SHIAMALA Suntharalinga, Julie Solway and Anushe Khan have teamed up for an important cause – to increase the number of migrant and refugee women undergoing breast screening in the ACT.

Dr Suntharalinga says cultural and language barriers stop the at-risk communities from reaching out.

“They may not understand or be aware of the fact that there is a screening program in Australia,” she says.

“So, language can be an issue, and as a migrant woman and a woman from the Tamil community, culturally I think they can be shy about exposing their breasts.”

Shiamala travelled to the UK from Sri Lanka when she was three, and then came to the ACT in 2012.

Now 50, Shiamala is a doctor at Erindale Healthcare in Wanniassa.

“Many years ago I organised with Julie, who is with BreastScreen ACT, a Canberra Tamil Women’s Association,” says Shiamala.

“We had a meeting with 25 women, and we spoke about self-breast checking and going for mammograms once you’re 40 years old, and definitely once you’re 50, but our refugee Tamil women didn’t attend.

“It’s so important to get screened, we don’t want to miss breast cancer or leave it late because the consequences are severe.

“The aim of breast screening is picking up on cancer that is not obviously showing, and we can intervene early, before it results in long-term health consequences.”

Julie, 59, through BreastScreen ACT, is hosting a project with linguistics group Navitas, to bridge the gap.

“In 2019, statistics showed the 50 to 74-year-old age group was sitting at about 27.5 per cent participation with breast screening,” says Julie.

“The other side of COVID-19, it dropped to 22 per cent, so we looked at how we could engage the refugee and migrant communities better.”

Anushe, 26, is project co-ordinator for the Health in My Language Program at Women’s Health Matters, and says there are more practical barriers that need to be addressed, too.

“When women, particularly from refugee or migrant backgrounds, come to the ACT they can find transport is a huge barrier, as is the cost of seeing the GP, or even awareness of where to go,” says Anushe.

“Going to see the doctor on top of trying to get steady employment, looking after their education, and/or putting kids in school in a completely new place can mean that health will become a very low priority.

“In particular, breast screening or cervical screening, that’s a lower rung because it’s a preventative thing. In some communities it’s only spoken about when it’s really bad, so the idea of preventative checks is not something that is widely thought about.”

Anushe moved to the ACT from Melbourne two and a half years ago, and said she found the ACT’s health system complicated.

“For many, another barrier could be that they’ve had bad experiences previously with doctors or tests,” she says.

Shiamala says: “The other thing about refugee women is they may have come from war zones, or areas that have had very severe hardships, so they may have been sexually assaulted, and that may be another barrier.”

Anushe, Julie and Shiamala are working together to create a safe and easily understood way to encourage women to come forward.

Julie says BreastScreen ACT makes it free, only has female technicians, allows group bookings and offers leaflets or interpreters.

“A lot of us are working together, because it’s such an important thing,” she says.

“I think the idea of group bookings is really good too, if you can come with someone that you have a positive relationship with, it further embeds this as a safe experience, which can build confidence.”

Anushe says she has attended sessions run by Julie.

“You can just see the importance of health information being shared. Even just showing what a mammogram looks like helps create a safe space where people can better understand what the process looks like,” she says.

Julie says the importance of breast screening is finding cancer before it can be seen or felt, and educating people on what to look for.

Shiamala lists pain, lumps, any discharge or any symptoms or concerns.

“We are urging women to come and see us, so that we can examine properly and investigate,” she says.

Anushe says beautiful faces and personalities like Shiamala and Julie bring warmth into the subject matter, “which creates a big difference and that’s what we’re hoping to do”.