Pine Hill Health Center

Navajo citizens in the Ramah area of the Navajo Nation form a semi-autonomous community of approximately 4,000 people. The Ramah population includes a high number of traditional Navajo people, a high rate of Navajo language retention and usage, and difficulty in accessing medical care beyond the basic care offered at the local clinic. Meanwhile, at Ramah as on many reservations, adequate attention to women’s health care issues presents its own distinctive challenge. In many parts of Indian Country, late detection and diagnosis have led to disproportionately high death rates from breast cancer, and Ramah has been no exception to this pattern. Until 1997, the state of New Mexico had provided a mobile screening center that stopped at Ramah, but funding problems ended those visits, and many Navajo women found the screening process intimidating or uncomfortable. By the early 2000s, less than 10% of Ramah women were receiving mammograms in any given year. In 2004, Ramah’s Pine Hill Health Center set out to address this issue. They launched a series of “Mammo Days,” days specially designed to encourage groups of Navajo women to overcome the barriers to regular breast cancer screenings. The process begins before the actual screening takes place, involving recruitment of Navajo women to participate, transportation from homes to the screening site, activities at the site so that the process becomes a social one, language translation services, lunch for all who attend, physical examination beyond the mammogram, follow-up based on the results of screenings, and other elements. The initiative has been a major success, overcoming much of the fear and nervousness surrounding medical examinations. Mammo Days have quickly grown in popularity; assuming there is adequate access to the necessary equipment, what was once a quarterly event will soon become monthly, addressing a critical need in a culturally sensitive and medically effective way.