Just steps from fancy stores with names such as Armani, Versace and Prada, a shiny 45-foot custom pink-and-blue bus sat earlier this month beneath a highway overpass in Miami’s Design District. Known affectionately as “the mammovan,” the vehicle welcomed aboard women looking for free mammograms because they couldn’t afford to pay.
Named for a 54-year-old who lost her battle with breast cancer in 2005, the Linda Fenner Mammography Health Facility is a state-of-the-art clinic on wheels run by FIU’s Herbert Wertheim College of Medicine. It offers a 3D mammogram to any woman who needs one but exists primarily to serve those who have limited options due to lack of health insurance.
Toni De La Barra, clinical manager of the OB/GYN department at the nonprofit Borinquen Health Centers, which caters to low-income individuals, welcomed the bus when it stopped for the day outside her location in the Design District, a mixed area of low-income housing and newly developed luxury retailers. The easy access meant those on her waiting list could finally get no-cost preventive care.
“Normally, we would try and seek out the cheapest option for our patients,” De La Barra explains, “but sometimes it still doesn’t help. They’re stuck. They have to seek childcare. They have to take two or three buses. They have to seek the money. Seventy dollars to them is a lot of money.”
Breaking down barriers
Enter the mammovan, an answer for women who face such deterrents.
“Any barrier that’s there, we’ll try and break that by being mobile and going to them,” says Lorraine Nowakowski, director of clinical initiatives for FIU’s Green Family Foundation NeighborhoodHELP, a community outreach program that includes the mammography facility and much more. Nowakowski rides the bus out to meet patients and take their information prior to screening. That critical step ensures that FIU staff can follow up with results and contact those whose scans indicate the need for additional services elsewhere, in which case referrals can be made for an MRI, a biopsy or even a visit to an oncologist or a surgeon.
“This is full service,” Nowakowski says, “and what that means is that we not only take an x-ray, but we have that continuity of care. It’s our responsibility.”
While scans are read off-site by a board-certified radiologist contracted by FIU, the imaging takes place on the bus using the most advanced mammography equipment available, even better than what some hospitals have, Nowakowski says. Two small changing rooms lead to the exam area, similar in size to that of clinical spaces in medical centers and doctors’ offices. There, Dana Stankiewicz, an experienced radiology technician, plies not just technical expertise but compassion.
“These women have never [before] had this opportunity,” says Stankiewicz, who in an easy-going manner takes the time to explain the entire process to patients. “Their fear is high. Their anxiety is high. So my job is to bring their anxiety down.”
The mobile mammography facility is accredited by the American College of Radiology and reflects the same high level of care provided by the innovative NeighborhoodHELP program under whose umbrella it operates. The Herbert Wertheim College of Medicine launched the program in 2010 as a way to train medical and other students while serving the community. It brings together medical, nursing, social and legal services to provide comprehensive assistance to those who need it most. In addition to home visits by FIU students and the faculty who oversee them, two buses outfitted as doctors’ offices visit low-income areas throughout greater Miami to offer primary-care services and specialist referrals.
Dr. Pedro Greer, a dean at the medical school, advocated for the mammography unit when his research pointed up a glaring need.
“We superimposed metastatic cancer data on the area in which we were working,” says Greer, speaking of statistics for the largely African-American suburb of Miami Gardens, with a population of more than 110,000 and no hospital within its boundaries. “We had the highest rate of breast cancer in Florida and the third highest in the country.”
Greer, a recipient of the Presidential Medal of Freedom for his work on behalf of the indigent, likens the lack of available health care in some places to what might be expected in a third-world country. And he decries the absence of easy transportation and flexible healthcare-provider service hours that keeps the working poor from getting the help they need. “We have the science,” he says, “but we haven’t built the bridges to get to the science.”
The mammography facility provides that bridge thanks to the generous support of the Braman Family Foundation—the mammovan is named for foundation principal Irma Braman’s late sister—and a matching gift from the Batchelor Foundation. It currently goes out once per week and stops at sites such as Chapman Partnership for Homeless, Camillus House and other shelters.
Kimberly Ferrer recently got her first mammogram, compliments of the mammovan.
“I’m over 40. Women should start getting mammograms at that age, and I put it off for a few years,” says Ferrer, who has no health insurance despite her husband’s being employed.
“It was time to take action. I wouldn’t have gone and done it had it not been available for me today. Getting a mammogram today gives me peace of mind.”