LET’S TALK ABOUT BREAST: Some Breast Cancer Facts

As we while away our time in the computer or with a favorite movie, a considerable number of women die of breast cancer around the world. Every year, 500,000 women worldwide die from it. In the Philippines, breast cancer remains to be one of the two leading causes of cancer death among women—the other one is cervical cancer—accounting for 13.3% of cancer cases in the country based on a DOH survey in 1998. Some estimates cited that 26 out of 100 females may develop breast cancer in the Philippines.

Normally, at risk persons include unmarried and married women in their 40’s to 60’s but recently, breast cancer has been observed to affect younger women. A population-based study by Esteban and his colleagues in 1998 pointed out that the survival rate of breast cancer patients in the Philippines was 44.4% which according to Dr. Mariluz Mojica of the UP College of Medicine was within the lower limits of survival rates in developing countries. A possible explanation for this is the fact that most breast cancer cases are diagnosed in the advanced stage.

The truth is breast cancer is highly curable as long as it is detected early. Mammography, an advancement of medical science, is one effective screening/detection method for abnormal lumps in the breast. If pre-cancerous masses are detected early on, combined with treatment plans, the chances of survival are increased. And yet, mammography is not readily available in the Philippines. How much it must be so for women in the rural areas who cannot afford costly medical examinations?

At present, there is only one method for detection of breast lumps among women specifically in the rural areas—breast self-examination. The breast self-examination involves regular palpation of the breast which can be done by the woman while she lay in bed or as she soaps her body during bath on a monthly basis. Husbands, familiar with their wives bodies, could also help detect lumps in the breast and armpit area. If in doubt, it is also necessary to have one’s healthcare provider conduct palpation of the breast.

One study conducted by Meyerowitz and Chaiken in 1987 cited that even American women are hesitant to perform breast-self examination. This was attributed to the degree of proximal risk associated to breast examination and mammography. Imagine yourself examining your breast and running the risk of finding out an abnormal lump in your breast. Most women would rather opt not to know, to be kept in the dark.

Yet, this should not be the case. Late detection, other than reducing the chances of survival, also calls for greater medical expenses and greater amount of care. This is the reason why breast cancer communication should embark on building self-efficacious behavior among women to increase their capability to handle and cope with the breast examination process and modify negative attitudes with culturally sensitive strategies aside from teaching them the breast cancer facts. Health care providers, from doctors in public hospitals and private clinics to the barangay health workers should be adequately trained not only in handling breast cancer patients but also in counseling and organizing communities to build strong social support system for breast cancer affected people. The government, particularly the Department of Health (DOH) could tap experts to help women with breast cancer heal through the use of creative pedagogies. Above all, the government should provide facilities and develop programs which are responsive and accessible to women. No amount of campaigns would work unless facilities for screening and treatment are available for everyone regardless of age and stature.

On Bebe Gandanghari

No other event in the Philippine entertainment industry today has generated such ambivalent feelings as the coming-out of Bebe Gandanghari and the ‘death’ of Rustom Padilla, the matinee actor of the 90’s. When Bebe sashayed in the Buzz all glam[med] up, all of a sudden gay activists have something to ponder, all of a sudden stand-up comedian and hairdresser, even Mother who rarely glances at TV, has something to say for Bebe. All of a sudden people are confused where to put Bebe in our well-ordered world of he and she where “he” covers everything male and “she” everything female.

“Abnormal,” my neighbor commented as Bebe relished her first interview in the Buzz, Ruffa and Kris paled beside the fresh and controversial face. Abnormal because like the millions of people who watched Bebe on TV, she did not know where Bebe fits into this whole order of penises and vaginas. If Bebe is neither he nor she, Bebe is an outsider, a pink spot in a black-and-white world.

Even Vice Ganda could not let go of the 90’s image that was Rustom Padilla. I do not blame him things like this take a lot of getting used to. Vice, half-jestingly, preferred the old Rustom over the new Bebe. Then the whole thing escalated into an issue of too much make-up (a violation of the lightly and naturally made-up look which the famous hairdresser himself was known for), mismatched clothes, overdressing, body weight (Bebe shedding off fats and muscles to achieve a thin, if not bony, body) and over kabaklaan.

