Friday, 27 January 2017

Cervical Cancer Prevention Week

It’s Cervical Cancer Prevention Week, so Louise has been looking again at Edinburgh’s history of advocacy and care reflected in our collections:

By their very nature, many archives tend to represent an ‘institutional’ view of the past, since it’s the history and accountability of organisations (such as the National Health Service) that these archives are set up to represent in the first place. For example, we have many, many records about patients in the form of various registers, ledgers and case histories, but these reflect hospitals’ aims in treating people and sending them out well again – case histories are taken down by a doctor or clerk (not always verbatim), clinical opinions are given on care and progress and the patient’s outcome assessed. First-hand patient experiences, reactions and feelings are almost always filtered through the clinical needs of the record and the voice of the physician – at least in our older holdings. Luckily, we have a number of more modern collections that reset this balance, conveying the direct experiences of those being cared for – one of these being our Cervical Smear and Women’s Health collection (GD31).  

As a result of publicised (and avoidable) deaths from cervical cancer in the early 1980s, Lothian Health Board’s existing cervical screening services were in extremely high demand – particularly since women were not invited to attend regular screenings. In 1985, laboratory facilities had a backlog of 10,000 un-read slides and froze the screening programme to catch up. In response to public concern about this, Edinburgh District Local Health Council and Edinburgh District Council Women’s Committee organised a public meeting, and the ‘Cervical Smear Campaign’ was formed.

The campaign petitioned Lothian Health Board to lift all screening restrictions and to demand a fully comprehensive service in Lothian and Scotland, including regular tests with organised call-backs and treatment for abnormal smears. Public support for the petition was massive in Lothian, Fife and the Borders, with nearly 18,000 signatures. In May 1988, Lothian Health Board introduced three-yearly screening for women aged 20 and over, a computerised recall system, and automatic notification of all test results to women themselves in addition to their doctors.

Cervical Smear Campaign video, 1987 (GD31/4/3)

The campaign became national as the decade went on. In November 1987, a second petition was launched, demanding a full screening service across Scotland. Campaign members also gave talks to hundreds of women across the region and produced information leaflets and a video in the absence of any other health education material, raising awareness and changing attitudes towards cervical cancer within the general public, the NHS and the media.

My favourite items in the Cervical Smear Campaign part of the collection are undoubtedly these publicity materials – they show a real grass-roots approach, giving straightforward and non-intimidating information about women’s health:
Cervical Smears and Women's Health leaflet, Cervical Smear Campaign, 1986 (GD31/3/1/1)
Importantly, this key information was made accessible for those whose first language was not English:
The same leaflet in Chinese (left) and Bengali (right) - GD31/3/1/2
As well as information generated by the Cervical Smear Campaign, there’s also local and national information and discussion on testing and attitudes to cervical cancer - for example, this Lothian Health Board 1988 leaflet, which echoes the imagery used in the earlier Cervical Smear Campaign:
Lothian Health Board leaflet, 1988 (GD31/3/7/1)
Debates around women’s health and morality, still very much on the agenda today, are also reflected in this collected literature. On the back page of a 1985 publication from the London-based Women’s Health Information Centre (GD31/6/1), the moral assumptions involved in abnormal smear results and cervical cancer diagnoses are explored. Since the virus that leads to cervical cancer is spread through sexual contact, the article reported women ‘already distressed by a diagnosis of cancer… additionally humiliated by insensitive questions about the number of sexual partners they have had.’ The author describes women being ascribed responsibility for the sexual promiscuity of any potential partners and being urged to keep themselves morally and physically pure to remain cancer-free. In contrast, despite the increasing incidence in young women in the 1980s, the article points out that cervical cancer ‘remains predominantly a disease of poverty and old age’ – since working class women without a bathroom at home and wives of men working in ‘dusty’ occupations (like mining, working with machine tools and with certain chemicals) were especially vulnerable. Regular testing, social change, health education and better environmental working and living conditions – rather than cementing stigma and fear – were then, as now, seen as the most effective health promotion.

If you’d like to know more about our collections around women’s health in Edinburgh and the Lothians, get in touch

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