Breaking down health barriers in culturally diverse communities

*Lakshmi’s story

Lakshmi, who moved to Australia from India in the 1970s when she was just eight years old, says that many women from culturally and linguistically diverse backgrounds often don’t seek help for their incontinence. “That’s why I wanted to share this story because if it inspires anyone to seek assistance, then I feel it's been worth it. I think there are many women from culturally diverse backgrounds who don’t seek help and just struggle in silence or just think this is their way of life and don’t seek some help to improve their lives.” 

Living in country Victoria, Lakshmi initially pursued a Diploma in Science and then a related career. However, after having children she pulled towards community work and pursued a Master of International and Community Development. 

“That’s what I did while I was at home with my children for a couple of years after they were born. I realised that community work was my passion and so I retrained in community development,” Lakshmi says.

“It was a very, very busy time for me. I was holding three part time jobs and studying, no doubt wearing down my body a little during the process without knowing it.”

It was during this time in her late 40s when she realised that she had a problem with incontinence.

“It happened every time I coughed or every time there was a bump on the road when I was driving. I knew I had urinary incontinence. I was always fearful of those situations, but I just put up with it,” Lakshmi says. 

The final straw, she says, was when she was on a family trip in India and was on a bus. She describes the roads in India as quite bumpy. She was travelling from one city to another and by the time she reached the destination, she says she was completely soaked. 

“I thought this is just ridiculous. When I came back from India, I sought help. But it took a while because all these tests needed to be done,” Lakshmi says. 

She was diagnosed with a bladder prolapse (pelvic organ prolapse) and needed surgery.

“I finally got the surgery. I can’t tell you just how much of a difference it made to my life afterwards. It was like a new lease on life.”

Preceding the years before the fateful bus trip in India, Lakshmi says she certainly didn’t think she had a prolapse, instead believing that it was related to her pregnancy, that simply muscles become looser with older age and that’s why one may become incontinent. 

“I have seen much older women forever running to the toilet, so I thought maybe that’s just something that women go through,” Lakshmi said. 

The journey to find a diagnosis and support was chartering into the unknown, as Lakshmi was unaware of the testing that needed to be done after her visit to a GP. The tests, she says, were quite involved and there were also many tests that needed to be done between the initial visit to the GP and the final surgery. 

“I can see that maybe some women would be put off by the many tests. You are sitting on a toilet and everyone is watching you to test the flow and volume of urine passed,” Lakshmi says. 

“I had no idea what the journey was going to be. I was just following the doctors’ instructions.”

Regardless of the discomfort of the testing, Lakshmi says she would still tell women who are experiencing symptoms that there is a better quality of life once you do go through it all.

She says people can still have a good quality of life if help is sought. People don’t need to spend time planning their days around where the toilets are or not going out at all for fear of not being close to a toilet.

Lakshmi says these women are simply missing out on a lot in life.

“I have seen older women just sticking around the house near the toilet because that’s where they feel safe. It is unfortunate that help wasn't sought earlier.”

“I have learned that help is available, there is an opportunity to improve the situation and have a 100% improvement in your life.”

Particularly for those from culturally and linguistically diverse backgrounds, Lakshmi says they don’t have to put up with incontinence and the problems that it causes and that it is important that you give yourself time to look after yourself and get some help with that.

“It might take a while to normalise incontinence in a conversation in the Indian community. There are many stigmas. Even talking about menopause will take a while for that to be an open issue. I think incontinence falls in the same bucket. We can work towards it,” she says. 

Her main message is quite simply, that you don’t have to suffer in silence.  

“Don't limit your lifestyle. I think subconsciously you do that and you kind of accept it. You subconsciously think 'I'm not going to go for a walk in the park because there's no public toilet available.’ You don't realise that your life is getting smaller. Life should be much better than that. You don't need to put up with substandard health.”

Cultural sensitivities need to be addressed and communities need education. Work needs to be done on both ends: current health services need to understand cultural sensitivities, and culturally and linguistically diverse communities need to try to remove any stigma, any shame, any misinformation and so on.

“I think it requires an education campaign to spread the message," says Lakshmi. “It should say, ‘don't suffer with this in silence. Seek help. Get quality back in your life.”

In the meantime, Lakshmi says she plans to continue working in advisory roles. She would like to use her experiences in life and health to shape policies. This is where she sees herself in the future. “I always want to contribute to my community work. I don’t ever see myself stopping or retiring.”

While having remained anonymous in the story *Lakshmi is open to having private conversations with people seeking support or help. Please contact [email protected]

“Don't limit your lifestyle. I think subconsciously you do that and you kind of accept it. You subconsciously think 'I'm not going to go for a walk in the park because there's no public toilet available.’ You don't realise that your life is getting smaller. Life should be much better than that. You don't need to put up with substandard health.”

Pelvic Organ Prolapse

Pelvic organ prolapse (POP), occurs when one of the pelvic organs sags and may bulge or protrude into the vagina. There are many different types of prolapse and it is important to have any prolapse properly assessed.

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