One of the most interesting developments here– one with a motivational beginning and considerable accomplishments–is the mobile unit project that brings cancer prevention to the people. I have heard about it, read about it, written about it (here), and now, I have also been a part of it.

 

Trip # 1– the inspiration

Early and sleepily at 6 a.m., Jessica and I hopped in the car with Carol, a supervisor in the mammography unit , on June 26th. Our destination? Monte Azul– a city where a Mammography Mobile Unit was hard at work!

(sunrise on our car ride to Monte Azul)

A team or, as they told us, a family of one nurse, three technicians, and one radiographer greeted us in Monte Azul, a small town with about 20,000 people. Like all other Mammography Mobile Units that visit the major municipals of Barretos, this unit helped perform mammograms and pap smears free of charge– yes, free!– to any woman that came to the unit . We toured the mobile unit and had amazing opportunities to observe the mobile unit in action throughout our morning there.

Toward lunchtime, Carol and Amanda, the nurse on the unit, invited us on an excursion around Monte Azul. Our mission? To look for opportunities–  more specifically, opportunities to inform more women in the city about cancer prevention and about the Mobile Unit. We drove around town and looked for health clinics, shops and radio stations to reach out to the people. Carol and Amanda were very genuine and passionate in their efforts to reach the people, but, gradually, I was starting to get a glimpse of their concerns. The work to reach the people wasn’t easy. To be more accurate, it was very, very difficult.

(Amanda and Jessica getting on the Mobile Unit in Monte Azul)

  

(Left: Mammography room, Right: Pap smear room)

It was very interesting to see and be a part of the health disparities I had learned and heard about in classrooms. Yes, health disparities exists, and they were even more apparent in the smaller town of Bebedouro, our new destination in the afternoon. Yes, the barriers to access health care and health information were there. The Mobile Unit inspiringly bridges the access to health care by bringing the prevention units to the people, but the barriers to access health information also makes it difficult for the hospital to reach the people and share the information.

(The street of Bebedouro)

You could say that we have been very fortunate the first few weeks  to be comfortably surrounded by the urbanized infrastructure and the wonderful health services that makes up the Cancer Hospital; but the simplicity of this trip also made it a fortunate opportunity of its own. There had been times when I would lose track of the fact that we’re interning in a foreign developing country; but seeing the mobile unit and the rural parts of town had been a inspiring reminder of all that I learned and wanted to do for global health.

With a inspiring refresher on our mission coupled with a new understanding of the barriers, I started thinking–  about lectures, ideas,  events and organizations that has worked in the US for bridging the access of cancer treatments and knowledge. We started discussing ideas with Carol, and I was even more encouraged by Carol’s enthusiasm! As ideas kept on evolving, I couldn’t wait to learn more about the people– the nurses, the team, the patients– to understand the people and bring that understanding to our ideas.

 

Trip # 2 — the people

“Because they are embarrassed”; “Because their husbands think there are male workers”; “Because 52 is not the recommended age”

These were all reasons why the friends of a couple of women we talked to in Bebedouro would not come to the Mobile Units; 2 out of 3 were unfortunately based on misinformation. I thought it was interesting that these specific facts that could really help the mobile unit team understand the the people”s knowledge and access to health information were facts that could only be learned, not from tours and observations from our first trip, but only from the people themselves.

And so, the people — the nurses, the mobile unit team and the patients — were the focuses of our second trips to Monte Azul and Bebedouro on July 3d and 4th respectively. We had with us ideas and questions prepared to better understand these people’s experiences and to hear their opinions and feedbacks on the caner prevention and on the Mobile Units.

(Mobile Unit in Bebedouro)

In Monte Azul and then Bebedouro, we talked to

• Amanda and the rest of the mobile unit team
• the chief nurse at the basic health unit
• the patients on the mobile unit
• the primary family physician at the basic health unit

At the end of the trip, we confirmed and learned about new promotional, educational and communicational barriers that we got us thinking about more ideas. The next day, we sat down with the nurses on the Mobile Units, Amanda and Silvia and, learned about the internal network behind the communication and the organization of the mobile units. Finally, after four days dedicated to asking many questions, talking to many people and trying to understand different aspects about the Mobile Unit with the wonderful and generous help from Carol, we had our ideas collected.

Our proposal was ready.

Now, more about the proposal and its presentation to Dr. Edmundo next time!