Rachel Ramirez: Our program was funded in 1999.
And we started screening in 2001.
Even now there's still a lot of women that doesn't know, that
there is a Guam Breast and Cervical Cancer Early Detection Program.
And even, I will not say even literacy level, low literacy, but even those
with, with, with degree still, still, still refuse to do their screening.
Sheila Tmarsel: Ethnicities, we said in Palau, uh, would tell us that the
reason why we don't come and access the program is we always thought
this program is only for Palauans.
For some Palauans they would say that, um, we know about the program,
but we just don't have time.
One of our barriers is our cultural taboo.
Sometimes they don't want other people to know that, you know,
they're sick and they don't want, they don't want to come to the hospital.
If a lady comes in for screening and she sees one of her relatives,
she won't go to the clinic
because it's against our custom.
So how would you approach in that time, that's a challenge to us, right?
It doesn't stop you from doing what you are doing, right?
From reaching out to them, from educating them, from giving them more information
That's why it's really important to have data driven information given
to the public so that they will know how important it is to get screened.
That's one aspect that you have to intensify in Guam, public education.
If you can change someone's behavior, to give an informed
decision about their health, that's really fulfilling for me.
I don't see why we have to spend our time going to the community
and do the screening and not following up on these people.
Then what's the point of screening.
The reason why we wanted to go out to the community and screen is to
identify these people and bring them in.
We go out of our way to make sure that woman comes in for their appointment.
It's hard to work with those non-compliant patients, but we always
remind ourselves, tell ourselves that let's not get tired of these people.
Let's make sure they really come in for their appointment.
We are looking at a health equity framework in which
we are trying to make sure that the Asian American Pacific Islander group
is also equally represented in who we are trying to reach and get screened.
Debra Younginer: We know now that these women are getting screened, it's the
same as reaching women everywhere.
We're trying to save lives.
So it doesn't matter where they live or who they are,
or their ethnicity, it's a woman and it's her life.
And we want to make her have the best life that she can.
She helps a lot of women, especially being a Marshallese doctor.
She speak their language. The underserved ladies, they cannot speak English.
And then when they see a Marshallese lady being a doctor, they will
finally, we have a Marshallese doctor.
We can communicate well with her.
She's very devoted, committed to the program, regardless of being busy,
She's very devoted, committed to the program.
Advising them and asking
how come you're not coming back?
The patient comes in, you know, with problem, she'll be asking, oh, why
now, what took you so long to come?
Your life is very important.
When she was diagnosed in 2016 with a stage four very invasive cancer,
she never give up.
She'd still continued to work despite treatment in between chemo.
She would always say to us, I still have a mission to do, to bring back
selfless love to the community.
As our promise to her, continue the work that she was doing.
Her vision is, please don't miss
anyone if you can, don't miss anyone to be screened in our program.
When she goes to churches or the communities
she talks about her experience when she had cancer.
People really listen to her story.
And what she went through with chemo.
People actually come in for a screening
after listening to her.
We go out there for outreach, we keep these promotional
items, you know, they just took them.
But then comparing to, survivor talking about their experience,
people actually listen, they come straight to the clinic.
She doesn't want any other to experience what she went through.
And she convinced ladies to have mammogram or have come to the
clinic for clinical breast exam.
She really tells them that, you know what I have gone through,
I don't want you to go through it.
I'm hoping that there will be no more cervical and breast cancer.
You know, the HPV vaccine, we also collaborate with immunization going to
the school and, um, making sure that these little girls, they get vaccinated with
the school and making sure that these little girls, they get vaccinated.
Thirty years from now, I think maybe there'll be less cervical cancer.
I hope we are free from cancer.
My hope for the next thirty years in the program, is to be able to utilize all
the resources given to us from CDC or other programs to develop
sustainable systems and processes to make sure that these women are screened
and to screen them before it's too late
So that's my, that's my hope, to have them take charge of their own health.
This job is really something that entails a lot of dedication and passion.
There's always unity in our work.
I believe in the saying that
in unity, there is power, you know, and in power there is change,
When you envision a change,
uh, you have to be united with that vision, uh, work with that vision and
together, we can make a change, yeah.