Conservative Viewpoint on Disease Leads to Late Detection

TEMPO.CO, Jakarta -

Written by: Kasyfil Warits

Many Indonesians are still being ignorant towards particular diseases symptoms—which are supposed to get immediate diagnosis—due to the fear and shame of social judgement whenever they are sentenced from suffering any serious or presumed-threatening diseases, while the fact is otherwise. There has been a prevailing belief among society that disease is a form of punishment or karma which is humiliating to be revealed. Living in such environment makes some people who actually have access to early detection of disease discouraged to get further examination. Hence, those people decide to ignore their disease symptoms instead of getting examination as they worry of being confirmed from suffering certain disease. Disturbing images of social judgement within their minds then become justification to conceal their conditions and convince themselves by positive thoughts telling that those symptoms do not count as anything.

There are several diseases considered as burdens by society, resulting in those being concealed and even to the extent of left unexamined, such as HIV-AIDS, cancer, leprocy, tumor, hydrocephalus and so forth. Alas, it will harden health services to treat already-severed diseases due to the delay in earlier detection. In fact, dr. Herfin Herdiana, a member of the Indonesian Medical Association (IDI) and Chairman of the Karawang Islamic and Social Preaching Association (Yayasan Dakwah Islam dan Sosial Karawang – YADISKA), elucidates the importance of early medical check-up which shouldn’t only be done when any symptoms occur in order to allow detection of the likely disease suffered by a person. Therefore, it will also be easier for doctor to track medical record, take preventive measures, and also administer the treatment of a person’s illness.

Studies report about 25% of cancer patients concealed their disease, even from their closest ones, and major cases ended up with death due to being late for receiving medical treatment. This is supported by the data from Ministry of Health showing that 70% patients visiting hospitals mostly had reached advanced stage. For instance, many patients believe that having medical check-up for cancer is still taboo among society and they are also afraid of being diagnosed to suffer from it. More heartbreaking condition happens to people with HIV-AIDS. Those who are diagnosed to suffer from this disease mostly give up during treatment process because of the negative social opinions and tendency to be excluded from society. In fact, the life expectancy of HIV-AIDS patients who do early detection, take regular medication, and get well-monitoring can be higher.

Unfortunately, this almost happened to my loved one.

If most of you think that this outmoded mindset is rarely found among society with more modern thinking and lifestyle, this is not the case. My beloved younger sister might have almost decided not to receive an early diagnosis of breast tumor that she suffered from. I can say she has an excellent education background and easy access to information sources. However, she turned out to prefer concealing her disease at the first place, until her closest ones had suspicions on symptoms she accidentally showed.

In short, my sister revealed her intention to do medical check-up to me without telling our parents or other family members. She was afraid that when the examination result was out, our parents would be too worried and situation would no longer be the same because of the new special attention directed to her which she had never received before. Furthermore, she also thought that if this news is known by our extended family members, their opinions would burden her and our parents. Hearing this, I was surprised but I could not deny the reasons she told me. As an illustration, my family is a typical Javanese big family that uphold the spirit of “guyub rukun” (to live in togetherness and harmony) and we have a close bond.

Eventually, we were bound to tell our parents and they were shocked, yet they were grateful that my sister was willing to tell them about her conditions before it turned to be too late. Results of her examination revealed the truth indeed. Doctor discovered that this tumor had occurred and shown some symptoms at least for the previous four months. Under this condition, I tried to see by using perspective of those who suffer from a certain disease yet they keep concealing it. Does the negative judgement of society around patients have such significant impact as they become too afraid to have their disease examined? Fortunately, my sister found a courage to take examination and her disease was still at early stage.

My reason for publicly sharing this is to help readers to think openly and lessen their concern towards any unnecessary things such as social judgement around them, and rather to focus on their recovery. Sometimes, excessive attention and sympathy from the closest ones may burden a patient. One day, a relative of mine met my sister and heard about the breast cancer she suffered from. She then shared a story about her neighbour who visited the so called “orang pintar” or a traditional healer and claimed that she fully recovered without having to go through chemotherapy. Hearing this drove me mad. Didn’t she try to find out the condition of my sister’s tumor which was still in the early stage back then so it was unnecessary to say something like a desperate and unreasonable way to recover? It is extremely unfortunate for such mindset to prevail, especially when people around us who could have been thinking with more modern and open viewpoint are stuck within this conservative paradigm of disease.

This old viewpoint on disease as disgrace which should be tightly concealed has become a hindrance for the efforts taken by Ministry of Health and some health-aware communities to do early detection of diseases. Society’s mindset seems to become a deep-rooted culture which is extremely hard to be changed only by communicating any fact telling that what they have done so far is completely wrong. In correcting an inappropriate culture, it is better to present an alternative culture that can be adapted to the current culture so community will not resist it and get used to this alternative as time passes by.

Society can be encouraged to habituate a culture of having routine medical check-ups as an effort to find out their health conditions periodically. When a lot of people doing so, it will no longer become taboo to discuss about health condition. Those who are detected to suffer from certain diseases will be seen by society to be in a secured state since their health record and medical treatments are obviously the result of their regular check-ups. Imagine if this ideal condition can be applied in Indonesia as a culture just like nowadays in other developed countries. It will be relieving since this conservative viewpoint on disease as disgrace is finally turned into an open-minded viewpoint on disease by focusing towards the next treatment steps.

In parallel, we can start by communicating to our loved ones whenever we have any suspicions on our health or notice some symptoms of diseases within ourselves. Communicating in a right way and time will relieve our burden regarding the likelihood of negative opinions or excessive sympathy from people around us in the future. Thus, an early detection of disease can be potentially created. The earlier we find out, the more comprehensive treatments that can be administered in order to ensure our recovery. (*)

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