Introduction
Oral cancer is one of the most dangerous cancers and is very common in parts of Africa, Asia and other parts of the world. One of the biggest challenges that doctors have in the fight against cancer is the fact that many of the patients lack knowledge about cancer. People have had cancer, but they do not have a clear way of knowing whether or not the little health complications they have could be related to cancer in any way. This has seen many individuals ignore this disease until it is in its advanced stage where treatment may not be easy. The patient realizes that the complication is worth taking to the hospital when the damage is already made. During such times, it becomes difficult to come up with measures through which the disease can properly be handled.
The people of Engcobo live in the remote parts of the Eastern Cape, in South Africa.
Most of the residents in this area are indigenous Africans who have been living in these places for a very long period (Castledine 56). They have encountered the western culture that has had an impact on their lifestyle. However, they have kept to their tradition. The literacy level of people in this area is relatively low. Although the current generation has gone through some level of education, there are those who are still semi-illiterate, while a few others are completely illiterate. These people still practice a number of traditional activities. One such evident traditional activity that they have held for a very long time is the traditional healing methods. They still believe in healing through traditional mechanisms such as traditional medicine. The region has a modern hospital, and most people in this area prefer going to hospital for simple complications such as headaches. However, any disease that appears unique is at times associated with witchcraft.
Unfortunately, oral cancer happens to be one of the diseases that they consider unnatural. Most of them have a general belief those normal health complications such as headaches and other complications of the body can be addressed in hospitals. Those that are related to witchcraft are treated traditionally. This is the major impediment in the fight against oral cancer among the Engcobo people. It becomes difficult for the medics to come up with mechanisms through which they can counter this disease. This research is focused on investigating knowledge levels and attitudes of the Engcobo population towards the prevention and early detection of oral cancer.
The General Infrastructural Development in the Area
An individual’s attitude and knowledge levels about a specific item will always be determined by a number of factors. When investigating the knowledge levels and attitude of Engcobo people towards the prevention and early detection of oral cancer, it is important to determine the infrastructural development in the area. Of interest will be the schools and hospitals in the area. For oral cancer or any other cancer for that matter, to be detected, a patient must go to the hospital (Werning 42). A patient must come out strongly and accept his condition and detach it from any other traditional beliefs. It is through this that a patient will be able to accept the fact that such complications are treatable in the hospitals, and that traditional healers have no role to play in this.
The region has a number of schools where formal education takes place. There are primary and secondary schools in this region. Although a good number of the populace has managed to successfully go through primary and secondary education, only a few have made it through to institutions of higher learning. A few Engcobo have a university education. The government of South Africa has been struggling to ensure that people in this area and other parts of the country get a full education. However, this has not been very successful. This area served as an African settlement during the apartheid era. It was difficult for them to go to school because the government was very unfriendly. During the liberation fight in the 1980s and early 1990s, the locals suffered heavily from attacks by government troops. Schools were some of the targets of the attack. As such, many parents were reluctant of taking their children to school. Others feared the brutality of the police towards students and therefore dropped out of school. This explains the high percentage of illiterate youths and adults in this area. Currently, the number of schools has increased and most children go to school.
The number of hospitals has increased over the recent past. The government of South Africa has been keen to ensure that people living in this area have access to free and fair Medicare. It has therefore increased the number of hospitals and improved health facilities in these hospitals. Although this effort has been lauded by a number of individuals, others have observed that the facilities in these hospitals are not enough to facilitate proper treatment for such complications as cancer (Myers 113). The experts at the hospitals may be able to detect the disease, but may not be in a position to offer treatment because of lack of proper facilities. They are always forced to make referrals to larger hospitals in Cape Town, or even abroad when the complication is serious. However, most of the locals lack the capacity to support the expensive cost of mitigating the complication. This has seen most of them ignore the advice given by the doctors.
