In Drachevo, in the Park of Defenders, an educational forum was held under the motto "Together for early detection, together for life". The organisers are the Municipality of Kisela Voda and the Hema-onko association, and the event opened the Pink October campaign in that municipality.

The speakers were doctors with names, which matters for a subject like this: specialist Dr Albina Chreslovnik Pupakoski, nurse Jasmina Jovcheska from the University Clinic for Radiotherapy and Oncology, and Dr Slavica Chalchevska, radiologist and internist at the 8 September general hospital. A woman in her fifth year of facing breast cancer - a member of Hema-onko - shared her own experience.

The distinction that most often gets blurred

Out of the whole campaign, one distinction deserves repeating more loudly than any slogan. Early detection and screening are not the same thing.

Early detection means a person notices a change themselves and gets to a doctor in time. Organised screening means the health system itself calls in people from a given age group for an examination, by protocol, without them asking for anything.

The first depends on how well informed the individual is. The second depends entirely on the state. And the second is exactly where the campaign ends and the obligation of institutions begins.

So the real question Pink October opens is not whether women know they should get checked - most of them do. The question is how many women received an invitation for mammographic screening last year, what share of the target group that covers, and how much time passes from suspicion to diagnosis and from diagnosis to the start of therapy. Those numbers exist inside the system. They do not get published alongside the pink ribbon.

The campaign in Kisela Voda continues with another forum on 26 September and will close with a "Pink picnic" at the Shell in the City Park. Events of this kind have clear value: they pull the subject out of the space of fear and silence, and the testimony of people who have been through the illness reduces stigma better than any leaflet.

But one month of awareness is not a health policy. The measure of October's success will not be how many pink ribbons are seen, but whether in November the examination is faster, more available and closer to the person hesitating over whether to go. The time lost in hesitation is the most expensive thing in this whole story - and part of that time is created by the system itself, through waiting lists.