Get married or die from cancer: Hyderabad diagnostic centres refuse to do pap smear tests on unmarried women

Hyderabad: Lying half-naked with her legs spread on a bed in the ultrasound room, Spurthi Kolipaka tried to calm herself. During a scan a week ago, she was asked to get a pap smear test done asap as her cervix seemed unhealthy and it was important to quickly rule out cancer. She had been scared the moment she was advised to take the test.

While lying in the ultrasound room, she was trying to calm her thoughts when the radiologist came in with a vaginal speculum (used to hold the vaginal walls apart and see the cervix), a small coned brush, and a spatula to collect samples of cervix cells. Just before inserting the instrument, the radiologist asked Spurthi, "Are you married?" to which she replied, "No." In a split second, the radiologist retracted the instrument and refused to do the test. Spurthi walked out of Sudha Diagnostic Centre in Kompally with tears in her eyes.

A pap smear test is done to check if a woman has cervical cancer. The test looks for the presence of precancerous or cancerous cells on the cervix, the opening of the uterus. During the test, cells from the cervix are gently scraped and taken to examine for any abnormal growth.

In a similar incident, Namrata Tripathi, a photo-video artist and an unmarried woman, was shamed multiple times when she went to get a pap smear test done at one of the branches of Vijaya Diagnostic Centre in Medchal Malkajgiri. "I have been taking pap smear tests since I was 24 years old. Now I am 28. Till now, I have done the test three times and every time I go, they ask me if I am married and shame me when I say I am not."

She added, "Initially, they refuse to do the test. Then I have to speak to a senior doctor and convince them. It's only after that that I get tested. This happens every single time." She said the lab technicians behave in an unprofessional way and start giggling when she tells them she is unmarried.

According to the American Cancer Society, all women 21 years and above are required to get a pap smear test done every three years. The American health information website, Healthline, also writes that a pap smear test should be done regardless of one's sexual activity status.

"So do you mean to say that all women should get married at 21?" Spurthi, a social worker and WASH consultant to the Telangana government, asked the radiologist.

Spurthi explained how difficult it is to find diagnostic centres that do the test. Some of them do the test but when she called and inquired, she was told, "Technician not available." She also said how some of these centres ask for a gynaecologist's prescription to conduct the test. "It's just an alibi to cover up their regressive thoughts," said Spurthi.

Women's identity linked to men for basic medical facilities

The important thing to remember is that in all these cases, the women were willing to get the test done but their consent had zero value. It shows how women have no authority over their own bodies. It is a very alarming situation where a woman's identity is linked to a man and she needs to prove that in order to get basic medical facilities.

Spurthi was also disturbed that these regressive remarks were coming from a woman doctor and that the diagnostic centre she had visited was run by women. "This is the perfect example of women upholding patriarchy," she said.

It is important to remember that doctors take a medical oath before joining the profession not to discriminate against any of their patients. But here, these doctors are not ready to leave their regressive notions. Rather, they tell the women to live and die with their cancerous cells if they are unwilling to follow societal norms.

Mental trauma

The entire episode is traumatic for women and crushes their confidence. "Firstly, after the ultrasound test which showed that I had to do a pap test, I was already scared to just go and face it. Also, while searching for a suitable diagnostic centre, I was all the more worried that I was running out of time. After my experience at the lab, I was deeply hurt by the humiliation and overall pain of patriarchy. To hear it from the most educated lot was even more painful," says Spurthi.

On the other hand, Namrata, who has now become used to this humiliation, is no more affected by it. Rather, she feels angry and sad about these still-persisting societal norms and lack of awareness.

NewsMeter tried contacting Dr. Sudha, the radiologist who runs Sudha Diagnostics, but she didn't respond. We spoke to one of the staff at the diagnostic centre but they could not cite any reasons for these instructions. They insisted that the doctor preferred to do the test after seeing a gynaecologist's prescription for a safer procedure.

"Huh? Sexually active before marriage?"

Dr. Prabha Agarwal of Care Hospital in Hyderabad said a pap smear test is done for a married woman or a sexually active woman above the age of 21 years. Unfortunately, the latter case is completely neglected in some of the labs in Hyderabad simply because our society does not approve of women being sexually active before marriage.

"If a woman above the age of 21 years shows any kind of symptoms, she has to get a doctor's prescription and get the pap smear test done. If there are no symptoms and the woman is sexually inactive, she needn't go for a test, as unnecessary tests can cause vaginal infections. Also, it would bring discomfort if the hymen is not perforated," explains Dr. Prabha.

Dr. Prabha also says that a gynaecologist's prescription is not required for a pap smear test. Any woman who wants to get it done can get tested with a doctor's prescription.