Dear Ms. A. A. Wilson,
It’s a rare thing to meet someone whose life mission is both succinct and incredibly ambitious. The fact that you have made it your life’s work to “empower women” not only in the space of the academy but also within communities across the world gives me hope that my current project might resonate with you on multiple levels.
You see, Ms. Wilson, I am currently studying cervical cancer prevention and care provision in Tanzania. Why, you might ask, would I travel so far away from my home in the U.S. to study a disease that seems to have been made manageable through the availability of the HPV vaccination, annual pap smears and early detection/treatment options?
Well, like many other maladies, these diseases – HPV and cervical cancer – have a geography that does not exist in isolation to other historical, economic, political or social factors. The landscape of care in Tanzania is frightfully uneven to begin with and the provision of preventative care for women is, quite frankly, extremely limited outside of the context of pregnancy and childbirth. Ironically, this focus on reproduction both illuminates the need for preventative care while downplaying the links between different reproductive health issues and the development of reproductive cancers. Unlike in the US, there are not adequate laboratory facilities in Tanzania to process pap smears nor are there the trained personnel to provide them. This is quite concerning when you consider the fact that cervical cancer is asymptomatic in the early stages and it is only once it has advanced that clear warning signs manifest themselves.
Well yes, you might say, this is all well and good but aren’t other issues more ‘important’ or ‘pressing’ in a low-resource context?
My response to this is twofold. First, the practice of prioritization in the provision of care often results in immense resources being funneled to particular health issues without bolstering the existing public health infrastructure. This ‘silo-ing’ or ‘vertical’ provision of care often occurs around specific illnesses, populations or geographic areas. The picking and choosing of when and where care comes to be available for some and not others is a form of triage that has implications for the lives and livelihoods of women and their families, as well as further exacerbating existing unevenness within the healthcare system.
Second, I view access to healthcare as a human right. I believe that taking a more holistic, preventative approach to care might actually allow for the more effective provision of care for all Tanzanians, and for women in particular. In the contest of non-communicable diseases (NCDs), the provision of preventative care only becomes possible when knowledge about cervical cancer – risk, incidence, diagnosis and treatment – spreads from centers of biomedical knowledge production to healthcare workers in rural areas to the women and men who might find their lives impacted by the disease.
Thus, my dissertation work will explore the spread of knowledge about cervical cancer amongst healthcare workers and community members in two regions of Tanzania. I hope that this work will lend itself to building a more robust understanding of the many factors influencing the diagnosis and early treatment of cervical cancer in Tanzania. I view this work as a kind of ’empowerment’ – one that facilitates greater knowledge about factors that produce inequities in disease incidence and the provision of care – that has the potential to illuminate pathways to a more hopeful future.
Thank you for listening and learning about my work!