But Bebe is more than just a clothes and make-up thing. Bebe is a political issue, as my gay friend declared. Unlike my neighbor whose concern is basic, where to find Bebe in a world defined by the penis and the vagina, my friend’s point takes the very issue a step higher—the identity of the bakla, the breaking of a world dichotomized by the male and the female where the bakla is not “the other.” As my friend commented, the struggle of the bakla movement to secure a space for the baklas where they are neither men nor women and yet equal to them is wasted with all the efforts at emulating womanhood. Dressing up like a woman and looking like one blatantly reinforces a world inhabited only by men and women and unforgiving of those in-between. “If you are not a man, who then could you be? A woman? But you are not!,” went the voice of someone who saw things through the barricade, my friend.

I am not well read on the theoretical underpinnings of the gay struggle other than the universal ones that hold true for all human struggles. Like my friend I saw a political incorrectness of being Bebe. I am uncomfortable with Bebe declaring Rustom dead without looking back. Rustom carried Bebe in his “womb” for years until by serendipity, a turn of events, he gave birth to Bebe. This whole other person is a product of Rustom’s struggle to protect what’s inside him so that Bebe could see the light. Bebe’s birthright is Rustom’s legacy.

And yet, how could it be that knowing all these, I felt so happy and light upon seeing Bebe pose for the photographers with slightly open and pouting “lacquered” lips? I see in Bebe a butterfly freed from its cocoon, gossamer wings spread into the sun. All the lines brought by years of living in the dark faded not only under make up but under the suffusion of light that comes with freedom. For all the things I failed to do, for all the little shocks in life I forgone for the deceptively safe well-ordered world, Bebe shamed me. Who am I to say there is a wrong and right way to fight through the barricades? My friend is right, Vice is right, above all Bebe is right. Each of us has our unique way of asserting freedom. In this well-ordered world where everyone struggles for a place, Bebe finds a very special way to assert a space. How I wish my friend could read this.

I am Home

Nothing compares to the leap of excitement and happiness that I feel as upon entering my room I drop my suitcase to the floor and throw myself across the bed. The smell of books from the nearby shelves mingling with the scent of the pillows is reviving. In the three weeks that I was away, though I loved and I missed the anonymity that the big city afforded me, I longed for the comfort of my room with its whitewashed walls and black framed wide windows—Mediterranean they called it.

Just two days ago I was shut in an almost airless room if not for the air conditioning unit that hummed and groaned and fanned the particles of dust, of life, of all the remnants of transient experiences encased in that forebodingly green space we called room 219 that did not help ease my claustrophobia. My roommate Renee probably wondered why I had such a habit of parting the curtains every morning and leaving them that way even after sundown.

Now that I am home, the distant mountain massif beckons at me, taunting me to get up and look down my window to the freshly plowed rice fields and all the signs of rural life beyond it. At the foot of the mountain is one river that gurgled and flowed all year round and farther still is Hinalaran, an old and forgotten place that cradles countless forgotten and unnamed lives laid to rest. Then there’s the mountain itself, Mt. Himababwan, dark, dark blue during summer, hidden during the rainy season, with its gently sloping hills, sheer drops and dangerous outcrops.

I could hear Ate Lenlen stirring at the kitchen, dashing from the sink to the stove to the table with our cute furry friends circling round her feet. She has been with us for four years. She rids the house of dust and clutter, starch and irons our clothes while feeding us with juicy pieces of village gossips which we are too busy to bother under other circumstances. Though I dislike her soggy noodle dish with its lumpy rice to go, I must admit I enjoyed her gossip and liked the smell of the house after she wiped the floor with damp soapy washcloth. And need I say she loved the cats too! Her presence adds warmth to a place that echoes with silence.

