Cervical cancer screening advice for gypsies and travellers

[RoyalCorgi]

This is fascinating. A very short leaflet with advice on cervical cancer screening.

https://www.gypsy-traveller.org/wp-content/uploads/2024/08/Cervical-Cancer-Leaflet.pdf

Absolutely nothing to say who the leaflet is aimed at, apart from the need to be aged over 25.

'As in the 2011 census 5], 60% of Gypsies and Travellers in this study had no qualifications; this compares with 23% for the whole population in England and Wales without qualifications.'

From the study upthread.

And:

https://wp-main.travellermovement.org.uk/wp-content/uploads/2021/09/GRT-in-Secondary-Education-2021.pdf

'Gypsies, Roma and Travellers experience some of the worst educational outcomes of all ethnic groups, and across all social indicators. Their children are
four times more likely to be excluded from school, and are the least likely to achieve any formal qualifications. In the 2017/2018 school year, the highest permanent exclusion rates were among Gypsy and Roma pupils (0.36%, or 36 exclusions per 10,000 pupils) and Traveller of Irish Heritage pupils (0.29%, or 29 per 10,000 pupils)'

Arabella I’ve also known traveller girls removed from schools once they were able to read at a fairly basic level.

🤷‍♀️

(and this would be an advance on their mum’s who often were illiterate)

🤷‍♀️🤷‍♀️

Agree that this is good health communication taking into account the specificities of the target audience. It uses multimodality (e.g. pictures as well as words) to get the necessary information across and is in line with NHS health communication guidelines in using simple language for an audience that will typically have low exposure to formal education.

Parliament’s Library appears to show a shift away from looking at GRT health - it’s still worth reading the 2019 WEQ Select Committee Report. While there are members of the GRT Community who are highly educated & who go into careers like law & medicine; overall poor levels of [health] literacy are absolutely a factor in access to, uptake of & navigation of care.

Relying on women remembering anatomical terms they may have heard mentioned when they gave birth is hardly quality healthcare. “I can tell this is for women because they mention it being done by a woman & my being able to say a woman must do it” it is also not a winner. Such incredible resistance to making the simple concession of just identifying who the leaflet is for. I’m sure there’s a culturally sensitive way to communicate the type of bleeding meant, too.

Wonder what the GRT Women’s Health Group would make of said leaflet.

Vast swathes of the GRT community are Catholic. Forcing the New Religion of Gender Identity is a failure to respect the faith aspect of their culture.

But I don't think it gets across the key information (even vaguely) around what actually happens. If this is a group who are removed from sex education and it isn't discussed at home, and they go to the appointment and are told to take their knickers off and presented with a speculum, that's surely far from ideal?

Even if you have to choose language carefully, making it clear that it's an intimate examination as opposed to something like an abdominal ultrasound would surely be a bit better? Unless the thinking is literally "if we tell them what sort of test it is, they won't come, so it's better to surprise them in the room"

The leaflet needs to mention in some way what this mysterious "screening" involves. It could be quite traumatic for a young woman to turn up & not realise what actually is about to happen.

Totally understand language, modesty concerns etc, so it can be done in a low key way that would be acceptable to that community

https://www.travellerstimes.org.uk/advice/join-fight-against-cancer-being-symptom-aware-and-attending-your-screening

Here's a different leaflet aimed at same demographic. Word 'woman' is conspicuously absent.

It uses multimodality (e.g. pictures as well as words) to get the necessary information across

It uses one picture. Will people look at that picture of a doctor's surgery, see the representation of the uterus and ovaries on the wall and understand that it is showing a woman's internal reproductive organs?

The more I look at this leaflet the more weird it seems. It's as if they've decided that they need to get an important health message across without using any of the terms that would make that health message comprehensible.

Lots of ignorant comments on here.

It’s absolutely designed for young women of low literacy levels who are from a culture where talking about certain things is taboo. It’s very likely to have been written in consultation with women from these communities as gypsy/traveller women have very low levels of attendance to cervical screening so obviously the usual communications aren’t working for them. There also may be males they live with who might read the leaflet and see information that leads to the female not being ‘allowed’ to go for screening so that information has been omitted as much as possible. There also may be some sort of distribution plan on pace ensuring it is given to the right people.

'There also may be males they live with who might read the leaflet and see information that leads to the female not being ‘allowed’ to go for screening so that information has been omitted as much as possible.

Such as what? What information?

I'm not seeing any reason that the word 'woman' would be omitted in health screening information.

https://women.travellermovement.org.uk/roma/

Twenty five is way too old for a culture who often marry and have kids in their teens/early 20s.
I think it should start at 16 personally.

I'm trying to work out why the language is so vague. Could it be that the word cancer is also very taboo. Like just saying it makes you more likely to get it? I guess they could be trying to make it simpler as they assume travellers have lower literacy. Could it be the leaflets need to be really subtle as if a man saw it they wouldn't want their wife to go?

'Professionals must do more as there is a lack of understanding by those in front-line services in relation to culture and barriers for these women. Traveller Movement has published a ‘Good Practise Guide’ which can be accessed through the link. Research has found that many GP’s will not accept Gypsy and Travellers onto their practise lists, which further isolates these women from seeking help.'

https://www.ncdv.org.uk/gypsy-roma-traveller-women/

(my bolding - that's shocking)

I'm not a teacher, so I don't understand which parts of education on biology/sex parents are allowed to exclude their children from.

But I think it's very concerning if parents are allowed to prevent girls having education on their own bodies as they approach puberty. Girl's rights to this information should override any sensitivities about 'culture' or 'religion'. No woman in this country should have her first period without understanding what is happening, or have her first experience of sexual intercourse without understanding how babies are made.

We shouldn't respect 'cultural taboos' if they damage women's health. All women should have a right to know that bleeding after sex is not normal, and should be investigated because it may be a sign of a cancer that could kill them.

Not all 'cultures' are equal, and we shouldn't allow any culture or religion to overrule women's rights in the UK.

If they all went to school until they were 16 and received proper sex education they wouldn't have poor literacy or think that some words were 'taboo'.

Gypsy and traveller girls should have the same right to education as everyone else in this country.

I agree Anna but unfortunately that’s what we have.

I do find the removing of children from school massively worrying too.

All of that is excellent, but if the outcome is that the girls get taken out of school then they still have no sex education, and they don't have any other formal education either.

At least if you keep them in school, they've got a better chance of having the tools to education themselves.

I agree.
I don't see a problem with this, if fact I think it's excellent. I doubt many women are going to get beaten up or shamed for leaving this leaflet on the kitchen table.

No one mentioned trans.

Why on earth would you.

They shouldn't be allowed to take the girls out of school.
They should face the same penalties for not ensuring their children receive an education as anyone else.
And learning to keep a caravan sparkling clean is not an education.

Also, the bottom line is if the leaflet works and more women attend screenings because of it. If it works, frankly I don't care how many of you lot it offends.

I don't think the issue anyone has with the leaflet is that it 'offends' us, it is that we're worried it WON'T work, because

1. it doesn't contain any useful information and
2. by waffling about mysterious symptoms it could easily give the impression that screening isn't that important if you don't have symptoms.

well. it IS Brighton.

we don't have genders here and everyone has a cervix AND a prostate.

Well, it has been produced by health communication specialists in conjunction with community representatives, so presumably it works on their terms.

I’m struggling to understand how this will be applied. Where will it be posted that only Gypsy and traveller women will see it? If you put this poster up next to one with actual information on it, will Gypsy and traveller women see that one and not understand, but see this one and go “ah, better get that vaginal bleeding checked out”. I’m genuinely curious about the practicalities of the application of this poster.