When Health Inequity Hits Close to Home
My mom was diagnosed with cancer in December.
C. A. N. C. E. R. Sometimes I have to spell it out in my head to remind myself that her ovarian stage three cancer is real. Not that I should need a reminder. Her five-day stay at the hospital over Christmas should be enough. But my mom is a beautiful, kind, vivacious soul who I have a hard time reconciling in my mind with someone who is sick. And yet, I have seen her lips turn cold and white after surgery and her hair fall to the floor as I buzzed her head after chemo.
I know cancer has made its way into my mother’s body.
But she is not the first nor will she be the last to experience cancer. A few months before I got the news about my mom, Kenn, my co-fellow, found out that his mother was also diagnosed with cancer. We both have our share of intense worry and anxiety for our mothers, but the commonalities in our experiences end there. As I watch the progression of each woman’s disease and treatment, a heartbreaking example of health inequity is unfolding right in front of me. This is not to discount my mother’s pain, fear or exhaustion, but as hard as my mom’s experience is and will be, Kenn’s mother’s is and will be much harder.
As I watch the progression of each woman’s disease and treatment, a heartbreaking example of health inequity is unfolding right in front of me. This is not to discount my mother’s pain, fear or exhaustion, but as hard as my mom’s experience is and will be, Kenn’s mother’s is and will be much harder.
In Kenya, where Kenn’s mother lives, there are only four radiation centers and treatment facilities. They are all located in Nairobi, forcing anyone living elsewhere to travel to the capital for treatment. Many cancer patients have to travel as far as 600 kilometers to access treatment and then may still wait months to access services because there are too few cancer specialists to treat everyone. In Kenya, there are only four radiation oncologists, six medical oncologists, four pediatric oncologists, five radiation therapy technologists, and three oncology nurses.
On the other hand, my mother, based in the U.S., has the privilege of living ten minutes away from an award-winning cancer research and treatment center. The center alone has 1,800 people on staff hosting 125,000 patient visits annually. They were able to fit her in immediately for care. The implications of this are far-reaching. When Kenn’s mother needed a blood transfusion, the nearest facility did not have her blood type in stock and she had to be transferred to a hospital many hours away. When my mother needed a blood transfusion, she had to wait for them to bring it up a few floors.
This visible inequity is painful. It hurts that my loved one has better access to better care based on the area of the world she resides in. I recognize that her access to care is more nuanced than just location. Even within the same community in the U.S., extreme disparities exist and a person’s access to a quality diagnosis and treatment can be based on numerous factors including race, gender, socio-economic status, various exposures, etc. When comparing the U.S. and Kenya, the determinants become even more complex resulting from large systems of power and oppression. This is not right.
So, what then?
There are solutions and systems that save lives every day. My mom’s experience is a great reminder of that. But it is the inequities that compel the global health community to act. They remind us that there is still much to be done and that we cannot afford to be complacent. For me, this year has reinforced my resolve to be an impactful member of the movement for health equity. I do not anticipate continuing my foray into the world of cancer. It currently feels a bit too personal and raw. Yet, I know as I go forward I will continue to draw purpose from this year. The systems of power and privilege that create the disparities seen within cancer diagnoses and treatments are all too prevalent elsewhere.
There are solutions and systems that save lives every day. My mom’s experience is a great reminder of that. But it is the inequities that compel the global health community to act.
There is actually one more commonality that Kenn and I share. Our mothers are incredibly strong and selfless women. Even as they are deep in the midst of chemotherapy and numerous medical procedures, they continue to worry about our wellbeing and to protect us from the worst of the disease. They are a source of inspiration and commitment. And I am both inspired and committed to continue to work to create a space where all people have the ability to grow, to discover, to create, and to reach their life’s potential because, simply put, Kenn’s mother deserves the same care my mother receives daily.
Sarah King is a 2016–2017 Global Health Corps fellow at BRAC USA.
