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International health care revolutionized: Bringing breast care to Bangladesh

Feb. 2012

Dr. Ophira Ginsburg

After more than 15 trips abroad since 2004 in an effort to help women with breast cancer in low-income countries, Women’s College adjunct scientist Dr. Ophira Ginsburg is back in Toronto. For now.

An assistant professor at the University of Toronto’s department of medicine and the Dalla Lana School of Public Health, Ginsburg and her partners at the International Breast Cancer Research Foundation (www.ibcrff.org) were invited to Bangladesh in 2007.

“We came to develop a research collaboration, and we ended up opening a breast centre,” Ginsburg says. “Very quickly, it became clear that cutting-and-pasting western health-care approaches to Bangladesh wouldn’t work.”

Bangladeshi women face a shortage of doctors and resources, especially in rural areas. There is virtually no publically funded health care and a dearth of physicians, especially female doctors. Poor roads and frequently inclement weather discourage people from traveling to health centres in urban areas, particularly given the high rate of doctor absenteeism.

In addition, Bangladeshis do not discuss breast issues, and there is no well-known term for breast cancer. Women have low social status, and disease – seen as a punishment and a curse – often leads to abandonment. Most people turn to more affordable and available homeopaths or healers; if a woman visits a doctor, it’s generally in the late stages of disease.

“Ultimately, systemic and cultural barriers to health care leave Bangladeshi women with no viable option to pursue treatment at all,” says Ginsburg.

The team summarized their experience in Bangladesh in a recent article published in the International Journal of Breast Cancer:

“Tedious bureaucratic systems, lack of collaboration across the health sector, and poor governance have contributed to delaying advances in health care solutions throughout South Asia and must be minimized for significant progress to be made. A commitment to this aim alone could have major implications for advances and cost savings in not only breast cancer care, but many other … diseases as well. This … subject (not limited to Bangladesh) is regularly… passed over in academic discussions of ways to improve health care outcomes1.”

Ginsburg is returning to Bangladesh to begin the next phase of her work with IBCRF partner NGO, Amader Gram “Our Village,” implementing a project that “will hopefully allow us to work within this system without enabling it and falling victim to its limitations.”

> read article

1 H. L. Story, R. R. Love, R. Salim, A. J. Roberto, J. L. Krieger, O. M. Ginsburg. Improving Outcomes from Breast Cancer in a Low-Income Country: Lessons from Bangladesh. International Journal of Breast Cancer 2012;423562


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