 USD) a month for her treatment, transportation, chemotherapy, doctors visits, and a bed at a shelter in Tapachula. Her husband is able to support her, but she said that some of the women being treated with her go hungry or take to the streets to look for food.

Twelve Mexican women a die of cervical cancer every day, according to statistics on the Presidential Office's website. Some independent non-governmental organizations such as Cimacnoticias, a newswire service, estimate that as many as four women per week die of cervical cancer in Chiapas.

After years of mounting death tolls, there is hope for women in Mexico with cervical cancer. In June, Mexico became the first country to approve a vaccine that protects women against three strains of the Human Papiloma Virus (HPV), which causes over 90 percent of cervical-uterine cancers. The vaccine, called Gardasil, received European license on October 18. Mexican health officials say the vaccine could reduce the incidence of cervical-uterine cancer by 70 percent. The vaccine was applied for the first time to a 22 year old Mexican woman on September 21 woman in front of press, doctors, and pharmaceutical company representatives.

Though the vaccine is not yet available in Chiapas, women can still protect themselves from HPV and the resultant cervical-uterine cancer by using condoms during sexual intercourse and getting regular pap smears, said Dr. Belinda Calvillo of the Marie Stopes Clinic in San Cristóbal de las Casas. But many women lack information about contraceptives and live hours away from the nearest clinic.

There are other factors that make Mexican women particularly susceptible to the caner. A 2003 study conducted by the National Institute of Public Health found that the mortality rate of cervical-uterine cancer is related to poverty, lack of schooling, unemployment, residency in rural areas, and lack of effective access to health services and The Pan-American Health Organization reported in 2004 that only 40 percent of women in rural areas of Mexico knew what a pap smear was.

Cristina Velazco, a nurse at the Regional Hospital in San Cristóbal says that sex education and better preventative medicine are needed. The Regional Hospital's goal this year, she said, is to see between 20,000 to 24,000 women. Given the number of doctors they employ, this means each woman would spend about six minutes with a doctor. This, she said, is not nearly enough time to give proper physical or emotional attention.

One federal progam, Oportunidades, has helped many poor women obtain reproductive health services. According to an independent evaluation commissioned by the National Health Institute in 2005, rural women who participated in the program, which aims to better the health, nutrition, and education opportunities of 5 million poor Mexicans, were 61 percent more likely to undergo pap smears and 17.2 percent more likely to use contraceptives than their peers.

Victoriana Méndez Velazco, 48, a mother of four, was diagnosed with terminal cervical cancer in 2005.  She said that two of her daughters, 14 and 20 years old, had to quit school and go to work as maids in order to support her and help pay for her treatments.

Doctors gave Méndez Velazco between two and five more years to live. She is being treated in Tuxtla-Gutiérrez. Méndez Velazco says her faith in God helps to ease her suffering, but she worries about what will become of her daughters once she is gone. Her husband left the family but has never agreed to hand over the deed to the house where Méndez Velazco and her daughters live. When she dies, she said, she doesn't know in what conditions her girls will live or even where they will live. "[Women who suffer from this disease] should ask God for help, because he is our true doctor," she said.

Sánchez, too, worries about the future. "No one was born to remain on earth until the world ends," she said. Still, she worries for her seven year old son who will be motherless when she dies.

Between tears, Sánchez said "I hope other women don't go through the same situation I am going through right now. They should see a doctor. If they've already received a pap smear and pain persists, they should find a trustworthy doctor to care for them, because illness is not a game, it is suffering."


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