Alumna Tears Down Health Care Barriers in Her Birth Land of Mauritius

Alumna Tears Down Health Care Barriers in Her Birth Land of Mauritius

Reported, December 10, 2011

By the time Dora Mamodesene, MD, (M’82, R’86) examined the modest Mauritian woman, who had refused to show the “rash” to anyone but her husband, it was far too late.

“The ‘rash’ eroded all the way to her chest wall,” she recounts. “That cancer was eating her chest muscle.” Soon after, the 30-year-old Mauritian woman died.

Modesty is a serial killer in the Republic of Mauritius, says Mamodesene, her ready smile fading.

Twice a year, she travels from her home in Silver Spring, Md., to her homeland, a nation of islands in the southwest Indian Ocean off the coast of Africa. There for at least six weeks, she crisscrosses communities, examining and educating Mauritian women, trying to save them from early, and often preventable, deaths.

By Mamodesene’s count, since October 2006 she has given 1,200 women gynecological exams, breast exams and pap smears, and has taught them how to do breast self-examinations.

“At Georgetown, I was having the Jesuit education where we have to be good and pay back to society,” she says, with a trace of Creole cadence. “Now I can, and I do. I do make a difference for [Mauritian women].”

Mamodesene has a desktop-published binder called “Sensitising (sic) Campaign on the importance of routine gynecological screening, breast examination and instruction on monthly self-breast examination by Dr. Dora Mamodesene, Washington, U.S.A.” which she uses to draw in the modest women of Mauritius.

“What’s scariest is their shame of their bodies … It is a culture of great modesty,” she explains. “The barrier is both sides. The doctor also has the barrier.”

Mamodesene also seeks to bust deeply entrenched myths she has encountered during her visits, such as the belief that people over 60 years old are immune to cancer and that doctor visits are only for when something is wrong.

“Fear, ignorance, and the culture keep them from having a mentality of prevention. They fear they may find something. I say, ‘Find it before it finds you,’” she says. “Education is expensive, but ignorance costs more.”

About 600 women met with Mamodesene during her first trip, which included visits to Terre-Rouge, Bambous and 11 other towns. The campaign, conducted with the support of the national councils for women, youth and senior citizens and some non-governmental organizations, had three goals: to foster awareness of breast and cervical cancer; to imbue the importance of routine, preventative screening and monthly self-exams; and to educate women about the female body.

A reef-encircled, volcanic island nearly 11 times the size of Washington, D.C., Mauritius includes the Agalega Islands, Saint Brandon and Rodrigues. The country is a stable democracy with regular free elections and a positive human rights record, and has attracted considerable foreign investment. The population of 1.2 million is 48 percent Hindu, 33 percent Christian and 17 percent Muslim.

Mamodesene, a petite, dynamic woman with an open demeanor, has four grown children and is semi-retired from her practice as a family doctor and obstetrician/gynecologist. In addition to her home in Silver Spring, she owns several businesses and some property in Mauritius. Seemingly running on endless energy, she is grounded in her belief in lessons learned early in life, both from her Mauritian childhood and from Jesuits during her medical education at Georgetown.

When she was 10, Mamodesene and her family left Mauritius because her Egyptian mother believed it was “not a good place to bring up daughters. You need to know more of the world than that little place.” At that young age, she was already watching cats give birth to litters, opening chicken eggs and drawing the contents at various stages of gestation, and dreaming of becoming a doctor.

Now, with years of clinical experience under her belt, she is trying to strategically change Mauritian women’s passive approach to health care and tune them into the value of prevention. “I teach the women to buddy up. I am teaching the teachers. If I teach you, you teach her. It goes like a wave effect and does not stop when I’m gone,” she said.

Mamodesene said her dream is to increase Mauritian women’s access to mammography, and maybe even to obtain a machine of her own so that she might start a mobile or community-centered clinic where women can get regular mammograms. Mammography machines are so scarce in Mauritius that doctors use them only to confirm diagnosis of breast cancer, not to screen for it.

“Don’t forget what I said, what I learned at Georgetown,” she says, smiling as she wags her finger in mock sternness, “… service to others, giving back, patience, listening and compassion.”

Credits: Victoria Churchville, excerpted from the 2009 Spring/Summer issue of Georgetown Medicine Magazine
More information:
http://gumc.georgetown.edu/news/stories/80278.html