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Indigenous communities worldwide have unique socio-cultural and health circumstances that often result in health disparities. These disparities manifest in various ways, including a higher incidence and prevalence of certain diseases, in particular cancers. Despite being largely preventable through early detection and human papillomavirus (HPV) vaccination, cervical cancer remains widespread and often fatal in these communities. Besides this, indigenous women have reduced cervical screening coverage, and delays in diagnosis and treatments.
Latin America is home to a significantly higher proportion of the indigenous population with 9.8% compared with the global average of 5%. Moreover, 30% of this population lives in extreme poverty, a percentage that is twice as high as the global average of 15%. Colombia is a multicultural country, rich in biodiversity, with 115 indigenous communities. For this population, cervical cancer represents a challenge as they have one of the lowest HPV vaccination rates in the region.1 2
Motivated by this pressing issue, a team of researchers has devised a strategy aimed at enhancing early detection and primary prevention of HPV within the Arhuacos indigenous community, located in northwestern Colombia. Since 2018, this multidisciplinary team of health and social science professionals has engaged in intercultural dialogues with the community where the magnitude of the problem of this cancer type was identified, after which, in-depth interviews and focus groups were developed with patients, leaders, and healthcare providers (physicians, nurses, traditional healers, etc.) to understand their perceptions on health and this type of cancer in particular, including prevention, screening, and treatment.
Our team has designed a multilevel holistic educational strategy according to the needs identified during the fieldwork. Several challenges were discovered, such as lack of understanding of ancestral knowledge, limited access, absence of proper infrastructure, and inadequate conditioning of the basic instruments for remote care. As a result, there is a significant need for research resources and support to help the community effectively use diagnostic aids and tackle the existing problem.
This approach marks significant progress towards the well-being and support of indigenous communities. However, it also presents considerable challenges in the design and implementation of strategic plans. Achieving these objectives will require the commitment of various stakeholders, such as educational and health organizations, governmental institutions, and members of the indigenous communities themselves. The successful implementation of these strategies relies on a deep respect for the community’s diversity, socio-cultural aspects, worldview, and territorial considerations.
Meetings about the establishment of health strategies.
Members of the Arhuacos community.
Community women’s meeting.
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Patient consent for publication
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Not applicable.
Footnotes
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Contributors ARZH: writing of the manuscript, critical revision of its intellectual content and acquisition, and interpretation of the results. LMGC: writing of the manuscript and critical revision of its intellectual content. FJBE: critical revision of its intellectual content and acquisition of the results. MAZI: critical revision of its intellectual content. ARZH is responsible for the overall content as guarantor.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.