Tag Archives: women’s health

Screening for Cervical Cancer in Africa with Mobile Phones

Laurie and Debbie say:

Some of the most exciting health innovations depending on mobile phones are happening in Africa, where a widespread mobile phone and tablet culture is making amazing advances in treating health problems, such as diagnosing pneumonia and cardiac disease.

Africa is often stereotyped as the continent of hopeless disaster and poverty. In reality a vibrant, exciting, innovative culture is addressing many African people’s life-and-death issues: the “developed” countries have a great deal to learn.

women lining up for cell phone cervical cancer screenings (photo by Abigail Higgins)

To get a cervical cancer screening in America, a woman has to go to her doctor or to Planned Parenthood (long may they survive and thrive!). Abigail Higgins at TakePart describes a different option in Africa:

More than a quarter of a million women die of cervical cancer every year, almost as many as are killed by pregnancy or childbirth complications. More than 88 percent of these women live in the developing world. …

[Catherine] Njeri was screened using visual inspection with acetic acid—simple, white vinegar that causes any precancerous lesions to turn white. It’s an attractive alternative in low-resource settings such as Kenya.

The smartphone device allows a nurse to take a detailed photograph of the cervix, a much less invasive procedure than a Pap smear.

“I love this technology because it makes so much sense. It’s so simple. It’s so practical,” said Dinah Mwangi, the head of field operations at MobileODT.

Mwangi was able to take the photograph and consult with other medical practitioners on the spot. If the appointment had been in a rural area, she could have consulted other doctors for a second opinion, using an application to send the photograph.

If the results had not been normal, she would have been treated with cryotherapy immediately, eliminating the possibility that doctors might lose touch with her until it was too late.

Stop for a moment and think about how amazing that is. A simple, inexpensive device that, used with ordinary white vinegar, identifies precancerous lesions, allows the practitioner to consult, and has an immediate treatment on site!

Triza Okal and Catherine NJeri after cervical cancer screening (photo: Abigail Higgins)

Plus, there’s a delightful body image aspect. It turns out that these women love seeing their own cervices.  Although the pictures are actually taken by nurses, the response to them is pure 21st century selfie culture:

“Women have been so excited about their cervix, it completely changed the patient encounter,” said [Curtis] Peterson [of Mobile ODT, which makes the screening device] “What was previously an opaque process is now clear.” …

“They want to text [the picture of their cervix] to their phone, or they want it emailed to them, or they want us to send it to them on WhatsApp so they can take it home and show their husband and friends,” said Peterson.

The combination of being able to get a picture of your own cervix and a culture which encourages you to share pictures is changing the way these women see their bodies, and especially the internal, usually invisible parts of their bodies.

Who knows when cervix-sharing pix will become a fad in the developed countries? Meanwhile, we celebrate the African women being screened and treated, and the people who are making it possible.

Breast Obsession: From Games to Hard Decisions

Laurie and Debbie say:

Melanie Testa’s “Shirts off, Underwear on:, Play Out, Breast Cancer and Gender Expectations” is superb.


Perhaps I am an anomaly in the world of breast cancer, having chosen against reconstruction while also choosing not to wear prosthesis. I was certainly made to feel as if my choice was abnormal by my doctors when I was asked to see a psychiatrist to make sure I was of sound mind in my ‘contralateral decision making process’. At that same office, my fellow sisters who chose reconstruction were not asked to justify their surgical choice to a psychiatrist, regardless of their contralateral choices. Perhaps my doctor wanted to be entirely sure that that they would not be removing a breast that I might come to miss, and regret my decision. I could have chosen to keep the unaffected breast. There was no question that a unilateral mastectomy was medically necessary, but I chose a bilateral mastectomy – a decision I have never regretted.

This bias is unacceptable, and clearly illustrates a preference for reconstruction to the shape of a breast and breastedness in general. It also serves to make it difficult for women to choose otherwise.

Testa’s observations both inform and are informed by Patricia Anderson’s post on Kotaku about “breast physics” and how and why video games gets breasts so wrong.


Plenty of people theorize about why games often feature bad breast physics, but there is little hard information about the actual breast-creation process. After looking into it a bit, I found that many amateur developers seemed to genuinely have a problem figuring out how to tackle breast physics in their games. There are a startling number of forum posts and tutorials where people discuss the best ways to achieve good breast physics online. One person even created a four-part Powerpoint presentation titled “The Quest for Boob Jiggle In Unity.” People have developed specialized tools for other developers to use, to help demystify the enigma that is “how do breasts work.”

For an excessively jiggly set of videogame breasts go here.

Anderson basically says that animating bones and rigid body action is easier than animating soft tissue body action. After explaining why realistic breasts are expensive to animate, she concludes (surprise!) that “absurd breast physics aren’t always unintentional.”

“Ultimately though, I sort of suspect that when a developer doesn’t get breast physics looking right, it’s because, for whatever reason, somebody wanted them to look that way,” [Tim Dawson, an indie developer] said.

So what does this have to do with Testa, and women with breast cancer?

As many as 58% of women who have mastectomies after cancer either do not reconstruct or do reconstruct and then later deconstruct, either out of choice or because of failed reconstruction. I pondered just how many of those breastless women disliked wearing prosthesis and presenting an image of a woman with breasts. Prior to my diagnosis, I had never knowingly met a single-breasted or bilaterally flat-chested woman. I imagine there are many women who don breast forms with hesitation, annoyance, or even resentment. Why do we feel that we need to promote the false impression that all women have breasts?

The bulk of her piece concerns the pressure on women to get reconstructive surgery and/or breast forms and not to “go flat,” including substantial medical and psychiatric pressure. She has had a lot of trouble being believed when she says: “Wearing fake breasts would do nothing positive for me, physically or emotionally; I quail at the idea of presenting two body types, a breasted public image and a flat private image.”

Rhylorien from Laurie's  Women En Large: Images of Fat Nudes
Rhylorien from Laurie’s Women En Large: Images of Fat Nudes

Reading these two pieces together, we can’t help but see that the psychiatrists and surgeons trying to force Testa into a false-breast look are influenced by, and themselves reinforcing, the game developers who like implausible breasts enough to keep making them. Of course, neither the medical establishment nor the game designers are working in a vacuum: they are both reflecting an obsession which is everywhere in the Western world, from billboards to fashion runways and everywhere in between.

In other words, Testa is talking about real breasts: why we want them, what they mean to us, what losing them means, what visibly losing them means. Anderson, to some extent, and the video game industry and breast surgery industry to a large extent, are talking about breast fantasies.

Both industries will come of age when women without breasts become part of their mental landscape. Testa says: “The sooner doctors and researchers collectively agree that women sometimes choose flat or bilateral mastectomy without reconstruction, the better. Get out of our minds.” She could also be talking about animators.