I am glad it does not rain today. I had a glimpse of my mom’s Japanese roses in bloom as I was going inside the house an hour ago. I vow to take a stroll in the garden this afternoon before the sun comes down. When I was a little girl, the garden is one of my favorite hangouts. Back then the tall hibiscus competed with the trees in their attempt to sweep the clouds and the golden cast of the afternoon sun that filtered through the leaves sent dancing bright patterns on the mossy soil beneath them. And there I was squatting or crawling under the flowers looking for Thumbelina.

A cry from the street startle me from my reverie…must be the little girl from the house across throwing her tantrums once again. I remember how her cries could go into a wild, shrill, bratty wailing which leaves the neighbors with no other choice but to feign deafness. I can hear Ate Lenlen calling for mother and father. Lunch is ready. At last, I’ll be eating good food once more. I was sick with what we were eating in the city. All those meat, eggs and grease…yew! Down here dinner always include fresh and homegrown vegetables to be eaten with great relish over an interesting story or two.

I wonder if my new found friends are already home. Maybe some of them are. I am sure they have many stories to tell of that two/one month-long journey of self-discovery. As for myself, my mother and father are waiting, a big platter of my favorite dish and a heap of cooked vegetables on the table. This time, I would be the storyteller and the story would be mine. Ate Lenlen would be staring at me, mouth agape, spoon poised in one hand, taking in what I have to tell and feeding them later to the village girls who must have heard of my return by now.

Here Comes The Rain Again

It’s beginning to get cold, wet and bleak now. I smelled the impending weather change three weeks ago when the sun set abnormally early and thick dark clouds hovered the orange-washed twilight skies. I told myself then, “It would be a day or two from now and umbrellas would once again be taking the Visca community by storm.”

The telltale signs of the bleak months are not difficult to recognize. I grew up in a village where people’s chatters are muted by the onslaught of monsoon winds and rains for three parts of the year. Back home, for most of their lives, people spend their days indoor, except for the farmers who have to work it out in the fields, face and body streaming sweat and rain. When I was a kid, I would lay bundled in thick blankets listening to the raging rain outside my window and to the winds that howled as they hit the roof gutter and the window awnings. If you were lucky you had just the soft tip-tapping sound of rain droplets upon the window pane. But this did not happen always as rains could go till midnight back there.

This morning, as I treaded water in slipper clad feet on my way to the Office, a sigh escaped from my lips. I know I would be missing the sun, the life and exuberance that go with it. I would miss the morning walks, the thrill of skirting the lichen-covered tree boles to take the less-frequented path on my way to work, the flitting ethereal experience of stepping into the sunlight streaming through the canopies while dodging bird droppings here and there. I would not be able to take my late afternoon-to-dusk walks on my way home, the streets glowing under the cyan-and-magenta-speckled western horizon, while my heart whistled a familiar melody. Absent would be the cyclists, legs on the pedal and lungs pumping air, rushing to their families, thoughts of simple but hearty dinner in their minds. And the full moon that inspired a hundred untold dreams and thoughts—that too would be dearly missed. It’s really a pity to hide the silver cast of the moon behind heavy rain clouds, its magic and beauty shrouded in the ominous illusion of darkness.

Gone would be the warm smiles of people as you meet them on the streets or on your way to the market. The rainy months has its way of getting to people’s affects that every time they lift their downcast faces to nod at you, there is something behind the eyes that is almost torrential and is about to break. If ever there is a small hint of smile on their lips, the raincoats would be doing a hell of a job covering it. Lost would be the light banter as people line for dinner in the food stalls, each one wrapped in his own dark thoughts, impenetrable as Mt. Pangasugan covered in a cloud of mist. Debts and the lack of money would be deeply felt. Hunger more painful. The coldness of the night would be demanding heat. Depression would be doubly isolating and crimes could go undetected. The birds would be silent and the crickets too.

