A well-known motto of Planned Parenthood is “care, no matter what.” This represents the constant challenge of overcoming barriers between provider and patient.
Many communities face unique and formidable barriers to accessing reproductive health care. From within, many patients may need to unlearn cultural conditioning, which can lead to people feeling embarrassed about their bodies and uncomfortable seeking reproductive health care in the first place. From without, barriers can consist of restrictive anti-abortion legislation or combative protestors making physical access to health care difficult. In many areas, reproductive health care providers are rare, making travel another barrier to add to the list.
An Ocean Between Patients and Provider: Traveling Between Islands
In Hawaiʻi, travel between islands is one of the top challenges in health care access, for both patients and providers. Patients commonly must fly between islands to get the care they need.
“If you want any kind of necessary health care procedure not offered on your island, you have to fly,” explained former Kahului Health Center Manager, Lisa Perry.
For many people living in Hawaiʻi, the necessity of air travel has always made obtaining reproductive health care a financial and logistical burden, and this was only made worse by the COVID-19 global health crisis.
Within the past two years, the state of Hawaii’s COVID-19 precautions included mandatory 14-day self-quarantines for both inter-island and trans-pacific travel. And throughout the pandemic, the state of Hawaiʻi lifted and re-instated inter-island travel restrictions.
Lead Clinician Margo Cohen has flown an average of 10 days a month throughout the pandemic.
“Margo has been travelling back and forth from her home on Maui to Honolulu this entire pandemic, including during quarantine, which meant upon her return to Maui she frequently had to self-quarantine at home due to island travel restrictions,” explained Executive Vice President of Patient Services Sharon Dudash.
“Our greatest responsibility is to the care and well-being of our patients,” asserted Cohen.
Perry, and Honolulu Health Center Manager Chellsea Delapena, both noted that despite the impacts of the pandemic, demand for reproductive health care is up.
“Our numbers have been steady, but I know we can see more patients,” said Delapena. Despite all the barriers facing patients, the need for reproductive health care is great.
Patients from outside Hawaiʻi have also come to health centers in Honolulu and Kahului for care. Until very recently, patients from Guam came to Planned Parenthood as their closest abortion provider – travelling up to 12 hours by plane one-way.
“We are still seeing one or two patients from Guam [per week] for abortion care,” said Delapena. She noted that the one provider now able to practice in Guam is not enough to keep up with the demand.
Protest Activity High at Honolulu Health Center
Delapena also mentioned an additional all-too-familiar barrier to care faced by patients all over the country: protestors.
Honolulu was the most-targeted health center among all six states of the Planned Parenthood affiliate, seeing over 100 security-related incidents in 2021, most related to protest activity.
“The protests are an ongoing, everyday thing,” said Delapena. “There have been numerous times where the police were called because protesters were either harassing my staff members or the patients, and sometimes [patients] come in crying or afraid to go back outside.”
Delapena said she and her staff are frustrated by the protestors, on the patients’ behalf.
“Some patients are too afraid to approach the front entrance where protesters stand,” she said. She noted the protestors can be a large crowd, and they often have young children with them.
According to Safety and Security Director George Collins, the official and best policy for dealing with protestors outside a Planned Parenthood health center is one of non-engagement.
Delapena emphasized that staff work with local authorities to minimize protestor impacts and put the comfort and safety of the patients as a top priority.
“It’s just one extra thing when getting care is hard enough,” said Delapena. She listed some additional barriers patients face: “Many people are out of work and without insurance. It’s so hard for them to seek care without income and insurance. And because of COVID-19 restrictions, patients can’t have their support person sitting there with them.”
To support Planned Parenthood health centers like Honolulu and Kahului as they navigate the myriad of barriers between patient and provider, please make a gift today.
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