By: Jean Johnson for Uterus1
The late Vine DeLoria, Jr. (Sioux) coined the term, ‘the nations within,’ referring not only to the political sovereignty that underlies Indian country in the United States, but also in an effort to convey the cultural chasm that exists between mainstream and native communities.
|To ensure early detection of breast cancer, adopt three prudent habits:|
Do a monthly breast self exam (BSE)
Have a mammogram yearly
Schedule an annual physician exam
Yet, while much can divide Americans in our increasingly multicultural society, breast cancer knows no boundaries. If anything, its effects are more pronounced in Indian communities. That’s why Uterus1 is pleased to profile Nellie Sandoval, breast cancer survivor and member of the Navajo Nation who has worked to raise awareness about breast cancer and promote the early detection required to save lives within her reservation.
Conflicts between Cultural Taboos and Modern Medicine
Since the early 1990s, Sandoval has been an active force within her tribe. Not even cultural taboos and criticism by elders have stopped her in her drive to help her peers. Perhaps that’s because from the beginning Sandoval confronted data that showed over 80 percent of the Navajo women diagnosed with breast cancer were succumbing to the disease.
“‘What’s wrong?’ I asked myself back then. Why are there so many Navajo women that die?” she said. “What we realized is that they were presenting with very late stage cancer when the prognosis is very grim. There was no such thing as early detection for them.”
But as a Navajo Sandoval understood, long-established cultural prohibitions existed about discussing unpleasant things. “In the Navajo way, if you talk about something bad they say you’re wishing for it to happen,” she explained. Her goal, though, was to turn this idea around. “What we started saying is that education and awareness about breast cancer empowers women.
“I have been scolded, and I have been chastised, I will tell you,” Sandoval added. “But somebody has to talk about it, and I’m not alive today because I sat in the corner. I’ve seen so many babies that are motherless because the women let the cancer go.”
In addition to being unwilling to talk about a potentially life-threatening disease, Navajo women also resisted the monthly breast self exams. So Sandoval partnered with an oncology nurse, Fran Robinson at the San Juan Regional Cancer Center in New Mexico, and put together television clips for airing throughout Navajo country.
“One of the TV segments showed a Navajo woman running her fingers through some wool and finding a burr, just like a woman might doing a self breast exam,” said Sandoval. “Around 80 percent of our women find their own lump, so we can’t continue to tell Navajo females that they can’t touch themselves.”
Sandoval and Robinson made a video in addition to the television spots. “We clocked thousands of miles and presented all over the reservation. Health care centers also helped out by putting our work up on the televisions in the waiting rooms. In addition to the monthly self breast exams, we focused on annual exams by a doctor along with annual mammograms.”
Navajo Women Now Seeking Mammograms in Greater Numbers
Although there’s no statistics to date on the effectiveness of Sandoval’s efforts, she is encouraged by at least one trend. “One of the most interesting things that has happened is that at the Northern Navajo Medical Center the mammogram appointment times doubled in terms of waits. Women used to have to book three months in advance and now it’s seven – so we’re guessing it’s from the video and TV segments.”
Click here for a guide to mammography.