When it comes to deciding on treatment options with breast cancer (or any other disease) it can get hugely confusing to understand the various statistics in favor of one treatment or another. Steve Kass, an old high-school buddy who now happens to be a professor of mathematics has some thoughtful observations about looking at survival rates and death rates when it comes to breast cancer:

The five-year death rate after mastectomy was 11.5% for women who had both breasts removed. It was 16.3% for those who only had the cancerous breast removed. Adding a contralateral prophylactic mastectomy to the original surgery therefore reduced the five-year death rate from 16.3% to 11.5%. Almost a third fewer mastectomy patients died within 5 years when they had chosen to remove the second (healthy) breast, compared to mastectomy patients who had not chosen to remove the second breast. The bilateral mastectomy decreased the 5-year death rate by 29.4%.

This strikes me as a significant benefit. Suppose I have breast cancer and need a mastectomy. I can choose a single mastectomy and have a one-in-6 chance of dying in five years, or I can choose a double mastectomy and have a one-in-9 chance of dying in five years. One-in-9 sounds quite a bit better to me. If 100,000 women with unilateral cancer need mastectomies, performing 100,000 double mastectomies instead of 100,000 unilateral mastectomies will reduce the number of deaths in the first five years from 16,300 to 11,500. About 4,800 fewer women will die within five years.

The reporting of this study takes a very different viewpoint. It compares the survival rate, not the death rate, and notes that the bilateral prophylactic mastectomy increases the survival rate from 83.7% to 88.5%, “a difference of less than 5%.” Five percent sounds like a small number, but 5,000 lives saved sounds like a large number.

Both statements (lowers by 30%; benefits only 5%) are the same. Only the intent to communicate is different.

The full post is well worth the read.  Being a strong believer in having as much information as possible when facing difficult decisions, thought this was worth passing along.  Also of note, this New York Times blog piece regarding women choosing bilateral mastectomies even when it does not improve their chances for survival.

The answer to the question posed in the title of this post is they are courageous enough to speak truth to power to CBS for its appalling decision to air the Focus on the Family Tebow ‘pro-life ad:

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Did they think she was going to run away in the middle of having a c-section?  Barbaric is not enough of a word here.

Miriam Mendiola-Martinez, an undocumented immigrant charged with using someone else’s identity to work, gave birth to a boy on Dec. 21 at Maricopa Medical Center. After her C-section, she was shackled for two days to her hospital bed. She was not allowed to nurse her baby. And when guards walked her out of the hospital in shackles, she had no idea what officials had done with her child…

…All hospitalized inmates are treated in the same manner as Mendiola-Martinez, according to Lt. Brain Lee, a spokesperson for the Maricopa County Sheriff’s Office. He said she had a “soft restraint” attached on one leg to her bed to prevent escape.

That soft restraint was a 12-foot-long chain…

…She says she was shackled during the two last months of her pregnancy too. Every time she had a pre-natal appointment, she waited in a small un-ventilated room with 20 other women. She had to sit in the floor. The chains were heavy and hurt her waist. Mendiola-Martinez often wept. She feared that her sadness could hurt the baby…

…About 1,500 pregnant women come through the Maricopa County Estrella jail every year. In 2009, 35 of them gave birth while in custody, according to Maricopa Medical Center records. More than 70 percent of the women detained in Maricopa County jails are accused of non-violent crimes and haven’t been sentenced yet. About 11 percent of them are undocumented immigrants. Health and county authorities say they don’t keep records on the immigration status or ethnicity of the women who give birth.

No of course they don’t keep records. Read the rest of this ghastly example of American injustice here.  Many thanks to Attica Scott for bringing this story to our attention.

The following is excerpted from a statement by INCITE! regarding the ongoing needs in Haiti and is an excellent blueprint of the analysis required  to provide  support that is responsive to people in need.

Right now, there are many people, organizations, and governmental agencies mobilized to provide immediate aid relief and rescue operations in Haiti. However, there tends to be more readiness to donate supplies and money in the “immediate” time when things are very chaotic and before we know what the conditions are on the ground and have identified the long-term re-development needs as articulated by those most impacted. The long-term vision is critical because, when the dust settles and the big international relief organizations have left, people’s lives will still be devastated, and the need to rebuild will still be there.

We are researching if and how we can develop an intentional political relationship with local women so we can help mobilize the INCITE! network to support just and sustainable development of a sovereign Haiti, both during the interim and the long term recovery process.

As many of us work to figure out appropriate strategies to support the people of Haiti, it’s important to note that the people most vulnerable–namely, women, LGBT folks, people with disabilities, incarcerated people, children, and elders–can experience a slower unfolding of specific crises that are consequences of the original disaster and the social conditions that preceded the disaster.

