For Nwabukwu, 70, the founder and executive director of the African Women’s Cancer Awareness Association (AWCAA), the mission is personal: When her mother, who has diabetes, came from Nigeria for a visit in 1989, Nwabukwu took her to see an endocrinologist. During that appointment, the doctor did a head-to-toe physical exam and discovered a lump in her mother’s breast. At the time, her mother had no health insurance or any knowledge of how to navigate the American healthcare system. Her mother was also aware of the lump, but had no idea how dangerous it could be. “When the doctor asked her how long it had been there, she told him she thought it was due to breastfeeding, but her youngest daughter was in her twenties at the time.” What happened next would change Nwabukwu’s life. Without insurance to pay for her mom’s surgery, she asked a friend (who happened to be a trauma surgeon) for help. That friend then rallied other colleagues who ultimately operated on her mom. “They did the radical mastectomy pro bono,” says Nwabukwu. “But I started thinking about all the other immigrant women who go through this and don’t have someone to come to their rescue.” So in 2004, Nwabukwu, also mom of four adult children, decided to do it herself. With financial support from Susan G. Komen for the Cure, she started the AWCAA, a community-based organization. The goal: to help her clients, many of whom don’t have health insurance, get access to preventive health studies, such as screening mammograms. In addition, the staff — all African immigrants themselves — helps clients navigate the complicated cancer world of MRIs, surgeries, and treatment plans. Her team also does regular community outreach efforts, with the goal of making sure that up to 60 women in the community book annual mammograms. The organization has served over 3,000 women in the DC area and throughout Africa during mission trips. There is always someone on staff to translate who speak one of 11 African languages, including Hausa, Swahili, and Shona. It’s these language barriers that can also limit care. “I tried to turn my pain into a purpose,” says Nwabukwu, whose mom passed away in 2007 after the cancer metastasized to her liver. “Within my community, women were dying, but the worst part was no one talked about it,” she explains. “You would hear whispers that a woman had breast cancer at a funeral but people in my community don’t want to put their business out there.” In fact, when she went home to Nigeria for her mother’s funeral, her sisters insisted she keep her cause of death private. “They barred me from telling anyone she had breast cancer,” she says. “This remains a real challenge in my culture.” Ultimately, when she was diagnosed with breast cancer in 2016, she made a vow to go public. “I wanted to let the world know,” she says. “The biggest thing I learned, too, is that we never pass down our family health history. My mom and my aunt had breast cancer, but I only knew about my mom because she was here with me when she was diagnosed.” This has led her, recently, to begin working with Howard University Hospital and Georgetown Lombardi Comprehensive Cancer Center to offer genetic testing and urge women to join clinical trials. Thanks to continuous funding from Washington, DC, and Maryland’s Department of Health as well as from private corporations and individuals, the organization is also able to offer quarterly mammograms in a mobile van parked in front of the organization’s office, mental health counseling, support groups, and also help with mastectomy bra and prosthesis fittings. Still, the challenges remain even as Nwabukwu prepares to open another branch of the nonprofit, this one in Atlanta. It’s not, for instance, all about money. “The resources are there but, for a woman to receive treatment, she needs a social security number and most of these women won’t have one,” she says. “The other worry is that there are residency requirements for care and many of our clients are living with relatives and their names won’t be on the lease of utilities. This poses a problem when we have forms for them to fill out.” And of course there’s the fear that they will be deported if they’re undocumented and turn over any information about where they live. “We tell our clients healthcare institutions have nothing to do with immigration,” she says. “The fear they have is if they give us information we will turn around and inform immigration.” What keeps Nwabukwu motivated is her commitment to ensuring her clients have what they need to make good health decisions. Nwabukwu strongly encourages her clients to get their mammogram screenings, so that if there is an abnormal finding or evidence of breast cancer, it is caught and treated early. “I want to be there to make sure that nobody walks through this journey alone,” she says. “There are a whole lot of women who are now warriors. We have to stand with our sisters. Breast cancer doesn’t discriminate. We all go through the same emotions and we want to be there to help.” Her best moment of satisfaction happens when she reunites with a client who has had a happy ending to what could have been a tragic outcome. “To know they found their cancer when they used one of our programs and that they got their treatment and survived is one of the best compliments anyone can give me,” she says.

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The American Cancer Society is dedicated to helping people who face cancer, including free rides to chemo, places to stay when treatment is far from home and a live 24/7 helpline. Breast Care for Washington is committed to reducing breast cancer mortality in the Washington, DC, area by promoting access to breast cancer screening. The Howard University Cancer Center provides research, education, and service for cancers that affect primarily Black American populations. Tigerlily Foundation is a national breast cancer foundation providing education, awareness, advocacy, and hands-on support to young women. Georgetown Lombardi Comprehensive Cancer Center is the research engine driving clinical cancer research at MedStar Health in the DC Metro area and northern New Jersey. The George Washington Cancer Center in Washington, DC, provides services for detection, diagnosis, and treatment of a variety of cancers as well as support programs and rehabilitation.