Nurse Leader Combats Cancer Among African Immigrant Women

    • July 25, 2013

Problem: New immigrants to the United States often have difficulty getting the health care they need. Many do not qualify for publicly provided services and are not aware of alternative resources that can help them overcome barriers to high-quality, affordable care—barriers such as language, cost, transportation, and child care.

Background: As a child, Ifeanyi Anne Nwabukwu, RN, BSN, a 2012 Robert Wood Johnson Foundation (RWJF) Community Health Leader, never dreamed she would grow up to be a nurse in a distant land, let alone the leader of an award-winning non-profit organization.

The daughter of a Nigerian miner, Nwabukwu grew up in a small city on the banks of the River Niger. Most of her female peers interrupted their education to become wives and mothers. But Nwabukwu had different ambitions and was determined to pursue them.

Her parents couldn’t afford to send her to college, but that didn’t stop Nwabukwu from going—even if it meant she had to travel half-way around the world to do so.

After graduating high school, she scrimped and saved and applied to colleges in the United States. Upon arriving in this country, she enrolled at Franklin University in Columbus, Ohio, and earned an associate’s degree in business administration. She then earned a bachelor’s degree in hospital administration at Strayer University in Washington, D.C. The second of five children, she was the first in her family to go to college.

My path was “very unusual,” she says. “My family didn’t understand it. They wondered why I needed to go so far, and they didn’t know how I was going to survive. But I just felt that if I worked hard enough, I would succeed.”

About a decade after earning her first bachelor’s degree, Nwabukwu earned a second—this time in nursing—from Howard University in Washington, D.C. She intended it to be a “stepping stone” to a career in medicine. But she soon discovered that she preferred nursing because it allowed her to spend time working with and counseling patients and, at the same time, gave her the flexibility she needed to care for her four children.

Then tragedy struck. In 1990, Nwabukwu’s mother, Lucy Adaba, who was visiting the United States to help care for Nwabukwu’s children, was diagnosed with breast cancer. Adaba was in urgent need of a mastectomy, but she couldn’t afford one. She didn’t have health insurance and did not qualify for Medicaid coverage because she was not a permanent U.S. resident. Adaba hadn’t lived in the United States long enough to qualify for state resources, either.

So, Nwabukwu reached out to her friends in the medical profession to ask for help. She got it; Adaba was treated on a pro bono basis and lived another 17 years. The experience opened Nwabukwu’s eyes to the difficulties immigrants face accessing health care and inspired her to do something about it. “I turned my tragedy into triumph,” she says.

Solution: In 2004, Nwabukwu founded the African Women’s Cancer Awareness Association (AWCAA). The association aims to address disparities in awareness, prevention, and access to quality health care services. It opens its doors to all people but targets African immigrant women in particular, especially those who are underserved or uninsured.

The need for services for this population remains high, despite passage of the 2010 health reform law. “Because the Affordable Care Act excludes some immigrants, we have to rely on charitable organizations and medical professionals to assist affected individuals,” Nwabukwu says.

AWCAA educates women about cancer and the resources that are available to prevent and treat it. The organization also refers African immigrants to health care providers who provide them with free cancer screenings, and helps women who are diagnosed with the disease access treatment from clinics, charities, and doctors who are willing to work on a pro-bono basis. As a last resort, the association appeals to members of its donor community to raise funds for women who cannot otherwise cover the cost of treatment.

AWCAA helps patients overcome other barriers, too. Through donations and corporate sponsors, it provides vouchers for public transportation or arranges for volunteers to drive patients to their appointments; offers translation services for women who do not speak fluent English; and arranges child care for mothers of young children during medical appointments.

Members and volunteers also work with undocumented immigrants to allay fears about providing personal information to health authorities. AWCAA works with lawmakers to address rules that require patients to provide personal information to receive health benefits. “Your immigration status should not determine the care you get when afflicted with cancer,” she says.

The organization operates on a budget of about $200,000 a year, employs five people, and coordinates the duties of about 35 volunteers. Members come from countries such as Cameroon, Nigeria, Ghana, Zambia, Sudan, Sierra Leone, Senegal, Guinea, Uganda, and Ethiopia.

Over the last decade, AWCAA has reached out to more than 6,500 women and has referred about 600 for screening, roughly 10 percent of whom were diagnosed with cancer. Many of these women were able to access treatment, and survive, thanks to AWCAA’s help. “There are a lot of survivors in our group,” Nwabukwu says. “They serve as a ‘happy face’ for us. They allow the newly diagnosed patients to know that there’s hope of surviving.”

One such happy survivor is Hanan Eltayeb, a Sudanese woman who noticed a lump in her breast in 2007 and was able to afford treatment with the help of AWCAA. Eltayeb is now paying AWCAA’s favor forward. She raises awareness about cancer in her immigrant community in Virginia, where she holds cancer workshops several times a year and registers fellow immigrant women for screening. “She is one of our best success stories,” Nwabukwu says.

Nwabukwu does not limit her services to women in the United States. Every year, she travels to a different country in Africa with a team of medical personnel who help raise awareness about cancer and conduct free surgeries and health screenings. In the future, she hopes to open offices in Nigeria and Cameroon. “They need more help in Africa than people here,” she says.

RWJF Perspective: The nation’s largest philanthropy dedicated solely to improving health and health care, RWJF is committed to narrowing health disparities. Nwabukwu is helping to advance those goals as a 2012 RWJF Community Health Leader, an award that recognizes individuals who overcome daunting obstacles to improve health and health care in their communities. The award carries a prize of $125,000, most of which is intended to enhance the leader’s work. The award “has been the most wonderful thing that could happen to our organization and to me as an individual,” Nwabukwu says. “People now take note of what we are doing and are interested in our work.”