Breast cancer is one of the most preventable, yet most common, forms of cancer.
According to BreastScreen Australia, one in every seven women in the country will develop breast cancer in their lives. Taking today’s population, that equates to nearly two million women that will be affected at some point.
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Early detection can be critically important in stopping breast cancer before it can do major damage. As such, BreastScreen has more than 750 locations Australia-wide, with all women over 40 having access to free screenings.
But even with so many centres to go to, rural and regional communities can be placed at a disadvantage. Particularly remote parts of Australia face issues, whether that be financial or road and infrastructure access, meaning a large population of women can’t take advantage of these potentially life-saving screenings.
That’s where BreastScreen’s mobile clinics come in. These units are in operation all over Australia, either as vans or trailers pulled by a truck.
BreastScreen Western Australia senior screening services officer Jenna Govan is in charge of organising the logistics of the trucks that travel across Australia’s largest state to some of the most isolated locations in our sprawling country.
This can be difficult with just the one truck to use, a Mercedes-Benz Atego, but a new Isuzu model will take the fleet to two by the end of the year.
But it’s more than just the truck that has to be considered when getting the mobile clinic on the road, with some smaller towns especially lacking a lot of infrastructure.
“We’ve got three trailers and one truck, with the new truck also coming on board at the end of this year,” Jenna says.
“We have a biennial schedule, so all those trailers visit regional towns every two years. In some of the bigger towns they’ll go for annual screenings.
“My role is to manage the mobile schedule of each of those trailers and trucks. I’m also keeping on top of the sites, accommodations and truck drivers.
“We contact the sites about three months prior to visits and let them know we’re coming, and make sure all the resources are there like water and power and things like that.
“Then we contact the drivers, we’ve got a list that are familiar with our equipment, and we book in our movements with them. The accommodation is then sourced six to 12 months prior to the visits.
“It’s about keeping on top of that, because if you don’t give the site enough time there could be other agencies using that space. The accommodation, especially in the spots that are popular with tourists, is especially important.
“I’m making sure it’s all scheduled and ready to open for screenings.”
The sheer volume that BreastScreen WA’s mobile unit takes on can also prove difficult, making the demand much higher than what they can provide at times — hence the need for a second truck.
This necessitates some journeys to be longer than others. The truck is currently stationed in the one place for half the year, which is as common as the smaller trips with more towns covered.
Both are necessary to serve WA’s sprawling population.
“The amount of screenings we do really depends on the place,” Jenna says.
“This year we’re currently in Geraldton for about six months. In our larger towns, we’re there for a substantial amount of time. Next year we’re in Busselton for four months.
“Each of those bigger towns, we might be there for a large chunk of time. One of the other trailers in Harvey has 13 towns they’ll visit between now and Christmas.
“We’re only in some of those towns for two and a half or three days. Sometimes eight days. They’re very short visits before they move again.
“They’re on a rotation, the trailers have got lots of little moves before they have a long stay.”
Desert Rose Schedule
While managing the location is one part of Jenna’s job, the other is making sure there’s enough staff on board and at the right places to keep screenings moving.
Especially with the trailers that are in one location for a long time, doctors and other staff aren’t able to stay with the clinic the whole time.
This requires rotations in not only the trailers, but the people working on them too.
“We try to have permanent staff on our mobiles,” Jenna says.
“We currently don’t on the trailer that’s in Geraldton. That’s easily accessible for us to fly staff up and back. We have coverage of about two weeks on, two weeks off FIFO with our metro staff.
“They get accommodation and their daily allowance. We do have permanent staff on our other mobiles. That’s our ideal scenario.
“We do recognise that it’s challenging being away from home. They are out there 12 months of the year all the time, so we do recognise it’s a difficult job to do.
“When we’re doing our scheduling, we’ve got things to factor in with the weather, mainly cyclone season. There’s not much flexibility in the schedule when we’re going up to the Kimberley, for instance.”
Saving lives one screening at a time
While most patients will only come in for one mammogram, receive their results, and be on their way, that’s not always the case.
The trailers are equipped for follow up screenings and further investigations if needed, which patients will have before doctors can decide if any further action needs to be taken at a hospital.
“We provide mammograms in the mobile clinics and further step-down assessments,” Jenna explains.
“The clients will go back to the mobile to do their further views if necessary. It saves them having to come into Perth if they need any further investigation. If they need an ultrasound or any biopsies, they can come into Perth.”
Being in regional communities, when the job needs to be done in just a few days, there’s no stopping.
As a health service, the mobile clinic won’t turn women away from getting a mammogram, even if it means putting in more hours in the day, recognising it may be the only opportunity and access some women coming into the clinic have.
“We see 25 ladies per day plus allowance for two or three further views,” Jenna says.
“They have to be really flexible, especially if we’re in Fitzroy Crossing or Halls Creek, anywhere in the Kimberley.
“The radiographer last year had to perform 32 in one day. We need to screen the women when they come.
“Clients coming in from the remote communities need allowances made.”
Ultimately, providing free mammograms is a service that’s done a lot for the prevention of advanced breast cancer across Australia.
Early detection is extremely crucial in stopping it before it can spread throughout the body, and with how common it is, treating it early goes a long way.
“Because breast cancer is one of the most treatable cancers, it’s really important to get it early,” Jenna says.
“Statistically we’ve trialled things like reducing the visits to try and encourage women to go into our fixed regional clinics, and they just don’t. We recognise that women in country areas can’t always venture out for these important appointments. If we don’t bring the service to them, they’re not going to access them.
“We recognise it’s a need for our clients, otherwise it would be overlooked. We value the importance of that, especially in the regional communities.
“In some of the smaller Aboriginal communities, women are coming in on buses but there’s no roads out to them. We’ve had to fly them in at times as well.
“They’d just never have access to those services, they’re just too remote.”
If you want to know where the BreastScreen WA mobile clinic is right now, scan the QR code above.
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