News publications and other organizations are encouraged to reuse Direct Relief-published content for free under a Creative Commons License (Attribution-Non-Commercial-No Derivatives 4.0 International), given the republisher complies with the requirements identified below.

When republishing:

  • Include a byline with the reporter’s name and Direct Relief in the following format: "Author Name, Direct Relief." If attribution in that format is not possible, include the following language at the top of the story: "This story was originally published by Direct Relief."
  • If publishing online, please link to the original URL of the story.
  • Maintain any tagline at the bottom of the story.
  • With Direct Relief's permission, news publications can make changes such as localizing the content for a particular area, using a different headline, or shortening story text. To confirm edits are acceptable, please check with Direct Relief by clicking this link.
  • If new content is added to the original story — for example, a comment from a local official — a note with language to the effect of the following must be included: "Additional reporting by [reporter and organization]."
  • If republished stories are shared on social media, Direct Relief appreciates being tagged in the posts:
    • Twitter (@DirectRelief)
    • Facebook (@DirectRelief)
    • Instagram (@DirectRelief)

Republishing Images:

Unless stated otherwise, images shot by Direct Relief may be republished for non-commercial purposes with proper attribution, given the republisher complies with the requirements identified below.

  • Maintain correct caption information.
  • Credit the photographer and Direct Relief in the caption. For example: "First and Last Name / Direct Relief."
  • Do not digitally alter images.

Direct Relief often contracts with freelance photographers who usually, but not always, allow their work to be published by Direct Relief’s media partners. Contact Direct Relief for permission to use images in which Direct Relief is not credited in the caption by clicking here.

Other Requirements:

  • Do not state or imply that donations to any third-party organization support Direct Relief's work.
  • Republishers may not sell Direct Relief's content.
  • Direct Relief's work is prohibited from populating web pages designed to improve rankings on search engines or solely to gain revenue from network-based advertisements.
  • Advance permission is required to translate Direct Relief's stories into a language different from the original language of publication. To inquire, contact us here.
  • If Direct Relief requests a change to or removal of republished Direct Relief content from a site or on-air, the republisher must comply.

For any additional questions about republishing Direct Relief content, please email the team here.

In Mexico, Reconstructive Surgeries Help Women Move on from Breast Cancer

Many women can’t afford the treatment but report feeling “incomplete” after a mastectomy. Two groups working with breast cancer survivors aim to change that.



Patients at Fundación Voluntarias contra el Cáncer pose for a photo. (Photo courtesy of Fundación Voluntarias contra el Cáncer)

The patient had just undergone a double mastectomy for breast cancer when Dr. Rina Gitler met her in Guerrero, Mexico. And she was crying.

The patient didn’t speak Spanish, only her Indigenous Nahuatl language. She had not realized that the procedure would mean that she was “going out flat,” or with her breasts completely removed, said Gitler, a breast reconstruction surgeon and founder of the ALMA Foundation.


The ALMA Foundation is a group of plastic surgeons who specialize in breast reconstruction and perform reconstructive surgeries at no cost to breast cancer survivors.

Gitler spoke with the patient through a translator and told her about the option of having reconstructive surgery. Soon thereafter, the patient became a candidate and received a reconstruction from Gitler’s team of volunteer surgeons. 

In 2020, Mexico saw more than 29,000 new cases of breast cancer and almost 8,000 related deaths, making it the most common cancer among Mexican women, according to the WHO. Treating the disease with a multidisciplinary medical team that includes an oncologist, mental health provider, and plastic surgeon is an important priority.

For many women, reconstructive surgery is an essential part of their recovery. But it’s generally not covered by public insurance, and many individuals can’t afford the procedure.

Direct Relief has provided ongoing support to two organizations in Mexico that work with breast cancer survivors: Fundación Alma, and Fundación Voluntarias Contra el Cáncer, which helps women with high economic vulnerability navigate breast cancer treatment and connect them to services.

Both organizations offer services free of charge, including helping a total of more than 800 women thus far access reconstructive surgery at Mexican hospitals.

Now, the company Johnson & Johnson Mexico has added its support, making it possible for Fundación Alma and Fundación Voluntarias Contra el Cáncer to help more women.

“It is extremely important to support women to feel comfortable with themselves, providing information that helps them develop the confidence to self-examine, as well as to know and explore comprehensive breast cancer treatment options, including breast reconstruction,” a Johnson & Johnson press release said.

Of course, reconstructive breast surgery isn’t for everyone.

“[Reconstruction] is entirely the patient’s decision,” said Esther Cisneros, the President of Fundación Voluntarias contra el Cáncer A.C., an organization that helps women navigate breast cancer treatment and connect them with free reconstructive surgeries. “What the foundation seeks is that the patient always has the option regardless of what they decide.”

But when presented with the option, an overwhelming majority of women in Mexico —more than two-thirds—said they’d prefer to have breast reconstruction after their mastectomy. “There are many studies that if you inform patients about the procedure, you…increase the uptake of the surgery by 30%,” said Paulina Bajonero, a researcher and general surgeon in Monterrey, Mexico.  

Many women report feeling less confident after surviving breast cancer and according to Bajonero’s research, just want “to look the same as they did before.”

Gitler, who is also a breast cancer survivor, said seeing her body after her double mastectomy was “one of the most shocking moments” of her life. Now, when she counsels patients at the ALMA Foundation, she understands why having breasts can be an important part of a woman’s identity. “The phrase I hear every day is that they ‘feel incomplete,’” she said. 

Additionally, some women face fallout in their romantic relationships after having breast cancer surgery. “Sadly in Mexico there is still this thought [among] men that…women are worthy because of their breasts,” said Gitler. Sixty percent of patients at the ALMA Foundation report being left by their partners after their diagnosis. 

For many women, receiving reconstructive surgery is an important part of resuming their social and professional lives. But it’s not just about reducing or erasing the negative consequences of breast cancer surgery. Instead, it’s often about moving on.

“Reconstruction makes it so [women] can close a window,” said Cisneros, allowing them to put their experience with cancer behind them. 

Direct Relief has provided more than $260,000 in medical aid to Fundación Alma and Fundación Voluntarias Contra el Cáncer. Johnson & Johnson Mexico provided breast implants for patients receiving reconstructive surgery through these two organizations.

Giving is Good Medicine

You don't have to donate. That's why it's so extraordinary if you do.