During a church charity activity, Yoko Nelson of Burke and her husband, Dr. Larry Nelson, met a single mother who had no health insurance. Despite the lack of coverage, the woman had the same health needs as other women, including periodic checkups and regular tests such as a pap smear.
The Nelsons sat down at the kitchen table of their Burke home with the woman and her child to find a way for her to receive treatment at no cost.
"The child has the coverage, not the mother," Yoko Nelson said. "The four of us got together at the kitchen table and decided to do something."
The kitchen table meeting led to the formation of Rachel's Well, a program that ties together donated time by a physician and donated space and money to give women the medical treatments they may need.
Nelson is one of the doctors who donates her time to the program, which also receives the help of several nurses from the Northern Virginia Community College medical campus in Springfield. In addition, the medical campus donates space for the program, which is still in its infancy.
"This is a community-based effort," said Larry Nelson, adding that the program has partnered with St. Matthew's United Methodist Church of Annandale.
Rachel's Well has conducted one testing session so far, but the program is looking to expand its services with additional volunteers and a laboratory that will read medical samples. Another testing session is tentatively scheduled for September 2004. Although the actual pap smears are performed at NVCC medical campus in Springfield, testing the samples must be done by another lab.
"This is a specialized test. Most hospitals don't read these tests on their own," Larry Nelson said. "They send it off to the lab."
"Cervical cancer is almost 100 percent preventable if people have a regular pap smear," said Dr. Charlene Connolly, of the NVCC medical campus. During a testing session, Rachel's Well patients are able to visit the Women's Health Center in the campus' medical mall and receive pap smears as well as other treatments.
ACCORDING TO the American College of Obstetricians and Gynecologists (ACOG) guidelines, a woman should have her first pap smear about three years after first engaging in sex, or by age 21, whichever comes first. For women up to age 30, they should have annual cervical cytology testing, and women over 30 have several options for testing.
Raymond Cox, M.D., is the director of OB-GYN at Prince George’s Hospital in Maryland and the vice chairman of underserved women at ACOG. Many times, uninsured patients fail to see a doctor about a problem in time. Cox had two patients die in the past because of this.
"By the time they do get the test, they have advanced stages of the disease, usually cancer," Cox said. "They end up getting sub-optimal care."
The lack of legislation concerning professional liability affects the uninsured because doctors will be wary of treating an uninsured patient for fear of getting sued.
"The professional liability crisis is going to affect the uninsured first," Cox said.
One of the Nelsons' goals is to get a laboratory to donate some testing time. Transportation for clients and care for their children while they are being tested are needed as well.
"We needed a third leg to this tool, a community partner," Larry Nelson said.
A LACK OF funding remains a concern for the Rachel's Well organizers. Larry and Yoko Nelson actively participate in the fund-raising efforts that are needed. The couple initially contributed $5,000 of their own money, and Yoko Nelson published a cookbook with recipes from Robinson Secondary School. She had previously taught art and Japanese there.
Titled "Food for the Busy Idealist," the cookbook contains recipes from people that Yoko Nelson worked with at Robinson. Ann Monday, former Robinson principal and now Cluster VI director, donated the first recipe in the book. So far, the Nelsons have sold $2,200 worth of books.
"Recipes just poured in mainly from Robinson friends and family," Yoko Nelson said. "For busy people, the preparation should be 30 minutes or less."
The Nelsons chose to name their health assistance program after Rachel, a figure from the Old Testament. Rachel from the Bible died in childbirth because of poor health. Although Rachel's Well is named for a figure from the Bible, the program is nondenominational.
"It's a name to represent any woman. We want to help anyone," Larry Nelson said.