By Roger Shuler

As their mammogram drive succeeded, the CHAs had to address a more complicated, life-threatening challenge: how to help the women whose tests were positive for cancer.

“Our volunteers were getting calls from women who didn’t know what to do,” Fouad says. With a grant from the Avon Foundation, 30 CHAs received additional training to become Patient Navigators, learning how to find resources to meet the cancer patients’ needs, which were urgent and often numerous.

Transportation is a continuing challenge. The nearest treatment centers are in Selma and Montgomery, and there isn’t any public transportation in the Black Belt. Some churches and other civic organizations have stepped in, joined by individuals who volunteered to ferry patients back and forth in their personal vehicles.

Some women also have to be convinced that treatment won’t mean financial ruin. “It’s very easy for a woman who gets sick to become homeless in the Black Belt,” Fouad says. Some simply don’t know that Medicaid can cover their medical costs, like the blind woman living on a $300-per-month disability check who told a CHA she couldn’t afford to pay for care. The volunteer helped her get Medicaid coverage and arranged for her to undergo treatment.

Fouad says the CHAs were able to find resources to satisfy a host of needs, including day care, meals for women too sick to cook, money for overdue power bills and other unpaid debts, and free legal assistance to deal with creditor threats. Now there are resource guides compiled by CHAs for each community.

The Patient Navigation project has succeeded in getting 95 percent of the women to keep their appointments for treatment, and the CHAs deserve a big share of the credit, emphasizes Fouad. “We’ve gone way beyond medicine here,” she says.

As the health-care system becomes more complicated and sophisticated, the role for local community health leaders will assume a greater prominence, adds Max Michael, M.D., dean of the School of Public Health and director of the Center for the Study of Community Health. “We are learning each day about the importance of health promotion and disease prevention in assuring individual and community health,” he notes. “The CHA model offers promise and hope for communities often isolated from the traditional health-care system.”