It’s not easy to show my scars. But I am proud to break the deadly silence around breast cancer in Nigeria

“Madam, this looks like breast cancer, and if it is, we will chop off your breast.” That was how the doctor welcomed me into the chaotic world of breast cancer in 2017 when I was 32 years old.

For a moment, I could no longer hear him. I thought of my three children, the university degree I had just bagged and the future I had envisaged. If I was going to die, what was the point of it all? I had invested everything I had to obtain that degree, subjecting my children to days of absence while I spent my nights in the university library.

After my diagnosis, everyone had an opinion. My mother insisted a medicine man could heal me and begged me to cancel the scheduled mastectomy. My friends dragged me to churches because all I needed was faith and prayers to be healed.

I was told that after the surgery I could focus on my life again. But a couple of days into my recovery, a group of doctors stood by my bedside and informed me that I would need further treatment, including chemotherapy.

Once they were gone, my friend – a pathologist who was visiting – convinced me that chemotherapy would kill me and further surgery was all I needed. A few friends echoed his sentiments, and with that, I refused chemotherapy.

Instead, I Googled alternative treatments and settled for “wonder foods”, such as cucumber, soursop, spices, roots and vegetables.

About 16 months after my mastectomy, the cancer recurred. Again my doctor recommended chemotherapy. Again I refused. This time I headed to a village in northern Nigeria for some well-touted herbal cure. A few months later, the aunt who referred me to the herbalist, whom we thought was cured of her breast cancer, died.

It was after her death that I realised other relatives on my maternal side had died from cancer. That was a wake-up call for me to return to the hospital and start chemotherapy.

Breast cancer is the most prevalent cancer among women in Nigeria, representing about 23% of all new cases. Despite this high burden, there is limited awareness, especially in rural areas, resulting in late presentation, diagnosis and treatment. Stigma, lack of psychological support and high rates of poverty seal the fates of many patients too. These factors have all contributed to Nigeria recording the highest breast cancer mortality rates in Africa.

During chemotherapy one day, I decided to become that person who would support fellow patients, challenge the stigma and catalyse positive action within the cancer space.

Since 2022, I have been sharing photographs of my scars on social media. Having the first pictures taken was hard – the shock on the photographers’ faces and the thought that my children might one day disapprove nearly stopped me.

Not everyone supported my decision. Some said I should keep my diagnosis private and take the pictures off the internet. But I was determined to show the reality of breast cancer, and give encouragement to other women whose self-worth has been battered by a mastectomy.

It has been a tough, unpredictable journey for me. But nine years on from my diagnosis, I feel a sense of pride when I look at the photos and realise the role I’ve played in rejecting the shame and secrecy that continues to surround cancer in Nigeria, and that other women might draw strength from my story.

Gloria Chinyere Okwu is a global cancer advocate, and author of On Close Examination, published by Ouida Books. Photograph: Talent Concept. Read the full article here

This image, called Holy Gang, combines an image of a church in my mother’s home town, Fateng-tse-Ntsho, in Free State province, South Africa, with self-portraits of me, multiplied to form a group of women. Although at first glance the women are moving towards the church, it is not the final destination.

Positioned higher, beyond the church, is what appears to be a rising sun. For me, the sun represents a place where I can meet and be with my ancestors beyond religious limitations, even though they were members of the church and I am not.

I was born in Soweto and moved to Johannesburg’s southern suburbs when I was seven. Throughout my early life, I moved between urban Johannesburg and Fateng-tse-Ntsho, where my mother and I returned each year to visit family or attend funerals. I grew up negotiating multiple ideas of “home” and “belonging” without feeling entirely rooted in any of them. This experience led me towards spirituality as a way of thinking about identity, belonging, and my relationship to a larger collective.

Whenever I visited my family in Fateng-tse-Ntsho, I would walk past the Nederduitse Gereformeerde Kerk in Afrika, or the Dutch reformed church in Africa, that my great-grandmother and her daughters belonged to. It enters the work as a remembered image rather than as a religious symbol – its significance lies in its familiarity, its connection to my childhood, and its relationship to the women in my lineage.

The artwork forms part of my Spirit series of digital collages. In it, I do not “enter” the image to become part of the church; I enter to meet and journey with those women beyond the church, toward the sun. The church becomes the backdrop against which this encounter takes place, a structure that is part of our shared history but not the limit of our spiritual belonging.

Puleng Mongale is a South African visual artist based in Lusaka, Zambia. See more of her work on Instagram. Read the full article here