Knowledge Levels and Attitude of Engcobo population towards prevention and early detection of oral cancer
Success towards course is always determined by the attitude of people involved. Attitude will always determine the will of an individual to fight on and win the course. An attitude is a tool that always propels an individual towards success. According to Reddi (39), success will always come when there is the will from the concerned individual always generated from a positive attitude. Attitude, on the other hand, is shaped by knowledge levels. Attitude is always developed out of a deeply rooted belief. Beliefs are always influenced by the levels of knowledge of an individual. When determining the ability of Engcobo people to detect and prevent oral cancer at early stages, it would be important to determine their knowledge, and then attitude towards the same.
The knowledge levels of Engcobo people towards oral cancer
It is very important to determine the knowledge levels of these people towards cancer in order to determine their capacity to fight it early enough. The people of Engcobo suffered a lot during the apartheid era. As stated above, it was very difficult for them to go to school during this era due to victimization. Because of their rebellious nature, the colonial government was reluctant in ensuring that they went to school. Parents were not very comfortable in letting their children learn the Whiteman’s ways under the conditions that were prevailing during the liberation fight. This resulted in a massive dropout among students in this region.
A good number of people in this region lack proper academic levels that can facilitate an understanding of cancer (Nielsen 29). These people have been associating cancer with a curse or witchcraft. This is because they lack enough knowledge to understand the disease. They find it very easy to associate oral cancer with black magic because that is what they can easily understand. They do not understand how an individual may have pale skin, open wounds on the lips, or those other symptoms of oral cancer without having experienced a physical cause for the wounds. They believe that such complications can only be a result of physical harm, and if not, then the cause is definitely black magic. This has been the main hindrance towards the early detection and treatment of this disease.
The knowledge levels of the youths may change this belief. The increased number of schools is enhancing the ability of the locals to understand this complication and appreciate the fact that hospital is the best remedy. However, the influence of the aging populace is still very strong. The aging population does not have an understanding of what cancer is. Although this disease must be in existence in those past years, it was associated with evil spirits, and those who were suffering from the disease would be taken to the bush and left to die for fear of plaguing others who were not infected (Acton 78). This is the perception that some of the old generations still holds. They would seek traditional mechanisms because that is what they have proper knowledge in. this has slowed the fight against oral cancer.
The attitude of Engcobo people towards oral cancer
The main problem that is experienced in the fight against oral cancer in this region is the attitude of the locals. People in this region have serious attitudinal problems with this disease. The problem is major with the aging population who are at higher risks of contracting the disease. The attitude of these people towards early treatment and detection of the disease comes on a number of fronts, and it is basically due to a lack of proper education and knowledge of the disease. The people in this area are coming to embrace modern hospitals as the best places where they can get medication when they are ill. During colonial rule, people did not trust hospitals, associating them with the colonizer. They believed that the only way to get genuine medication was through traditional medication. They, therefore, resented hospitals, an attitude that would take years to overcome. Society is slowly embracing the hospitals, but only some health complications.
The attitude of Engcobo people towards cancer is a major problem towards early detection and prevention of oral cancer. The majority of people in this area have no knowledge of cancer. Therefore, they do not have a hint on how best they can avoid the disease. In most hospitals, they only state probable causes of oral cancer, without having precision in their causes. Patients find it difficult to believe in such imprecise predictions of the disease. This has been the main jeopardy towards the successful prevention of the disease. Although a few individuals with proper knowledge of this disease have tried to lead a life free of cancer, the knowledge of the disease among most of the locals is very low. According to Hong (119), knowledge of cancer, and the means through which it can be detected early, or prevented is low even among the graduates in this area. It becomes complex for the health experts to come up with a remedy that can allow for a successful fight against the disease.
Another serious attitudinal problem comes from the perception that people have towards the disease. Due to a lack of knowledge, some people have come to associate cancer with HIV/AIDs complications. People feel that the moment one is suffering from this disease; such an individual is already infected with the virus. The victimization will therefore start with the patient. The patient will alienate himself or herself from people for fear of being alienated. People will feel that such a person is suffering from an HIV infection and will completely avoid the patient (Schwartz 28). This problem emanates from the fact that there was a general belief that the HIV virus is a disease of people who are morally loose and that it can only be contracted through illicit sexual relationships. The disease therefore still carries with it a lot of shame even today. People suffering from the infection die not because of AIDs, but due to stress caused by rejection and victimization. When oral cancer is associated with this disease, the chances that the patient will undergo the same consequences as an individual suffering from HIV infection is very high.
