"Care beyond the Walls': breast and gynaecological prevention in Bollate prison

Taking care of women living in socially fragile conditions is an integral part of the mission of the Fondazione Libellule Insieme. With this objective in mind, "Cura oltre le Mura" was born, a breast and gynaecological prevention project within the Bollate Prison, with a complete programme aimed at women in prison: in one year, more than 500 specialist visits, bilateral breast ultrasounds, mammograms, gynaecological examinations, transvaginal ultrasounds and pap smears, carried out on dedicated days, organised within the prison to ensure accessibility and continuity.

The project stems from the awareness that imprisonment profoundly affects women's psychophysical wellbeing: often, shortly after entering prison, there are deteriorations in health, early menopause and a progressive abandonment of self-care. Prevention therefore becomes an essential tool to detect possible pathologies early and to improve the quality of life, both during detention and in the delicate moment of social reintegration.

'Cura oltre le Mura' is characterised by a multidisciplinary and highly personalised approach: a medical team composed of senologists, gynaecologists and radiologists, who collaborate permanently with the Foundation, welcomed and accompanied each woman on a path that integrated clinical, psychological and emotional aspects, providing not only high-level medical expertise, but also great human sensitivity. Particular attention was paid to reconstructing medical histories, often made difficult by the absence of complete clinical documentation. In some cases, it was necessary to involve family members to retrieve useful information and previous reports. Where familiarity with oncological pathologies emerged, patients were made aware of the importance of extending preventive checks to first-degree relatives as well, extending the project's impact beyond the prison context.

Alongside clinical screening, the project promoted intensive educational activities on cancer prevention and the importance of early diagnosis, with informative meetings and practical tools to promote awareness and autonomy in self-care. Participation exceeded 80% and, in addition to the health results, the human value of the initiative emerged above all: many women felt listened to, welcomed and respected, not only as patients. This approach fostered a concrete change in their attitude, made them more open to dialogue and more serene and participatory in the proposed pathway, and gave them the sense of finally being at the centre of respectful and non-judgmental attention, making them experience the pathway as not only a clinical but also a relational care experience.

"Cura oltre le Mura" is not just a health intervention, but a concrete sign of inclusion: a gesture of attention and closeness towards women who are too often invisible, to reaffirm that the right to health is universal and must be guaranteed to all, without exception. This is why it does not represent a point of arrival, but the beginning of a broader path. The objective is to continue to bring prevention to the most fragile contexts, progressively expanding the health offer also through new collaborations, such as the one with IMI - Intergruppo Melanoma Italia to introduce dermatological examinations dedicated to the prevention of melanoma, an aggressive but curable tumour if diagnosed early, and other malignant skin tumours.