Hype and hope: breast cancer awareness in Tonga

A delightful pink attendee
at a fundraising lunch

I couldn't believe my eyes, but there they were: a a prominent national rugby and a very recognized political figure hula-hooping next to each other on stage to the crowd's wild delight. It was admittedly one of the funniest moments during the events of this past month: October as breast cancer awareness month.  Last year I had helped in a minor way with publicity, and this year, enjoyed being a bigger part of each of the events during the month.  Everyone got into the spirit: it was a month for community, fun, and altogether too much bright pink.

With all the dressing up, parading through town, and festooning everything in sight with pink ribbons, it only takes one survivor's story to remind everyone the real reason for all the hype. During a radio show last week, a woman called in to tell her story; she was obviously trying to hold back her tears. Her aunt, she said, had died of breast cancer, and none of the family had known of her struggles until it was too late. She had been diligently hiding it for years, ashamed to tell anyone, even her own family.

We were exhausted but
happy after most events

Afraid of what she would find if she went to the hospital, she had been going to a traditional Tongan healer, her family found out.

Like many forms of Western medicine, Tongan medicine is incredibly effective in some methods and hopelessly misguided in others. William Mariner, a English man who lived for four years in Tonga as a young man in the early 1800s, described forms of Tongan surgery, medicine, and medical procedures that were far advanced beyond that of his mother country. Tongan doctors at that time had a good understanding of how to prevent infection, and successfully treated tetanus, elephantiasis, and war wounds with a greater success rate (i.e. less people died) than in Europe.

Tongan Herbal Medicine by W. Arthur Whistler does a fascinating job of outlining some of these practices, including this gem of a description for a successful 1804 tetanus operation "when the patient had spasms, a reed moistened with saliva was forced up his urethra..." apparently this was very successful, a procedure that made me seriously appreciate how awful tetanus must be considering that as the alternative, until I read further that "it was also performed on other ailments, such as 'general langour and inactivity of the system." (page 14) What!! I thought, but the book deftly moves on to another subject from there.

The surgical knowledge from two hundred years ago has been lost, but a skilled modern "traditional" Tongan healer (who now has to be distinguished from the Tongan MDs) knows which local plants are good for pain relief, constipation, skin rashes, and a host of other ailments. For the most part, these do have scientifically proven compounds now used in pharmaceutical medicine -- think of how willow bark had been used for thousands of years as a pain killer until Bayer decided to sell its extract as Aspirin in the early 1900s.

The small print says this elixer accomplishes
what decades of research around the world
hasn't yet been able to do: cure cancer!

On the other hand, Mariner also might have been comforted to find that Tongan medicine during his time also practiced a familiar treatment to his own country's medicine: blood-letting.  He described a "disordered state of the stomach and bowels, attended with headache and drowsiness," whose only cure was blood-letting -- an illness which I am suspicious might have simply come from too much kava the night before. (Whistler, 18) Fortunately, Tongans abandoned this practice generations ago, figuring out, as the Europeans eventually did, too, that cutting someone wasn't a cure.

I felt equal horror last week when I looked on a bottle of medicinal vai Tonga, literally translated as Tongan water, and some enterprising salesperson had printed on it "Heals: Different forms of cancer such as Colon, Breast, Pancreas.." Vai Tonga is a natural extract of fruits, medicinal bark, and other plants and is good for calming an upset stomach and mildly relieving pain, not an alternative to chemotherapy.

So, when the woman on the radio started describing as her aunt deteriorated in health, hiding her condition from her family, and continuing to spend large sums of money at her Tongan healer, none of us listening were surprised. Tongan healers are generally wonderful for a large range of complaints, but we were sad that the healers this woman went to obviously didn't put pressure on her to compliment their treatments with other needed forms of medicine.

"Breast cancer is not a shame or a curse.
It's not your own fault. Get tested immediately"
(Creative Commons: I was the graphic designer)

One time last year, when I was talking to an acquaintance about another volunteer's chronic sickness, they said "Well, it's because they stopped going to church, you know." Other than the difficulties women face with the fear of going to the hospital, many people also hold the belief that God causes everything in life to happen whether it's bad or good, and that a bad event is evidence of God's displeasure with the person.

Because of this belief, many people diagnosed with cancer tend to attribute their sickness to God punishing them, and therefore don't want to reveal their troubles to anyone because it will be evidence to their friends and family that they did something worthy of that punishment.

The poster to the right is one of four ads that Tonga Breast Cancer Society published in the local newspaper each week, with four different messages. While other posters urge screening early or encourage family support, this one speaks to the individuals who hide their sickness because of that belief. It's not a shame or a curse; it's not your own fault.

With more people hearing the radio shows and reading the newspaper we all hope that the story told by the woman on the radio will become less and less common.