In 2015, melanoma of the skin was the 11th most common malignant tumour affecting women and men in Serbia1 , while one in eight women in Serbia will develop breast cancer during their lifetime. In both cases, if detected at an early stage, the tumour is almost completely curable. Because of the need for facilitation of preventive care for patients, non-governmental organizations Jedna za drugu, Kolibri za porodice and Omladina Jazas Novi Sad started their initiatives. These organizations help women at risk of breast cancer, people with HIV and young people to get the necessary services, knowledge and skills so that they can protect their health in the best possible way. The importance of these initiatives was also recognized by the Regional Programme on Local Democracy in the Western Balkans 2 (ReLOaD2), financed by the European Union and implemented by the United Nations Development Programme (UNDP).
“Women rarely want to talk about their painful experience. It’s seen as shameful,” says Ruža from Hajdukovo, a village near Subotica, who beat breast cancer nine years ago. However, Ruža bravely shared her experiences from day one with the intent to help other women. “I still told everyone about it, but outside of my family and close friends, I didn’t get much support.”
In the villages around Subotica, the associations Jedna uz drugu and Kolibri za porodice noticed this phenomenon and decided to educate their fellow citizens about the importance of open conversation and mutual support in the prevention of breast cancer. Thanks to their workshops, held in Serbian and Hungarian, over the last few months, more than 150 women and four men received valuable advice.
“We noticed that in rural areas there is less conversation about this, that there are certain social barriers. With these workshops, we wanted to break the taboo. It is a process and we have started it, but there is still a lot of work ahead of us. We cannot prevent breast cancer, that is not our mission. But we can train women to take care of themselves and see a doctor on time, because if they do that, breast cancer is more likely curable,” says Nora Gajda, from the Kolibri za porodice association.
These workshops were held from November to February in four villages around Subotica: Hajdukovo, Kelebija, Čantavir and Bajmok. They were intended for both patients and their family members, as well as for everyone who is interested in learning about ways to prevent this disease. Participants learned from experts about ways to prevent malignant diseases, about healthy lifestyles, nutrition, risk factors, as well as how to properly perform breast self-examination.
Edina Huber is a young mother from Kelebija who participated in the workshop. “I didn’t have any health problems, but I thought this would be useful and it was. I also invited many women to join and most of them responded, mainly young mothers. During the workshop, we learned to make healthy sweets, which encouraged me to reduce my sugar intake. I also learned to do a proper self-examination, as well as exercises that we should do regularly, and I plan to incorporate that into my everyday life as well”.
Ruža from Hajdukovo, from the beginning of the story, pointed out another important advantage of the workshops. “I am very sorry that nine years ago I didn’t have the information that I needed, since the doctor’s advice was quite limited In addition to the advice and knowledge you gain, which is certainly important, there is another important thing, and that is support. These are big changes for a woman. My family gave me support, but there wasn’t much outside of the family. I had a doctor and medicine, but I always wondered – where is the help for the soul. That support, mutual conversations and exchange of experiences, the optimism you get from women who have gone through this agony or are going through it side by side with you – that’s what I didn’t have nine years ago.”
It was around this idea of mutual support and making it easier to go through the process after breast cancer is discovered that the associations Jedna uz drugu and Kolibri za porodice were founded. Nora notes that both organizations rely on the cooperation of women who came together. “We serve as a bridge that connects a woman or a family in need, with an institution or any other support or help that she needs. To tell her what is the easiest way to get to a doctor, to empower her or give her the support from another woman who went through it all. Our task is to also fill in the gap in the organised support. These associations also conducted a survey for women to find out what kind of support they need. The survey singled out the need for psychological workshops, because not all women cope with the fact that they have breast cancer in the same way. That is why the plan for the future is to organise psychological workshops, not only for sick women, but also for family members and all those who have a sick person in their life, so that they can understand easier what they are facing and be able to support them better.
One hundred kilometres south of Subotica, in Novi Sad, the Omladina Jazas Novi Sad association carries out a different but equally noble mission every Saturday afternoon. Their goal is to contribute to the early detection of melanoma and other forms of skin cancer through preventive examinations. Everyone who is interested, including people who are HIV positive, has the opportunity to undergo professional skin screening in an informal atmosphere at the skin consultation centre, as part of the “What does my skin tell me” initiative.
“I saw a post on Facebook, so I came to check my moles, which I have a lot of, and make sure everything is okay. Honestly, I didn’t go to the doctor because it’s not easy to make an appointment and the waitlists are long. This screening turned out to be a great opportunity, it’s Saturday afternoon, we’re free, and here we do everything we need to quickly. I shared the post with my friends, and one of them came here with her son. I think there should be other preventive health check-ups like this,” says Jelica, a user who got screened at the skin clinic.
Milana, Marko and Miloš from the association Omladina Jazas Novi Sad started this initiative due to the increase in cases of skin cancer, which, when detected in the initial stage, are almost 100% curable. “Young people are not educated enough, and sometimes they feel uncomfortable to go to a skin examination because of acne or some other skin problems. This is especially notable with people who are HIV-positive and already do not trust the health system”, explains Miloš Nišavić, a specialist in dermatovenerology who performs the screenings, and adds that it is especially important to examine them because certain skin problems can indicate HIV infection. “It is sometimes difficult for them to find a doctor that would treat them continuously because stigma among health workers still exists. While carrying out these examinations, we realized that there are a lot of people who are interested so we don’t turn down anyone, everyone is welcome”.
“I came to get the screening because I don’t know what is and what is not harmful to the skin , and I take good care of my health. My conclusion is that the aesthetics of the skin is often more important to young people than the function, which is why we have cases of excessive exposure to the sun. I think it’s important that we all know the consequences and take care of our health, which should be a priority,” says Damjan, a user of this service.
The screening is designed so that patients first express their observations about pigment changes on the skin through a questionnaire, and then get a detailed examination from a dermatologist who advises them on wearing sun protection and doing skin self-examinations. During the examination, they can stay as long as they want and have the freedom to ask anything about the condition of the skin.
“This is, in a way, a space between state health institutions and the patient. In order to have a regular skin examination, a young person must go to a selected general practitioner, who will then assess whether they will be referred to a dermatologist, and make an appointment, that the patient has to wait for. . We skip that step. Patients can do a screening here if they have any doubts and want to consult. If there is nothing suspicious, the patient will not schedule an appointment with a dermatologist in a state health institution, and this way we achieve a double benefit – the patients received a service and cleared their doubts, and the health system is relieved. It is a kind of decentralization of health services. Let’s not forget the patients who get examined in private institutions, so the financial aspect also plays a role in everything,” says Dr. Marko Davidović.
In addition to screening, this organization also educates on sun protection and skin self-examination as part of the same initiative, as well as organise workshops that help young people develop life skills and strengthen self-confidence in order to face problems or discrimination due to their appearance.
“Young people receive a lot of information that they sometimes apply immediately without thinking. Our goal is to educate them properly and teach them to to think critically about skin protection, because they will one day pass on this knowledge and will not overexpose their children to the sun,” adds Milana Božulić, youth worker and president of the organization.
The initiatives “Healthy mother – healthy family” and “What my skin tells me” received support for implementation within the Regional Programme on Local Democracy in the Western Balkans 2 (ReLOaD2), financed by the European Union and implemented by the United Nations Development Programme (UNDP). . These activities contribute to the achievement of the Sustainable Development Goals of the United Nations, especially Goal 3 – Good health.