By DERRICA BONNER
Southern Rural Black Women’s Initiative and Human Rights Watch
(American Forum) – There are people throughout our community who seem to be out of sight and out of mind. Older people. People with disabilities or without cars. These people still need access to health care, and yet lack of transportation creates insurmountable odds. Imagine an aunty or friend, in her fifties, in a wheelchair, out of her medication that she needs with no one to call – sitting and struggling.
For the past year and a half, as a community-based researcher with the Southern Rural Black Women’s Initiative and Human Rights Watch, I’ve been speaking to women in our community about access to life-saving preventative cervical cancer care.
With cervical cancer, preventative care is key. If caught early, cervical cancer has a 93% survival rate. But more than 4,000 women a year die of cervical cancer. In Georgia, Black women were almost one and half times as likely to die of cervical cancer. These disparities increase at alarming rates as women age, and Black women over the age of 70 are almost three times as likely to die of cervical cancer in comparison to white women in the same age group.
And the further away from big cities you go, the more disparities there are in cervical cancer care. In fact, in rural Georgia, Black women face a cervical cancer incidence rate that is almost 50 percent higher than white women. In all of Georgia, compared to white Georgian women, Black Georgian women are more likely to have never been screened for cervical cancer. This can be deadly. And SRBWI and Human Rights Watch found out that for some women, the simple fact that they can’t get to the doctor can be a barrier to preventative care.
You have people in the community who can get out of their homes, walk, have cars, and can get to the doctor if they need to do that. They can do for themselves. But there are other people just sitting in their house suffering. Especially with COVID-19, especially with Wilcox County. The public transportation only takes you to two designated places. You can pay $2-3 to get on the bus, but it can’t take you to specialists outside the area.
One woman I spoke to made me understand how difficult this is for accessing care. She’s lived in the county for nearly forty years. She has a disability, so doesn’t have a job. Luckily, she has Medicaid to cover her medical expenses, but she has to rely on family to take her to see the doctor, and that can be difficult. There is a transit bus, but it’s hard for her to use.
Five years ago, she received an abnormal pap test. While that doesn’t mean she has cervical cancer, she needed to have follow up treatment. She received it but keeping up preventative care without adequate transportation is hard.
From personal experience, in Wilcox we have a health department, and I was going through my own gynecological issues. There was a registered nurse, but she wasn’t a physician, she wasn’t specialized. She’s really there for women who are pregnant, she gives info on WIC, the Special Supplemental Nutrition Program for Women, Infants, and Children. We don’t have hematologist, oncologist, cardiologist. When I was sick, I had to leave the county for a second opinion, they diagnosed me with something else. The staff at the local department aren’t really trained in illnesses or certain types of diagnoses. They are just trained for basic care. We always have to go outside of Rochelle, Albany and sometimes Cardiff. In Macon where they listen to what you say, that’s almost an hour and 45 minutes away.
People that I interviewed – they don’t get care in Wilcox. The differences between Wilcox and Atlanta are vast and to be honest, as a young person it is hard to imagine a future here.
There are so many barriers to accessing care, but I’m most struck by how difficult it is to physically get care if you don’t have the means or the family and friends to help you. To get care, it has to be simple. There should be a system in Wilcox and other rural communities, that if they need to go to a doctor’s appointment, they can do that.
The Georgia Legislature needs to set up and do more to address the unavailability of public transportation in places like Wilcox County – as a matter of public health. We also need Congress to help out the state and help fund a study on barriers to transportation impacting the ability of low-income women, particularly women of color, in rural communities and pilot a project to see what will work for places like Wilcox County.
If we’re serious about saving women’s lives, we need to take action now. It’s inexcusable that women are becoming sick and even dying because they lack transportation to get to a doctor’s appointment.
Derrica Bonner is a 2021 nursing graduate of Albany State University and is a community-based researcher for Southern Rural Black Women’s Initiative and Human Right Watch.