A grass roots healthcare revolution is under way in Bermuda. With many men — particularly those lacking health insurance — reluctant to go to the doctor, two doctors decided they would go to the men instead.
The result is the DailyMale Clinic, a charity providing free health screenings to men over 40, targeting the uninsured and underinsured. Since its launch two years ago, DailyMale has screened over 300 men and diagnosed ten cases of prostate cancer, most of which would have otherwise gone undetected until it was too late.
The co-executive directors and co-founders are Jonathan Makanjuola, consultant urologist at King Edward VII Memorial Hospital, and K Jade Robinson, a Master of Public Health.
A series of monthly, four-hour, pop-up clinics at venues including sports clubs, workmen’s clubs and the Bermuda Industrial Union, have been a powerful draw. Supported by a pool of 100 volunteers, including nurses and doctors from across Bermuda’s healthcare services, the clinics have seen an average of six men per hour.
The next clinic is scheduled for June 14, from 9am to 1pm, at the Freemasons’ Hall in Hamilton. Visitors will be seen on a first-come, first-served basis.
Having registered as a charity in 2024, the DailyMale raised money for a fully outfitted mobile clinic, which cost about $150,000, funded by generous contributions from organisations including pharmaceutical company Roche, Argus, and the Lahey Clinic in the US. The vehicle will overcome many of the heavy labour and logistical demands of pop-up clinics.
Dr Makanjuola, who moved to Bermuda from the UK three years ago with his Bermudian wife, realised the need for this service soon after he arrived.
“In my first week at work, I saw three cases of prostate cancer that had spread to the bones,” he said. “In the UK, I might see one such case every six months, but here it was three in a single week.”
All three cases were uninsured men, who had not been screened. It highlighted an alarming gap in preventive care for prostate cancer — a condition disproportionately affecting Black men.
“It wasn’t just a medical concern,” he said. “It was a health equity issue. The men who couldn’t afford insurance were also the ones most at risk.”
Prostate cancer is the number one cancer affecting males and accounts for 33 per cent of cancer diagnoses in men in Bermuda. The prostate gland, which is at the base of the bladder, tends to swell up as men get older. Sometimes, the cells can become cancerous and spread to other parts of the body.
“Men have no symptoms in the early stages, but symptoms like blood in the urine or difficulty in urinating happen at a later stage,” Dr Makanjuola said. “If you catch it early, prostate cancer can be cured.”
The mortality rate for prostate cancer in Bermuda is twice that of the average in Organisation for Economic Co-operation and Development countries. Too many cases are being detected too late.
Regular screening is a key part of the solution. This can be done through a prostate-specific antigen (PSA) blood test. Elevated levels of PSA may be an indication of prostate cancer.
Visitors to the DailyMale Clinic take a finger-prick blood test. Thanks to the point-of-care machines, PSA results are available in just ten minutes.
The Bermuda Hospitals Board launched new guidelines on prostate health and PSA testing in February this year. They recommend screening should start at age 40 for Black men or those with a family history, and from age 50 for all others. Bermuda is the first country in the northern hemisphere to adopt this proactive stance on prostate cancer, Dr Makanjuola said.
There has been a change of approach, moving away from the traditional digital rectal examination, avoided by many men through fear or embarrassment, and “one of the biggest barriers to screening”, according to Dr Makanjuola.
“Instead, we start with the PSA blood test and, if it’s elevated, then see your doctor or specialist, and we can then do an MRI scan, which is the gold standard now,” he added. “That change of approach is helping to increase the number of men being screened.”
Already, DailyMale’s impact has been considerable. Men who had not seen a doctor in years have visited for screening. Some walked away with peace of mind, others received life-saving early diagnoses. Scott Pearman, CEO of the BHB, has said the impact of DailyMale has “exceeded all expectations” and “helped to remove barriers to care for men in Bermuda”.
The clinic has tried to break down some of the barriers to healthcare that it has recognised: lack of coverage for uninsured seniors, high insurance costs, mistrust in healthcare and the fear of unwelcome test results. Its response has been to build trust through partnerships and a focus on compassionate, free healthcare access.
Clinic visitors who feature in a video on the DailyMale website give glowing reviews, praising the efficiency and ease of the screening process, and the “inspirational” and knowledgeable staff.
The new mobile clinic will enable the charity to be opportunistic, bringing healthcare to events like football matches and golf tournaments, reaching men in environments where they feel comfortable.
In addition to prostate screening, the DailyMale Clinic also offers heart health exams, blood pressure checks, and advice on matters including diet, giving up smoking, and getting further support and referrals. The clinic’s data shows visitors have an average age of 64, the majority are uninsured and 95 per cent are Black. Test results found 17 per cent had abnormal PSA levels and 58 per cent had high blood pressure.
Dr Makanjuola sees expanded potential for the van, and perhaps others like it, to be used for diabetes screening, mental health check-ups, and other types of healthcare outreach. His hope is that the DailyMale model will may also one day be adopted across the Caribbean region.
“Around the world we’re moving away from the model of going to a hospital or doctor’s office for healthcare,” he added. “I think Bermuda has to catch up and understand that people can access healthcare in a variety of different ways.”
- For more information, visit the DailyMale website at www.dailymaleclinic.com
