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How Blind Women Are Being Employed To Detect Breast Cancer

Photographed by Lauren Perstein
Entrepreneur and former gynaecologist Frank Hoffmann is combining his medical expertise and business prowess to solve two of modern life’s seemingly disconnected problems: the first – a lack of resources allowing for the early detection of breast cancer; the second – high unemployment among the blind. Through bold thinking, rigorous testing and sheer determination, he has launched Discovering Hands, a German initiative that employs blind women based on their heightened touch sensory capacity, to conduct thorough breast examinations that identify small tumours before they become life-threatening.

Those trained as part of the scheme are referred to as Medical Tactile Examiners, or MTEs. In addition to helping save the lives of breast cancer sufferers, Hoffman hopes that their example will serve to change perceptions of blindness being a limiting factor. Each MTE undergoes rigorous training to understand the physiology of the breast tissue and lymph nodes, as well as the wider symptoms and psychological impact of the disease.

“Many women, particularly younger women, feel uncomfortable about their breasts,” Hoffmann explains. Discretion being another of the scheme's happy consequences. “With Discovering Hands they are more relaxed, and able to sit through the examination while talking to someone who is trained to know everything there is to know about the disease.” An average examination lasts approximately one hour, almost ten times longer than the traditional examination conducted by GPs. During that time the MTE is also able to answer a patient’s queries and administer advice that is pre-approved by medical experts.

With Discovering Hands they are more relaxed, and able to sit through the examination while talking to someone who is trained to know everything there is to know about the disease and women’s health more broadly

So who does it target?

In theory, everyone. In the UK and Germany, mammograms are offered to women between the ages of 50 and 70. But that leaves out the high-risk 40-50 year-olds, for whom breast cancer is still the leading cause of death, despite early detection being their greatest hope in fighting it. Incidents of breast cancer rise considerably after the age of 35.

In Germany, where Hoffmann lives and works, as in the UK, any woman below the age of 50 seeking a mammogram without the referral of a doctor would ordinarily have to pay for the costly service out of their own pocket. Since Discovering Hands was co-opted by key medical insurance providers however, more than eight million women can now access MTEs without any extra cost. It has reached the point that Hoffman is worried about having enough trained individuals to cater to present demand.

Understandably, Discovering Hands has also attracted its fair share of scepticism. Hoffmann reminds those in the medical community who are distrustful of his idea that MTEs are always working in tandem with trained doctors. “They lend their well-trained hands to the medical professional, allowing them to make a more accurate diagnosis,” he insists. Tests are being carried out all the time to monitor, evaluate, and improve the service, including a lengthy assessment launched in 2015, the results of which are due to be published later this month; while research carried out as early as 2008 showed that blind women who had been trained according to Hoffmann’s system are able to detect lumps up to 50% smaller than those traceable by traditional methods.

A former gynaecologist, Hoffmann is also conscious of the problems caused to women’s health through a lack of political will to redress limited resources. He became frustrated by the speed with which breast cancer screenings were conducted, believing that five minutes was too short a timeframe for reaching any meaningful conclusions. He also realised that in order to circumnavigate the federal system, he would have to ensure that Discovering Hands was run privately. As a social enterprise, the business classification de jure and in this case an accurate summation, it enjoys full independence and the possibility of expanding elsewhere.
Revenues come via insurance providers and through selling a limited range of patented products. The Discovering Hands model can only be replicated through the purchase of orientation strips, for example, needed for conducting thorough and accurate examinations, and a subscription of the programme’s patented training manual. It’s a corporate model that will worry some, but Hoffmann fiercely defends his decision on the basis that this is the only way of providing quick and effective solutions to the limitations of the federal system, in order to reach as many women as soon as possible.

There are now 300 MTEs working across Germany, each able to examine between 500-600 people per year. But Hoffmann doesn’t want to stop there. Needless to say, in parts of the world with limited infrastructure and access to medical care, Discovering Hands could also be used as a viable alternative for women of all ages. While an alternative for men – detecting early symptoms of testicular and prostate cancer – is another long term option.

After attending a convention on disability in Barcelona, Hoffmann visited a think tank working in connection with the South American development bank, CAF. An investment was made to launch a pilot programme of Discovering Hands in Colombia that is due to end at the beginning of next year. Should it be deemed successful, Hoffmann believes that the programme will then be expanded for use in other countries across the continent. He has also recently launched a pilot programme in India, the results of which will dictate how the scheme will expand across Asia. With any luck, it might soon be available here too.