Improving screening for Aboriginal women

VAHS site director Susan Hedges and BSV radiographer Monique Warrillow screening.

The number of Aboriginal women who have regular breast screens continues to rise each year. We want to increase screening rates even more, by making sure our services are accessible, culturally safe and welcoming.

BreastScreen Victoria and Victorian Aboriginal Community Controlled Health Organisation (VACCHO) collaborated with Aboriginal health organisations to bring breast screening to more Aboriginal women. 

The Aboriginal Breast Screening Shawl Trial

Aboriginal women have reported a lack of cultural awareness among health professionals, fear, shame and logistical barriers as negative impacts on screening. To address these barriers, in 2018, we developed the Aboriginal Breast Screening Shawl Trial. The Victorian Aboriginal Community Controlled Health Organisation (VACCHO) and the Victorian Aboriginal Health Service (VAHS) led this project and ensured that Aboriginal Community Control was central at every stage.

The shawls were made for Aboriginal women in the trial to wear during their breast screen. They are a culturally safe alternative to being naked from the waist up or asking for a standard screening gown. The shawls aim to improve Aboriginal women's experience with breast screening. Other objectives were to support Aboriginal women to screen together as a group and to increase the cultural competence of BreastScreen Victoria staff.

Artist Lynette Briggs and her artwork.

The original shawl used in the trial featured detailed artwork by respected Wiradjuri and Yorta Yorta artist Lynnette Briggs. She was inspired by the many stories of women and their personal journeys they shared in yarning circles.

The Aboriginal Breast Screening Shawl Trial won a 2019 VicHealth Award in the category of Improving health equity.

This week, the Aboriginal Breast Screening Shawl Trial won a 2019 VicHealth Awardin the category of Improving health equity. Congratulations and thank you to everyone who worked on this fantastic project: Annie Cooper, Monique Warrillow, Mel Davis, and Lisa Joyce. And to our partners: VACCHO, VAHS, DHHS, Deakin University, Cancer Council Victoria, St Vincent's Hospital BreastScreen clinic, Western Health, and Women's Health West.

The shawls go on the road with the mobile screening service

The success of the trial led us to roll it out across Victoria. In October and November, our mobile screening service visited seven Aboriginal Community Controlled Health Organisations (ACCOs). Women who screened received a shawl.

The project has been an enormous success. 160 Aboriginal women screened, a significant achievement for an under-screened group. 82% of the women who screened were new to breast screening or had lapsed. That is, they had screened before but had not returned within the recommended two-year period. The experience was overwhelmingly positive, with 82% of women agreeing that the shawl made them feel culturally safe. 95% of women agreed that they felt more comfortable screening because the mobile screening service was located at their local Aboriginal health service.

About the shawls

The team at Dhauwurd-Wurrung Elderly and Community Health Service (DWECH).

"The two hands in the far left corner represent support for each other as we journey, depicted in the footprints, through challenges leading in the hope of celebration and victory, shown in the raised hands on the far right corner. The yarning circles on each corner represent the importance of women getting together to share with and encourage each other in a safe, cultural environment. The hands are holding the heart and the dove, which represents love and hope. They are surrounded by two joined circles with a line weaving around those circles to encourage women to always keep going and remain strong. The heart also incorporates the breast cancer symbol, reminding us that we do not have to go it alone if going through health care challenges." -Bronwyn Ferguson, Gunditjmara

The team at Winda-Mara Aboriginal Corporation.

"The symbols here represent breast cancer survivors coming together and supporting one another. The circles represent each of the four communities in the south-west: Warnanbool is Gunditjmara and Kirrae, Portland has Dhauwurd Wurrung Elders, and Heywood has Windamara and Hamilton. The ring around those big circles represents the community supporting and sharing and raising awareness about the importance of breast screening in the community. And how the community supports everyone looking after their breast health. The circles represent every breast screen that has been achieved so far in the community and the importance of breast screening for women in the Aboriginal community in the south-west." -Jenna Bamblett, Yigar, Gunditjmara

The team at Gunditjmara Aboriginal Cooperative.

"The green and blue waves at the top of the painting represent Gunditjmara Country, Land and Coast. The symbol of people on the green/blue is the Gunditjmara community women. The large symbols of women across the centre of the painting are the elders who have taken the lead in women's health, who have had their regular breast screening, pap smears and other women's business consults. The design on the women is a traditional Warlpiri ceremonial pattern. The design for Warlpiri women is painted on the chest, breast and arms for women's business. The dotted area at the bottom and the symbols represented represent the extended Aboriginal community of women from other places who live on Gunditjmara Country. The colours of traditional and no traditional colours indicate the individual journey that we all have and the way of identity, acceptance, acknowledgement and following the footsteps of the local leaders and role models who take the lead in better health care choices." -Rebecca Clayton, Warlpiri

The team at Kirrae Health Services.

This shawl is titled, 'You Are Strong'.

"The hands represent the strength, love and hugs from all the people. The water holes and rivers represent the journeys through life, the connection between mobs and the connections to land. The shield represents the warrior within and acts as a protection against shame when undergoing check-ups. The colours represent and acknowledge the beautiful nature and animals that we have across the lands. The dots and lines represent and acknowledge the art and the stories from all the people across the lands." -Shylee Corrigan, Yirandali (Queensland)

The team at Traralgon BreastScreen with Ramahyuck District Aboriginal Corporation (Morwell).

"This artwork represents women coming together, mother, aunty, grandmother, cousins, all coming together as one to get the breast screen done. These are two separate artworks. But it all breaks down as one. We all come together as one to worry about our health and our wellbeing to get our breast screen. [The images in the corners] is me, my mum and my grandmother. We are all strong and strong-headed women. My grandmother and my mum are not here, so I have to make a stand and stand up for my kids and my granddaughters." -Marilyn Fenton, Gunai Kurnai

The team at Wathaurong Aboriginal Co-Operative.

 "This piece is called Kardeeneeyoo Toort-Barram. In Wathaurong language, this means Morning Stars. The rising sun represents a new day, and the stars above are our ancestors watching over us. "-Jasmine –Skye Marinos, Arrente

The team at Ramahyuck District Aboriginal Corporation (Sale).

"The story of this artwork is about women's business, Aboriginal women and their children in their clans, then coming together and meeting in the middle for women's business with breast screen nurse." - Brenda Farnham, Walbunia, Dhungutti

The team at Rumbalara Aboriginal Co-operative.

"The story behind my artwork is calmness, as when you are having your breast cancer screening, you can become nervous, overthinking and a lot of other emotions in that time which then might bring on stress or anxiety. Flowers always bring a smile to anyone's face as they often bring good memories which will calm you. The butterflies are a representation of the journey we have in life, and at the end of any hard times, there is always a positive light at the end. The colours used are different shades of pink to represent the colour of breast cancer. -Rebecca Atkinson, Moiradu Tribe of the Bangerang Nation and Kerrupmara of the Gunditjmara Nation