A Not-So-Level Playing Field: Navigating Cancer Care In Tribal Communities

By Kelly Hansen, TNBC Survivor and Tribal Community Health Educator

In 2021, I was working as a Health Educator for a Tribal Community in the Upper Peninsula of Michigan. Up until that year, I had no idea my work in health education would also intertwine with my own personal health journey. My name is Kelly Hansen and I am a Triple Negative Breast Cancer Survivor, and although I transitioned from educator to patient, I was keenly aware of how different my experience was going to be compared to the community I serve.

I have worked under cancer grants and have done years of cancer prevention and awareness work in our Tribal Community. Working alongside many cancer survivors through the years, I have seen firsthand the burden that cancer puts on not only the individual fighting but the entire family and support system. Up until my own diagnosis I could only offer navigation services, support and sympathy. Now, through a completely different lens, I can share my experience, offer solidarity and have true empathy for my patients.

As I journeyed through 16 rounds of chemotherapy and a double mastectomy, I experienced little to no issues with my medical teams, support system, career, finances and personal life. I had the knowledge to ask questions and pursue reasoning behind my treatments, leaving me able to make the best decisions for my wellbeing. I had an incredible support system of friends, family and community to help pick up the slack of a sick mother and wife. My job was secure and I had health insurance. I could solely focus on defeating my cancer and beginning to heal again. I know how incredibly fortunate I was because in my line of work, I have seen that cancer treatment journeys and survivorship are not always parallel to my experience.

The Tribal Community I work for and the cancer patients I help have not had the same experiences that I have. I have talked with patients who were fighting addiction at the same time they were going through treatment; I have had discussions with individuals that were going to skip their treatment for a week because they needed to work to feed their children and grandchildren. I have watched a woman cry in my office because she was never told that reconstruction surgery was an option after her double mastectomy and thought she had to remain flat forever. This left her feeling as if her identity as women had been ripped from her.  I have observed patients going through treatment completely alone, exhausted and worried with only their own thoughts to get them through the torment that cancer treatment creates.

Due the place these patients are born in, live in, and learn in, they have been factored into a different and unjust opportunity than me, which has been upsetting but also fueling at the same time. I have strived to gain the trust of our community members so that I can help them reach the same health care that I have been given.

Witnessing two completely different experiences has fueled me to do more for the Tribal community I love. I have worked with the Inter-Tribal Council of Michigan and the Betty Ford Breast Care Service to bring a mobile mammogram unit to our reservation, giving women the opportunity to get screened each year. With the closest hospital being 20 minutes away, transportation has been a barrier for women to get the screenings they need.

The lack of health care access in our communities is not just limited to breast cancer alone. Outside of the breast cancer space, I have also worked with Health Center staff to provide colonoscopy prep for our patients who have an upcoming colonoscopy, so they do not have to pay out of pocket for their prep medicine. I promote Turquoise Tuesday every January to raise awareness about the importance of getting PAP smears. I also align myself with other events, programs and campaigns to stress the importance of cancer screenings, patient navigation and health equity in our Tribal community. None of this is possible without the help of my amazing co-workers, health center staff and outside partnerships.

As I grow as a survivor and a health educator, I can only hope to amplify the importance of Health Equity in our Tribal communities. Our people deserve the same best practices, medical advice, financial support and solidarity that other races and ethnicities are shown, and the highest level of health should be uniform for all walks of life.