Ferry service to southwest Alaska has been up in the air all summer, as workers scramble to fix the M/V Tustumena. A substitute ferry is scheduled to pick up some of the slack later this fall, but it won’t be able to get a medical device to Unalaska that women have been expecting all year.
When it comes to specialized health care, Unalaskans usually have a choice. They can either fly out to Anchorage, or wait for doctors to visit the island to get procedures like colonoscopies and eye exams.
It used to be the same for mammograms. Last year, the Breast Cancer Detection Center of Fairbanks sent a mobile mammography unit — a 33-foot-long pink bus — to Unalaska by ferry.
Unalaska’s clinic director, Eileen Conlon Scott, says it was a perfect fit.
Scott: In the belly of the ferry, they can keep it temperature controlled. And the fact that we didn’t have to actually hoist it on there, we could drive it on there and drive it off.
Scott was planning to get the mammogram equipment out on the ferry again this fall. But now, the Tustumena is being held in shipyard indefinitely, and there’s no more room for vehicles on the fill-in vessel that’s coming in September.
Scott says she looked for an alternative, but couldn’t find one.
Scott: It took us another week to say, nothing’s going to work.
That’s when the clinic announced that their patients would have to fly to Anchorage this year to get mammograms.
When she heard that news, Unalaska resident Flor Luna wasn’t sure what to do. Flying out for a breast exam would be a headache. But Luna is 53 years old — and groups like the American Cancer Society recommend that all women over 40 get screened every year, no matter what.
Luna: I did give it some thought and everything kept pointing towards just going. When you’re older, you should just get it done. So I’m not going to take any chances.
But Luna has insurance to cover the cost of the procedure. About a third of the women who usually get mammograms here in Unalaska don’t have health coverage. Instead, they pay out of pocket on a sliding scale.
Scott, the clinic director, says she expects that some uninsured women will skip their mammogram this year because they can’t afford to travel for care.
Scott: It comes out to like close to a $4,000 little trip to have a mammogram.
If there’s a ferry up and running again next year, the mammogram truck will be back. But Scott says the whole situation’s gotten her thinking:
Scott: I don’t like to rely on anybody to do services for our clinic. I like our community to have all the services we can get them out here. And that way we can ensure everybody gets what they need done.
In light of this, she’s looking into buying a mammogram machine to keep at the clinic permanently. But that’s a big investment — and probably a long way off.
So in the meantime, women in Unalaska will have to decide if they can afford to travel to get the health care they need, or if they can afford to wait.