DISCOVERING HANDS – Germany

Visually impaired women are trained to perform breast examinations at medical facilities. Early studies show that they detect 30% more and 50% smaller tissue alterations. Hoffmann created a new profession for blind people teaching them a new skill set and a new service for women. The goals of the SI are providing a low-priced, effective breast cancer alternative while offering visually impaired people a working place and establishing a new product (specific braille strips). He founded a nonprofit organization in 2010 to spread the method which later turned into one for-profit social business and two non-profit entities.

Discovering Hands trains visually impaired women to perform breast examinations at medical facilities. The business model was founded in 2010 by Dr Frank Hoffmann who is married to Christine Hoffmann, a nonmedical practitioner. He came up with the idea in 2006 after a 19-yearsexperience in the field. In the early 1990s he established a joint private gynecological practice in Duisburg, Germany. Later, he founded a roundtable called «Quality Circle of Gynecologists» in Duisburg to standardize quality control in this medical field. An oncological clinic is part of the joint practice. He concluded in this time that the actual techniques for prevention and early detection for breast cancer don’t offer enough protection for women. Breast cancer is the most frequent cause of death for women between 40 and 44. It’s also the most common cancer type for women between 25 and 74. A quick detection of the tumour is essential as halving the time between the emergence and its detection usually means doubling the survival rate. In his opinion the problems in the health system are manifold. The routine mammograms are only offered to women aged between 50 and 69 years while 20 percent of breast cancer patients are under the age of 50. In 2005 the German government changed the law: every woman between 50 and 69 without clinical suspicion of breast cancer will be invited to a mammography screening every two years. (BFS, 2014) According to Hoffmann after the legislative change he could not «serve his patients with the quality of care he wanted» based on high costs for the mammography screenings. Additionally Hoffmann criticizes the regular procedure of prevention, palpation diagnostics, for younger women – physicians examine the breast in a standard female check-up once or twice a year while investing too little time in the process without a standardized or evaluated method. Germany has also the lowest participation rate for breast-cancer diagnosis in Europe.

The discovering hands® model aims at applying the extraordinary tactile capabilities of blind and visually impaired people in the enhancement of early breast cancer detection, while fostering positive mind-set change. Eligible blind and visually impaired women are trained as Medical Tactile Examiners (MTEs) via a 9-month training program carried out at specialized vocational training centers by certified trainers.

A first qualitative study shows that MTEs detect more 28% larger and 50% smaller tissue-alterations in the breast tissue than gynecologists. This globally unique concept, brings inclusion to the health care sector in a completely new way, because it allows for less harmful treatment and significantly increases patients’ chances of survival, while offering a meaningful and sustainable occupational field for blind and visually impaired women not “despite their disability” but because of their specific skill-set.

To date, 39 MTEs have been trained and employed in Germany, Austria and Colombia, more candidates will finish the course this year. Furthermore pilot projects already started in Delhi, India, Xalapa and Mexico.

In order to provide adequate infrastructure each MTE receives an equal set-up of her workplace including a computer with screen reading and/or magnifying software (e.g. JAWS or MAGIC respectively), a braille keyboard, massage bed, a stripe-dispenser, and a number of further necessary items to be able enabling her to adequately attend her patients and document their clinical histories.

Before the MTEs starts their job at the workplace, a sensibilization workshop is conducted with the team to make sure everybody understands the new situation, is comfortable with it and able to support each other adequately should the need arise.

The remuneration the MTEs receive is in accordance with the regular salary paid to doctors’ assistants or assistant nurses in the country in questions. Additionally, Discovering Hands offers career opportunities such assistant trainer positions for experienced MTEs, management positions in the social enterprise as well as in the association (e.g. HR, board-positions and PR).