Lack of Hepatitis B awareness and knowledge among South Asian immigrants

South Asian immigrantsACCORDING to the World Health Organization, hepatitis is the inflammation of the liver, with viral infection as the most common cause of hepatitis. There are five main types of the hepatitis virus: A, B, C, D, and E. Not only have Hepatitis B and C infected hundreds of millions of people chronically, these two viruses are also the main causes of cirrhosis and liver cancer. Chronic Hepatitis B is very common among Asian populations, including South Asian. It is estimated that India has more than 40 million chronic Hepatitis B carriers and over 100,000 Indians die each year due to Hepatitis B-related illnesses. Although generally uncommon in Canada, Hepatitis B infection rates approach that of Asia in areas where there are large Asian communities, such as the British Columbia Lower Mainland. There is an estimated 60,000 Hepatitis B infected individuals in B.C. in which 70% of them are immigrants and among those, South Asian immigrants account for about 5-10%.

HEPATITIS B virus attacks the liver causing either acute or chronic Hepatitis B infection. The virus could have already been in your body for days or months before you develop any symptoms, sickness or discomfort. During this time, the infected individuals are highly infectious and may unknowingly transmit the virus to others. If your immune system is unable to clear the virus, you will develop chronic Hepatitis B. However, condition for some of these people may turn for the worse causing hepatic failure or even death.

Chronic Hepatitis B is the most common hepatitis and infected individuals may not have any symptoms at all. However, chronic hepatitis B is the main risk factor for liver diseases including liver cancer. A chronic carrier has 1-in-4 chance of developing liver diseases and liver cancer if the chronic Hepatitis B infection is not monitored regularly and properly treated. Furthermore, if left untreated, an individual with liver cancer has as low as only 10% chance of survival within the first 5 years of discovering the cancer.

Compared to non-infected individuals, a chronic hepatitis B carrier has 100 times higher risk of developing liver cancer. Since chronic Hepatitis B infections have a long latency period and are often asymptomatic, a large proportion of chronic carriers aren’t even diagnosed until the liver is severely damaged and too late for effective treatment. Taking care of your liver through vaccination, regular monitoring and practicing of healthy behaviours save lives.

RECOGNIZING this devastating, yet overlooked, silent disease in our communities, S.U.C.C.E.S.S. worked with medical experts from the University of British Columbia and was successful at advocating for better Hepatitis B treatment policies in B.C. To further understand the needs and the depth of the Hepatitis B issue among Asians, S.U.C.C.E.S.S., again, collaborated with the B.C. Hepatitis Program and the Division of Gastroenterology of University of British Columbia in 2012 to conduct a Hepatitis B Awareness survey focusing on Asian communities in B.C.

Almost half of the South Asian respondents had low awareness of the consequences of Hepatitis B infection, and were unaware that Hepatitis B was a leading cause of liver cancer. Furthermore, roughly 75% of the South Asian immigrants have NOT been tested and / or vaccinated for Hepatitis B, suggesting a large group of the South Asian community are at risk of Hepatitis B virus as well as developing liver diseases including liver cancer. This health burden on South Asian communities is likely due to the lack of systematic testing, vaccination, and culturally appropriate health education about Hepatitis B.

RECOGNIZING S.U.C.C.E.S.S.’ previous advocacy work in Hepatitis B care and responding to the desperate need for accessible and cultural specific education on Hepatitis B for the South Asian communities in B.C., the Government of British Columbia has provided funding for the Hepatitis B Public Education Program. This program aims to improve Hepatitis B awareness, knowledge, and preventative practices, specifically the screening of Hepatitis B, as well as to provide resources to Hepatitis B-infected individuals to manage their health.

By encouraging the South Asian community to take an active role in their health management and to get tested for Hepatitis B, this project hopes to prevent people from discovering liver diseases too late when the liver is severely damaged. Our Hepatitis B education curriculum incorporates scientifically research based evidence and was developed following consultation with people from various ethnic populations and medical professionals.

Major themes of the curriculum include:
1) transcultural barriers and misconception preventing the public from talking about Hepatitis B;
2) resources and supports currently available for the public and infected individuals;
3) meaningful ways to engage your family doctor and your loved ones about Hepatitis B; and
4) general overview of treatment and management of Hepatitis B.

Free Hepatitis B education workshops are offered in Punjabi, Mandarin, Tagalog, Korean, and English regularly throughout Greater Vancouver Region.

Join us at our next workshop in Punjabi:
Gurdwara Sahib Brookside: Canadian Ramgarhia Society
Date: Sunday, May 25
Time: 11 a.m.-12 p.m.
Address: 8365 140 Street, Surrey

To register for our free workshops or to learn more about why Hepatitis B matters to you and our community, visit You can access various educational materials and resources about Hepatitis B in Punjabi. Through educating the public more about Hepatitis B, please join us in making a difference in the lives of those around you as well as your own. Talk to your doctor and get tested for Hepatitis B. We look forward to meeting all of you in the upcoming workshops and events.

Established in 1973, S.U.C.C.E.S.S. is one of the largest social service agencies in British Columbia. It is a charitable organization providing services in settlement, language training, employment, family and youth counselling, business and economic development, health care, housing and community development. For more details, visit: