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Women falling through holes in safety net
HEALTH CARE | Breast screening exams suspended as Stroger Hospital faces backlog of unread mammograms

Sunday, August 12, 2007
Chicago Sun-Times
by CAROL MARIN

It is one of life's leveling moments: There you awkwardly sit in a wrinkled, blue cotton hospital gown you had trouble tying, waiting for your name to be called so you can untie, strip and be squeezed into the vice-like grip of a mammogram machine.
It was early Wednesday morning last week, and I was the only woman in the waiting area of Northwestern Memorial Hospital's Lynn Sage Clinic until Jenny Vega burst into the room. I'm calling her that, though it's not her real name, to protect her privacy.
Jenny was about 42, a big-boned woman with wild, wavy hair and a breathlessness about her as she collapsed into the chair next to me.
"You been here before?" she asked.
Yes, I said, I come here every year.
"Whoa, really? It's my first time and I'm scared," she confided. "I've never had a drink in my life, but I'm getting cirrhosis of the liver because of having hepatitis C."
Heroin user? Infected by dirty needles?
"Yep," said Jenny. "When they cut my methadone treatments way back, I said to hell with it, I'll go cold turkey. I'm not on anything now."
Why the mammogram?
''They sent me here for tests," she said, not making it clear who "they" were.
Just then, a medical staffer called Jenny into one of the examining rooms. I never got to ask if she has insurance, but I'd bet anything she doesn't.
If I'm right about that, then Jenny's examination at an excellent, respectful place like the Lynn Sage Clinic is a hopeful sign that pieces of our frayed public health safety net still exist. Vouchers for poor women, financial assistance from community groups and federal funding funneled through the Illinois Breast and Cervical Cancer Program fill some critical gaps.
The looming gap, however -- the biggest hole in the safety net -- is still at Cook County's Stroger Hospital. Because of backlogs of thousands of unread screening and diagnostic mammograms, much of that service to poor women has been suspended until the hospital can bring that backlog down.
''The program will relaunch in October,'' said Cook County spokesman Sean Howard, who added that President Todd Stroger is also setting up a nonprofit foundation to fund a fleet of mammogram screening vans for community outreach.
''The two vans we have are in deplorable condition and must be replaced," Howard said.
In the meantime, the county is referring women to other clinics and hospitals.
But it isn't working.
Here's why, according to Jude Andrews, executive director of Y-ME Illinois: When a woman arrives at Stroger Hospital, she is told to go home and wait by the phone to receive a referral to another health-care provider. In poor and transient populations, that in itself is an iffy way to proceed.
If and when she gets that call, when the woman arrives at the assigned clinic, she learns they need her records and X-ray films from past mammograms, requiring a trip back to Stroger, a $22 fee, and another wait to see if they can even locate her file. Then another trip to pick it up.
Provided she has the time and carfare for all those journeys, maybe she'll finally get her mammogram.
''Most women have stopped going to Stroger,'' Andrews said. ''We don't know how many women have been rerouted.''
''Y-ME,'' she said, ''has left a lot of messages on [county hospital] answering machines but hasn't been called back. . . . There's a real transparency issue here.''
Other advocacy groups such as Gilda's Club and the Sisters Network, she said, complain they've hit the same information stonewall.
Howard said he would look into that and called back Friday morning to say that they were addressing the problem ''as we speak.''
Meanwhile, back at the Lynn Sage Clinic last week, as my name was called to go in, Jenny was coming out. She looked relieved.
''It wasn't so bad!'' she said of her first mammogram. ''Good luck to you, Carol.''
Good luck to you, too, Jenny.


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