When climbing aboard the Gynécobus, her step is hesitant: Marie (1) fears falling. But her smile and the way she extends her hand to ask for help from the caregivers who accompany her reveal all the confidence with which she approaches this examination feared by many women, and not only the most fragile.
It is just after 9 a.m. and the Gynécobus has just parked in the parking lot of the specialized reception center (MAS) La Route d’Espigoule, an establishment of the Umane group – the new name of Adapei in the Var – welcoming adults suffering from autism spectrum disorders.
A long process of getting used to
That morning, ten patients were listed on the consultation schedule that Maeva, the driver and administrative secretary of the Gynécobus, kept in hand.
She announces to Carla Rosanvallon and Laure Fabre, the midwives, and to Dr Gérard Grellet, the gynecologist, the arrival of Mélissa. The young woman, frightened, screams and struggles. Unlike Marie, she refuses to get on the bus. The team does not insist.
Laure Fabre and Sylvie Bonneau, the nurse from the establishment who came to accompany the patients, reassure her and decide to take her back to her room. That day, the consultation will perhaps boil down to taking tension… And working to build confidence, hoping that things go better the next time, or the one after that.
“As our residents live there for many years, we have time to work to get them used to these consultations, confirms Sylvie Bonneau. In general, they agree to a breast examination by palpation. But unless absolutely necessary, we do not do vaginal consultations, it is too intrusive, too stressful. If necessary, there is an ultrasound machine on board the bus. Before the invention of the Gynecobus, we had a visit from the midwife, but when we had to go and consult a gynecologist in town, it was very complicated!”
Initially, the Gynécobus team worked with the establishment’s psychologist. “We have developed pictograms to explain the procedure of the consultation. They are used before the arrival of the Gynécobus to prepare the consultation with the patient, to understand what she expects and what she authorizes. They also allow nurses and staff who support patients on a daily basis to include the consultation in the day’s program, to avoid destabilizing people who are easily distressed.”
The Gynécobus goes to accommodation establishments for people with disabilities at their request.
“This facilitates access to complicated care for these women, simplifies the organization for the establishments which welcome them but above all, it allows prevention, which is quite rare among populations “, summarizes Laure Fabre.
An asset for structures
“In a structure like ours, out of the way and located in a medical desert, it’s a double penalty, confirms director Jean-Maurice Airaudo. The fact that professionals come to us makes our lives a lot easier. For each consultation in town, even the most minor, it is necessary to mobilize two or three professionals who will accompany the resident, and with the travel time, this can take half a day. The arrival of the Gynécobus, and on the same model of HandiDent for dental care, it’s royal!”
“Especially, continues the nurse, that they are professionals aware of disability. That’s not always the case when we go to the city to consult, and it doesn’t always go very well – even if little by little, we build our network.”
Listening to them, the Gynécobus has only one fault: it is too… unique. On the La Route d’Espigoule side, we would love for the model to spread to ensure consultations for other specialties. “A cardiobus for our patients who often take neuroleptics, an ENT bus because there are a lot of earplugs… That would be great!”
1. The first names of the patients have been changed.