As I passed behind the row of laboratories and crumbling greenhouses, water rivulets forming dirty streaks at glass windows darkened by dust, I dreaded the heavy rain even more. The rain would make the day to day reporting to work and the weekly journey for home twice the effort. But since it will be five months before the sun peeks at us again, I would content myself with the thought that “the leaves are always greener after the rain.” Meanwhile the Journey’s “Girl Can’t Help It” booming in my ears, competing with the rain and heating up my day.

On Nurturing Love for Reading Among Children

(This is an expanded excerpt from a comment I made to an article at www.devcompage.com.)

We could say that love for reading is either innate or learned—there are children who are born to read, there are those who aren’t. But the fact that toddlers develop an appreciation that progresses from colors to shape to patterns, as shown in Jean Piaget’s studies, there lie a possibility to develop reading interest even to those who do not exhibit the aptitude at first. Not unless, of course, if the child has a learning disability. Wherever side of the fence the child finds himself in, the responsibility of developing that gift or of providing the right stimulations in priming an otherwise “not-so-interested” child for reading are upon the parents’ shoulders.

Parents should have a keen sense of knowing their children. As soon as the child starts leafing through a book, that should make them realize that there is something in it that interests the child. It should also give them the cue to nurture that interest. How?

They could start with learning the alphabet through play. My mother once told me of an experiment which worked on me. She bought those plastic blocks with the alphabet letters on them. She would throw a block to me while pronouncing the letter. I would throw back the block while mouthing the letter too. That was the start of my reading journey.

Reading with your children is not yet outdated. So, make reading a family activity. Parents who read to their children are teaching reading by example. There is a direct relationship between the parents’ and their kid’s reading habits. Today, most families substitute TV watching for quality family time. Back then when electricity was a luxury and TV a fantasy, parents and their children huddled together in front of the gas lamp to read books which developed the kids’ ability to form mental pictures of the story they just heard. I could remember vividly one man’s story of crossing the heavily guarded and heavily wired border in East Germany to get through Austria where he sought refuge during the reign of communism in Eastern Europe. It was a story our mother read to us for three nights—we were so involved that the man’s story became our own story of adventure. I saw the mushrooms he had to eat, smelled the stale bread and the moldy cheese he had to munch to keep his strength, every night as soon as the lights went out and I closed my eyes.

Parents should make sure that they ask questions after the reading session to make children think and winnow the information they just heard. In so doing, children would come to appreciate the value embedded in each reading selection. Not knowing what you are getting from the material would flag down your interest to even open the book’s cover.

Showing interest in what the child is reading would also reinforce his reading inclination. As long as the material is not graphic for his age, don’t criticize and start picking at the child for it. This would temper his young interest. Instead, let the child explain to you what it is he is reading. In other words, let him tell you the story as you did during the reading session.

Provide a variety of reading materials. This is also a reinforcing factor. Make a balance between the availability of fiction and non-fiction books. Although my mother read to me the stories of Brothers Grimm, she read to me about eastern philosophy, history, child rearing and…Margaret Thatcher. Varied materials let the child explore and discover his reading proclivity. (Plus, it will prepare your child for the varied reading tasks that he/she would be exposed to in college.)

However, any parent should be wise enough not to push the child. A child can get bored too, can be blindsided by the other stimuli that compete with books, can experience information overload. Just be around to step in as soon as the child feels the need for you to do so. But if the kids show no inclination to learn at all despite of their progressing age, parents must have to intervene. I didn’t know how to read in grade one. Honest. I leafed through my books and pretended to be reading even if I couldn’t stitch the letters together then because a classmate who had been taught by her mommy to read was bullying me. Then, the day just came when I asked my father to teach me how to read and that was it. He didn’t even ask me to. He was the one reading and I was just following through. It was so easy it seemed to me then because in grade one I was already ripe for it.

So, where does this leave the child who was born with the gift but could not afford to have books? Let the parents tell him stories. This will develop his imagination. When imagination is heightened, the child would seek other sources to quench the thirst to learn more. Chances are he might pick a book in school. Parents could also borrow books from neighbors. My neighbors did it and look where their children are now.