Breast cancer survivors anthropological challenges in Côte d’Ivoire - Nédelec, Élise
According to the Global Cancer Observatory (GLOBOCAN), breast cancer is the leading cancer in terms of incidence among women in Africa (1). In sub-Saharan Africa (SSA), 65% of women consult at an advanced or very advanced stage of the disease, including 18% at a metastatic stage (2). 5-years survival rates are low in SSA (66 %) and the lowest in low and middle HDI countries (2). In this context, my thesis work in anthropology deals with breast cancer experiences (illness and care) of women and healthcare workers (doctors and nurses) in Abidjan, Côte d’Ivoire. I have realized an ethnographic study (seventeen months on fieldwork between 2015 and 2018), that includes participant observations in medical and family contexts and eighty-three interviews with women affected by cancer, spouses and healthcare workers in oncology and gynecology wards. This paper will explore how survivors deal with the many challenges of breast cancer rehabilitation. Results show three main challenges, impacting physical, social and symbolic dimensions. The first one is how women handle stigma (3, 4) of radical mastectomy in a local context of a lack of breast reconstruction and prothesis. The second one is how survivors evolve into a new social role as “expert patient” and become a “key person” for providers in the process of cancer treatments adherence and acceptance. Indeed, there are many barriers to chemotherapy and breast surgery (radiotherapy weren’t available in Côte d’Ivoire). A large majority of women refuse it, at first. The ultimate challenge is the acceptance of cancer chronic’s dimension, notions of remission and surveillance by survivors. Women experience cognitive dissonance about these biomedical concepts, in a social and religious context characterized by a quest of healing. Therefore, women experiment consequences of survivorship and have to recompose and negotiate a new way of life.
Keywords: conferencePaper