International Day for the Elimination of Violence against Women

“Not until the half of our population represented by women and girls can live free from fear, violence and everyday insecurity, can we truly say we live in a fair and equal world.” — UN Secretary-General António Guterres

The United Nations General Assembly has designated the 25th of November as the international day of violence against women. Violence against women and girls (VAWG) is one of the most widespread, and devastating human rights violations in our world today and the worse part is that it remains largely unreported due to the impunity, silence, stigma and shame surrounding it. Worldwide, almost 750 million women and girls alive today were married before their 18th birthday; while 200 million women and girls have undergone female genital mutilation (FGM). 71% of all human trafficking victims worldwide are women and girls, and 3 out of 4 of these women and girls are sexually exploited. These figures prove the alarming situation at hand where violence against women and girls is still a pressing issue that needs to be discussed within peers and in bigger forums.

In Indonesia, the situation is just as horrible. According to Komnas Perempuan, as of March 2018, there were 248.446 cases of violence against women reported and handled throughout 2017. In the private/personal sector, the highest percentage is physical violence (41% or 3.982 cases) followed by sexual violence (31% or 2.972 cases), followed by psychological violence and economical violence. The most shocking and despicable fact recorded by the CATAHU 2018, is that incest (when the sexual offense is committed by someone of close familial relations) has been the most widely reported case in Indonesia, however with only 22% of them being reported to the police, and only 13.2% being brought to court. We have all heard of the case in Jambi, of the brother who raped his sister and gotten her pregnant which forced her to have an abortion and her ended up going to prison due to said abortion. This proves how critical the situation is in Indonesia and how much awareness needs to be raised regarding said topics.

And yet, to make the situation even worse than it already is, the stigma and prejudice towards women and girls in Indonesia is at an all time high. Proven by the recent case of sexual violence towards a university student during KKN, where instead of her offender being directly prosecuted by law, the blame was shifted on her by the university officials. Stigma and prejudice has also led to the decrease in reported cases of sexual violence as women grow more and more afraid of being judged by society for being victims of such acts, and instead of ensuring their rights, they remain in the shadows.

If you, or anyone you know have been a victim of violence, never hesitate to report the case to the authorities. One thing everyone, both men and women, should remember is that your body is your authority and if anyone touches it without your consent, you have the right to report.

article by SCORA CIMSA

Di Indonesia, kanker serviks menjadi penyakit kanker pada wanita dengan jumlah penderita terbesar setelah kanker payudara. Pada tahun 2018, diperkirakan 570.000 wanita didiagnosis menderita kanker serviks di seluruh dunia dan sekitar 311.000 wanita meninggal karena penyakit tersebut. Berdasarkan data Kemkes tahun 2019, di Indonesia kanker serviks didapatkan pada 23,4 per 100.000 penduduk, dengan rata-rata kematian 13,9 per 100.000 penduduk. Kanker serviks adalah kanker yang ditemukan di mulut rahim, yaitu bagian antara vagina dan rahim. Hampir semua kasus kanker serviks (99%) terkait dengan infeksi human papillomavirus (HPV) risiko tinggi, virus yang sangat umum ditularkan melalui kontak seksual. Saat terpapar HPV, sistem kekebalan tubuh biasanya mencegah virus melakukan kerusakan. Namun, pada sebagian kecil orang, virus bertahan selama bertahun-tahun, berkontribusi pada proses yang menyebabkan beberapa sel serviks menjadi sel kanker.  

Penyakit ini bisa dicegah dengan melakukan tes skrining yaitu dengan pemeriksaan serviks, yang bertujuan untuk menemukan dan mengobati perubahan pada sel sebelum berubah menjadi kanker. Kanker serviks biasanya tumbuh sangat lambat, sehingga bila dilakukan skrining yang teratur penyakit ini bisa dicegah. Diawali dengan perubahan serviks normal menjadi lesi prakanker, Lesi prakanker pada serviks adalah perubahan pada sel serviks yang membuatnya lebih mungkin berkembang menjadi kanker.

 Pendekatan pencegahan primer (dengan vaksinasi HPV) dan pencegahan sekunder yang efektif (penyaringan/tes skrining dan pengobatan lesi prakanker) adalah bagian dari upada pencegahan kanker serviks. Di Indonesia, prevalensi dan determinan dari lesi prakanker serviks di kalangan wanita membantu untuk mengambil tindakan seperti program vaksinasi pada anak usia 12-13 tahun, meningkatkan cakupan skrining bagi semua wanita antara usia 25 dan 65 tahun, dan manajemen yang ketat dan tindak lanjut yang dapat menurunkan morbiditas dan mortalitas yang disebabkan oleh kanker serviksIni membantu melindungi terhadap semua kanker yang disebabkan oleh HPV, serta kutil kelamin. Skrining serviks secara teratur adalah perlindungan terbaik terhadap kanker serviks. Wanita berusia 25-65 tahun dan memiliki serviks serta pernah aktif secara seksual memerlukan tes skrining serviks. Skrining kanker serviks dengan tes HPV saja atau tes HPV sekaligus Pap smear dapat dilakukan setiap 5 tahun sekali, atau tes Pap smear (sitologi) setiap 3 tahun sekali. Pada usia di atas 65 tahun dengan hasil skrining sebelumnya normal tidak perlu lagi melakukan tes skrining.

Referensi:

– The American College of Obstetrician ang Gynecologist Update Cervical Cancer Screening Guideline 2021
– WHO Guideline for screening and treatment of cervical pre cancer lesions for cervical cancer prevention 2021

Artikel dibuat oleh: dr. Hartatiek Nila Karmila, Sp.OG

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