The attitude of people towards oral cancer is not helping the fight against the disease. Once the symptoms come out, people will refrain from coming into contact with the patient due to a possibility of infection. The patient, therefore, feels alienated. The feeling of rejection and solitude may make the patient withdrawn, and therefore may fail to seek early intervention for the disease. They may consider embracing the physical and psychological pain and resent mingling with people, including those who could be having the ability to help.
Another serious problem with early detection and prevention is an assumption on the side of the patient. During the early stages of the disease, it is always easy to ignore the disease. This is especially because it comes with mild pain. An individual lacking knowledge of cancer, which is very common among the people of Engcobo, will consider taking the wrong medication. Such a patient will believe that this complication is a result of some wounds in the mouth. Another major problem in this area is the wrong diagnosis. It always takes a long before oral cancer can successfully be detected. In this area, the most common health facilities are dispensaries and private clinics. In private clinics, the individuals who are in charge lack knowledge of cancer. They, therefore, tend to give the wrong diagnosis of the disease. This is very dangerous as the patient ends up treating the wrong disease for a very long time. By the time the patient will realize that this is oral cancer, it is always too late and very little can be done at this stage.
Oral Cancer among the Engcobo Population
Awareness about oral cancer is still very low. People in this region do not have an understanding of what cancer is. According to Tropp (78), the main problem in countering oral cancer is that people in this area do not know much about the disease. The few individuals in the upper social class are who can afford the treatment have come strongly to speak about cancer. However, instead of the locals taking this positively, they have come to associate the disease with the rich. The poor therefore believe that the disease is for the rich. This belief is justified. The cost of diagnosis of cancer is very high. The private clinics, which are very common in this region, do not have the facility to successfully conduct a diagnosis of oral cancer. The workforces in these clinics also lack the capacity to diagnose the disease. The situation is even work in the government dispensaries.
The dispensaries lack proper mechanisms through which they can help diagnose oral cancer. Non-governmental bodies have come to the aid of the poor in this society. Partnering with the dispensaries and other local organizations, they have made an effort to enhance the local’s knowledge on oral cancer. Although the locals are not able to understand medical terms like the abnormal mutation that always take place in some parts of the body, hence causing cancer, the experts have tried to use normal terms that can easily be understood by the locals. They have warned them of smoking tobacco which has been proven to be the main cause of oral cancer. The locals have positively received this news and are struggling to quit smoking. Another cause of oral cancer that the locals have been warned about is drinking alcohol, especially the cheaply available liquor which is brewed using dangerous ingredients (DeLong 69). This positive reception towards the fight against oral cancer is seen by an increase in the number of people who are visiting the rehabilitation centers.
Although a good number of the locals still do not understand what oral cancer is, and its dangers, others have come to appreciate the fact that oral cancer can be detected early enough and treated early. They appreciate the fact that detecting the disease at an advanced stage can be costly to treat, they are aware that this can be prevented when detected early enough. Nongovernmental organizations have also been advocating for preventive measures. As stated above, this involves refraining from activities that can enhance chances of contracting the disease such as smoking tobacco and drinking alcohol.
Conclusion
Engcobo people have not come to appreciate the fact that oral cancer is a disease that they are prone to and that care should be taken to prevent it, or at least detect it early in order to make the treatment process easier. The main reason for this is that the literacy level of the elderly population is law, and therefore lacks an understanding of what cancer is. Their belief and trust in traditional healing methods have also negatively impacted their attitude towards early detection and prevention of this disease can be a success. The costs associated with diagnosis and treatment of the disease have also made these people refrain from seeking early medical attention for the disease. These factors have worked against the development of positive knowledge about the prevention and early treatment of oral cancer in Engcobo.
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