Death, contagion and shame: The potential of cancer survivors' advocacy in Zambia

24 February, 2019

Dear HIFA-Zambia colleagues,

Cancer is 'a death sentence’, ‘contagious’ and 'a shameful illness’. These are the themes emerging from in-depth interviews. And yet survivors can be effective advocates to dispel stigma, myths and misconceptions.

CITATION: Death, contagion and shame: The potential of cancer survivors' advocacy in Zambia

Britta Wigginton, Kim Farmer, Sharon Kapambwe, Lisa Fitzgerald, Marina M. Reeves & Sheleigh P. Lawler

Health Care for Women International 2018

Download citation:

Email: b.wigginton AT


Cancer has become a global health concern with marked differences in the incidence and mortality rates between developing and developed countries. Understanding the factors that shape uptake of preventative and screening services is the key. We use in-depth interviews with 13 Zambian urban-based female cancer survivors to explore the facilitators and barriers to screening, diagnosis and treatment, with a particular focus on cultural influences. We identified a central theme (i.e. a story told about cancer) in all of the interviews: ‘cancer is a death sentence’. Most women referenced this theme to describe their own, their family members', or community members' reactions to their diagnosis, along with references to cancer as ‘contagious’ and ‘a shameful illness’. We also identified a theme entitled ‘survivors as advocates’, within which women described engaging in advocacy work to challenge stigma, misconceptions and misinformation about cancer; and advocating early detection and diagnosis, compliance with medical treatment and the sharing of success stories. This analysis points to the need for survivors to be front and center of preventative efforts. Their personal experiences, legitimacy and connections in the community, and their enthusiasm in helping others should be fostered, particularly in low-resource settings.

Best wishes, Neil

Working together for health in Zambia - Join HIFA-Zambia:

HIFA profile: Neil Pakenham-Walsh is the coordinator of HIFA-Zambia and the HIFA campaign (Healthcare Information For All - ) and current chair of the Dgroups Foundation (, which supports 700 communities of practice for international development, social justice and global health. Twitter: @hifa_org FB: