5C Woman’s Body Self Examination Fact: Almost all of the women and girls in the study noted their lack of basic health care knowledge and the desire for more written materials in their own language. Their primary health concerns focused on reproductive health issues such as birth control, abortion, pre- and post-natal care…. Title Target Audience Objectives Time Needed Instruction Know your body Foreign Domestic Worker, NGO’s, women, civil society 1. To understand the anatomy of woman’s body 2. To keep oneself healthy 3. To prevent dangers on woman’s health Minimum of two hours maximum of four. 1. Break the ice by doing some games to unfreeze everyone to talk about health and sexuality. Tell them to count their scores. Or get a pen and paper and mark the correct answers they have. The game is true or false. Tell them that the objective of the game is not to give them a failure grade if they do not answer the questions correctly. It is a way to level off where are we in understanding about women’s health 2. Another way to do it for more fun is to request participants to stand up and put a mark of Yes in one line and another line for No answers. You may also want to put another line for not so sure answers. Then every time you ask them the question you may tell them which line are they in? Yes or No? After each question you may give them the correct answer. UNDERSTANDING YOUR BODY… FACTS AND MYTHS ABOUT WOMEN’S HEALTH 1. All women’s normal menstrual cycle is 28 days? No. A healthy menstrual cycle may vary from 21-35 days, and may vary within individuals. 2. You can get pregnant as a result of sex during your period? Yes. Ovulation doesn’t necessarily happen at the exact same time each time pregnancy can result if you have vagina-penile intercourse during your period and you ovulate very early your cycle. 3. All women ovulate on day 14 of their cycle? No. Most women ovulate 14 days BEFORE they begin bleeding, rather than 14 days into their cycle. But every woman is different and you may ovulate sooner or later depending on health, stress, travel or other disruptions in your routine. 4. When you feel a lump in your breast is it cancer? No. Do not panic! This is a cause of great anxiety for many women when they start doing breast exams (see below diagram). Normal breast tissue can feel somewhat lumpy and uneven. The key is to get a feel for your breasts then notice anything that feels harder or rounder than usual. 5. Breast self examination should be done each month during your period? No. Your breasts change slightly each month in reaction to hormone levels during menstruations. The best time to examine tour breast is a day or two after your period ends. 6. You must get pap smear only when you reach 40? No. Beginning 18 (or earlier if you are sexually active) you should have a yearly pap smear as a routine part of your health. Even if you are not sexually active, a pap smear provides very important information about the health of your reproductive system and can help detect any abnormalities early. 7. Only ageing people suffer from heart disease? No. It appears to be more prevalent among women aged 29-30 having a Metabolic syndrome (a condition indicated by too much weight around the mid-section, insulin resistance and elevated blood pressure). 8. Breast cancer is the leading cause of death among women? No. Heart attacks, strokes, and other cardiovascular diseases claim the lives of more than 500,000 women each year compared to 43,000 for breast cancer. Many doctors say that women fear breast cancer more than heart disease. 9. You can get sexually transmitted diseases (STD) from toilet seats? No. Most organisms that cause STD’s will not survive for long on a toilet seat. Viruses such as those that causes herpes and hepatitis can survive, but a woman would have to make genital contact with the seat to become infected. 10. You can get HIV AIDS from kissing? No. HIV AIDS is acquired by unprotected sex, blood transfusion, exchange of needles. It is not also true that you get the disease from swimming in the pool. You may end by saying: Some of us (or most of us) may not have the perfect score because we are not aware of the myths and facts in women’s health. 3. Present to them a life size picture of women’s anatomy. Frontal and back see page 93 of the Self Help and Self Exam. The images on the ﬂoor. Before you present the anatomy of the woman’s body you need to prepare the group that the intention of showing it is for training and health purposes. NOTE: Some Asian women are not comfortable of looking at these naked images because of their socialization. The Filipinos may see it as dirty and may giggle impishly when they see it because of the “Catholic in them”, The Indonesians may be shocked, etc. 4. Ask them to mark with a red color marker on the body outline depicting any health problem or symptom they ever had. 5. The next part is to mark in different color this time in blue color marker the problems for which they got treatment from the doctor. 6. After everyone has ﬁnished their markings. Present the images this time. Post it on the wall. Ask them the following questions: • What do you observe in the markings? Where do we usually have pains and troubles in our bodies? • Observe the markings on the “sensitive” areas of the body like breasts and vagina. Ask them why these parts of the body have little or more markings? • What causes these pains and problems? List down all answers on the board. 7. Observe the blue marks? Why are there only few visits to the doctors? Write down all the answers: Input 1. Most of us have got treatment only when we could no longer bear the pain. The disorders which we took to doctors were general weakness, backache, headache, joint pains, and burning in the stomach. 2. It was easier to mark “usual” kinds of problems, as we relate them to general conditions in life. But we hesitate to mark genital and urinary ailments. We are ashamed about these body parts, and we fear being punished by husbands and partners and abused if we got to a doctor. We are always conditioned that sex is dirty and it should never be talked about in public. Or even raise the issue within the family. Women should keep their virginity until they marry and women who are no longer virgins when they marry are looked down, stigmatised, and associated with the name calling, “loose woman” or whore. 3. If there is an opportunity for you to invite a woman medical doctor to speak about women’s health in the group. This is a perfect chance to get answers from an expert. Some Medical Check List: 1. HEAD Some Symptoms: Constant pain, migraine, 2. TEETH Some Symptoms: Poorly cared can cause bad breath, toothache, bleeding gums Care for you: Visit to a dentist at least once every six months. Use of ﬂuoride-enriched toothpaste. If too expensive, what alternative could you use? Avoid food and drinks high in sugar because when plaque comes into contact with sugar or starch in the mouth, acid is produced that attacks the teeth and could cause tooth decay. 3. EYES Some symptoms: Frequent headaches or blurring of vision Care for you: Visit to an ophthalmologist. It is better to see an eye doctor rather than optometrist because an ophthalmologist can perform a more detailed and complete eye examination. See an eye doctor once from age 19-20, then at least twice from age 20-39, then every two years thereafter to have your eyes thoroughly evaluated. 4. BREAST Some symptoms: Dimpling, puckering, or bulging of the skin. A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out). Redness, soreness, rash, or swelling. Lump (do not panic). Care for you: The Five Steps of a Breast Self Exam THE FIVE STEPS OF A BREAST SELF EXAM Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips. Here’s what you should look for: • Breasts that are their usual size, shape, and color. • Breasts that are evenly shaped without visible distortion or swelling. If you see any of the following changes, bring them to your doctor’s attention: Dimpling, puckering, or bulging of the skin. • A nipple that has changed position or an inverted nipple (pushed inward instead of sticking out). • Redness, soreness, rash, or swelling. Step 2: Now, raise your arms and look for the same changes. Step 3: While you’re at the mirror, gently squeeze each nipple between your ﬁnger and thumb and check for nipple discharge (this could be a milky or yellow ﬂuid or blood). Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast. Use a ﬁrm, smooth touch with the ﬁrst few ﬁngers of your hand, keeping the ﬁngers ﬂat and together. Cover the entire breast from top to bottom, side to side—from your collarbone to the top of your abdomen, and from your armpit to your cleavage. Follow a pattern to be sure that you cover the whole breast. You can begin at the nipple, moving in larger and larger circles until you reach the outer edge of the breast. You can also move your ﬁngers up and down vertically, in rows, as if you were mowing a lawn. Be sure to feel all the breast tissue: just beneath your skin with a soft touch and down deeper with a ﬁrmer touch. Begin examining each area with a very soft touch, and then increase pressure so that you can feel the deeper tissue, down to your ribcage. Step 5: Finally, feel your breasts while you are standing or sitting. Many women ﬁnd that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower. Cover your entire breast, using the same hand movements described in Step 4. 5. BONES Some symptoms: back pain, curve back, joint pains Care for you: As we age we tend to lose more bone than our body can build, which can cause our bones to become brittle and your spine to curve. Doctors can order for a bone density exam: a painless exam that tells you how your bone compares to other women of your age. However, this is not ordered routinely until you turn 45 or once you begin menopause. If you are in your 20’s and 30’s eating calcium-rich food will prevent frequent injuries caused by having brittle bones due to aging at a later stage. 6. HEART Some symptoms: Shortness of Palpitations (irregular heart beats, skipped beats or a “ﬂip-ﬂop” feeling in your chest) A faster heartbeat, weakness or dizziness, nausea, sweating. Care for you: Check blood pressure at least once a year. Once you reach 40 annual screening of diabetes, check your cholesterol level and sugar. USEFUL REMINDER: Cancer Symptoms Since prevention is one of the most important cancer-ﬁghting tools, it is important that cancer be detected as early as possible before it spreads. Telltale Signs of Cancer include: A lump or thickening in the breast or testicles; a change in a wart or mole; a skin sore or a persistent sore throat that doesn’t heal; a change in bowel or bladder habits; a persistent cough or coughing blood; constant indigestion or trouble swallowing; unusual bleeding or vaginal discharge; and chronic fatigue. If you notice any of these symptoms, you should see a physician for testing. We also have a web page that lists some of the tests that are available to detect cancer. The following are symptoms that may occur in speciﬁc types of cancers: Bladder cancer: Blood in the urine, pain or burning upon urination; frequent urination; or cloudy urine Bone cancer: Pain in the bone or swelling around the affected site; fractures in bones; weakness, fatigue; weight loss; repeated infections; nausea, vomiting, constipation, problems with urination; weakness or numbness in the legs; bumps and bruises that persist Brain cancer: Dizziness; drowsiness; abnormal eye movements or changes in vision; weakness, loss of feeling in arms or legs or difﬁculties in walking; ﬁts or convulsions; changes in personality, memory or speech; headaches that tend to be worse in the morning and ease during the day, that may be accompanied by nausea or vomiting Breast cancer: A lump or thickening of the breast; discharge from the nipple; change in the skin of the breast; a feeling of heat; or enlarged lymph nodes under the arm Colorectal cancer: Rectal bleeding (red blood in stools or black stools); abdominal cramps; constipation alternating with diarrhea; weight loss; loss of appetite; weakness; pallid complexion Kidney cancer: Blood in urine; dull ache or pain in the back or side; lump in kidney area, sometimes accompanied by high blood pressure or abnormality in red blood cell count Leukemia: Weakness, paleness; fever and ﬂu-like symptoms; bruising and prolonged bleeding; enlarged lymph nodes, spleen, liver; pain in bones and joints; frequent infections; weight loss; night sweats Lung cancer: Wheezing, persistent cough for months; bloodstreaked sputum; persistent ache in chest; congestion in lungs; enlarged lymph nodes in the neck Melanoma: Change in mole or other bump on the skin, including bleeding or change in size, shape, color, or texture Non-Hodgkin’s lymphoma: Painless swelling in the lymph nodes in the neck, underarm, or groin; persistent fever; feeling of fatigue; unexplained weight loss; itchy skin and rashes; small lumps in skin; bone pain; swelling in the abdomen; liver or spleen enlargement Oral cancer: A lump in the mouth, ulceration of the lip, tongue or inside of the mouth that does not heal within a couple of weeks; dentures that no longer ﬁt well; oral pain, bleeding, foul breath, loose teeth, and changes in speech Ovarian cancer: Abdominal swelling; in rare cases, abnormal vaginal bleeding; digestive discomfort Pancreatic cancer: Upper abdominal pain and unexplained weight loss; pain near the center of the back; intolerance of fatty foods; yellowing of the skin; abdominal masses; enlargement of liver and spleen Prostate cancer: Urination difﬁculties due to blockage of the urethra; bladder retains urine, creating frequent feelings of urgency to urinate, especially at night; bladder not emptying completely; burning or painful urination; bloody urine; tenderness over the bladder; and dull ache in the pelvis or back Stomach cancer: Indigestion or heartburn; discomfort or pain in the abdomen; nausea and vomiting; diarrhea or constipation; bloating after meals; loss of appetite; weakness and fatigue; bleeding - vomiting blood or blood in the stool Uterine cancer: Abnormal vaginal bleeding, a watery bloody discharge in postmenopausal women; a painful urination; pain during intercourse; pain in pelvic area Conclusion It is true that our investment in this ﬁeld of work is to keep ourselves healthy and strong. The above knowledge and practical ways to prevent these possible diseases are for us to be mindful about always. However, if governments of the sending countries are sincere in recognizing that foreign migrant workers are their modern day heroes then providing regular free medical mission in collaboration with the receiving countries would surely be a positive way to address protection of FDW Health and Human Rights.