For example, women experience the most negative consequences of catastrophic events, particularly with regards to higher rates of injury and death, displacement, unemployment, increased incidents of HIV rates, sexual and domestic violence, increased poverty, and the disproportionate responsibility for caring for others. This is especially true for women marginalized by race, sexual orientation, gender identity, class, health, ability, age, housing, and legal status. Additionally, in times of crises and environmental emergencies, poor and marginalized women, who are least responsible for the horrific conditions in which they live, are often blamed for their poverty and become subjected to regulatory population control policies through family planning, poverty reduction, and so-called environmental protection programs.

So, given what we have learned from Hurricane Katrina and the disasters of war, occupation, neoliberal economic dominance, and neglect that continue to plague and pathologize many of our families and friends internationally, we would like to use this time to organize an effective and accountable response during this interim phase of the crisis.

Kudos to INCITE! for this nuanced analysis of what a real aid policy should look like.

The following provides more information ( see also Providing Gender Responsive Aid in Haiti)  about addressing the needs of Haitian women in the aftermath of the earthquake:

Donations to the International Planned Parenthood Federation’s Profamil program will help them get their clinics and mobile health units in Haiti back to being fully operational.

Since 1984 PROFAMIL has provided low-cost, quality sexual and reproductive healthcare. As a leader in the field, PROFAMIL meets regularly with the Minister of Health to develop strategies for increasing access to sexual and reproductive healthcare.

Programs that Profamil offers include:

* Sexual & Reproductive Health Services: PROFAMIL clinics provide family planning, early detection of breast and cervical cancers, high-quality sexual and reproductive health clinical services for men and women, and pre-and-post natal services.

* Mobile Health Clinics: PROFAMIL brings health providers directly to the rural communities where the people are totally isolated. Approximately 200 men, women and children are provided with basic health care services at each visit.

* HIV/AIDS Prevention: PROFAMIL conducts voluntary testing and counseling for HIV/AIDS, educates the public about prevention and ensures widespread access to condoms.

* PROFAMIL Youth Program: PROFAMIL provides youth-friendly clinical and educational services to young people aged 10-25.

* Health Education: PROFAMIL covers issues such as promoting family planning and presenting various methods; cervical cancer and the need for routine pap smears; relationships; gender issues; domestic violence; HIV/AIDS prevention with regular condom demonstrations. In 2006, PROFAMIL educated over 225,000 people.

Peacewomen has a list of numerous organizations that are working with women in Haiti here.

The UNFPA has launched a flash appeal to fund programs that will allow them to:

• Refurbish maternity wards to handle emergency obstetric care and other life-saving health services;
• Deploy skilled health professionals, such as midwives, obstetricians and nurses, to affected areas to provide maternal health and emergency obstetric care;
• Provide emergency safe delivery and reproductive health medicines and supplies to temporary clinics and health facilities being set up;
• Help safeguard the personal hygiene and dignity of women and girls by providing related sanitary supplies;
• Facilitate access of affected populations, especially young people, to psychosocial counselling and other services; and
• Carry out interventions to prevent gender based violence.

The Women’s Refugee Commission has a list of the ten most pressing needs that must be met to ensure the well-being and safety of those displaced in the aftermath of the earthquake.

Amnesty has issued a statement regarding the need to protect women against sexual violence and exploitation in the wake of the earthquake.

The Global Fund for Women is  asking Haitian women to help them formulate long-range responses and to inform the fund of their perceptions of need.  (Note–while this perhaps sounds non-specific, I particularly like that they are asking what is needed, rather than telling those whose  lives have been impacted what they see as the needs.  Given that women are hugely under-represented in the organizations that organize aid in response to disasters, this is a very important shift  in formulating response policy.)

AWID has an excellent piece by Masum Momaya on the role of women in the Haitian Economy, a subject that is the basis for the film Poto Mitan:

And WomenArts has this wonderful page about Haitian women in the arts including a poem entitled Mud Mothers by Lenelle Moise, here are just a few lines from the poem which I urge you to read in its entirety.

Mud Mothers

the children of haiti
are not mythological
we are starving
or eating salty cakes
made of clay

because in 1804 we felled
our former slave captors
the graceless losers sunk
vindictive yellow
teeth into our forests

what was green is now
dust & everyone knows
trees unleash oxygen
(another humble word
for life)

Please also see Providing Gender Responsive Aid in Haiti.  H/t to Change.org for pointing to many of the links provided here and Sue Katz for pointing to the WomenArts link.  Also, although not women-specific, h/t to Global Voices for providing updates from independent voices on the ground in Haiti.