LACONIA — It's the end of one chapter and the beginning of another for nurse practitioner Nancy E. Dirubbo as she prepares to close the Laconia Women's Health Center to concentrate on a new venture, the Travel Clinic of New Hampshire, which will provide preventive medical care to international travelers.
Dirubbo said when she started the Women's Health Center in 1985 on Union Avenue, the attitude toward women's health issues was very different.
"Nobody was doing much in those years," she said, noting she had been working at at clinic in Plymouth and the law had recently changed to allow nurse practitioners to prescribe medicines.
"I was making money for someone else and I thought, I could be doing this for me," she said.
But her mission in opening the Women's Health Center — one of the oldest and longest lasting nurse-practitioner-owned clinics in the country — was something other than the financial benefits of owning her own business. She said she was able to give women the educational and emotional support they needed as well as the medical care.
"I didn't just treat 'em and street 'em," she said.
In the 1980, said Dirubbo, there was no information out there for women about their own bodies. She said the public libraries wouldn't carry the book "Our Bodies Ourselves" so she started a small lending library from her office so women could get some information on their own. "Women were starved for information," she said.
Over time and with the advent of the Internet, Dirubbo said women gradually became more knowledgeable about their own bodies.
"I think women are much more informed, but now they are on overload," Dirubbo said.
The problem she sees in many cases is that too much information comes direct from the advertisers to the consumers and not enough people let the medical experts make the medical determination.
"In my generation we had anxiety because we didn't know what was happening. This generation has anxiety because they think everything they see will happen to them," she said.
"Sometimes they'll see a commercial and come in and ask for a specific drug," she said, noting that most of the time, the patient has no idea why they want this particular drug. "Kids today learn that all solutions come from a bottle."
When asked what is most noteworthy in women's health other than awareness, she said she sees far fewer unplanned pregnancies than she did in the 1980sand credits that to advances in long-term birth-control medicine.
She said that she decided to make the business transition from women's health to adult immunizations because of her own personal travel experiences, recent education achievements, and a friend who has a similar clinic in New York state.
"I thought, that's what I can do when I grow up," said Dirubbo, who noted that Travel Clinic of New Hampshire will operate from the Women's Health Center's present location.
Dirubbo recently earned her doctorate in Nursing Practice from Northeastern University and her work was focused on adult and geriatric immunizations. She spent two weeks in Dublin, Ireland, participating in the International School and was an invited speaker to the International Council of Advanced Practice Nursing in Helsinki, Finland.
She noted that most colleges require some type of student trip, people are traveling for adoptions, and visiting friends and relatives. Dirubbo said she has clients who own second homes in other parts of the world that still struggle with diseases like malaria, hepatitis A, yellow fever, and diphtheria.
She said even people who have been immunized against many of these diseases years ago should consider updates or boosters when traveling for pleasure to certain areas of the world.
As an example, she said people traveling to Pakistan would need a polio booster, and most people don't know that a diphtheria vaccine is only good for five years.
"Parents will come in and know every vaccine their children have, but when I ask them about themselves, most can't remember," she said.
Dirubbo said the recent measles outbreaks in the United States stemmed from European travelers coming for vacations and to visit family.
"It's not just a issue of whether the traveler stays well, it's also a public health issue," she said.
Dirubbo said in order to store and offer the vaccines, she had to pass a test offered once a year by the International Society of Travel Medicine but she was fortunate because the year she passed, the test was offered in Boston. She started Travel Health N.H. in 2008.
She said at one point the U.S. State Department contacted her because they were out of yellow fever vaccine and she had some.
Dirubbo will continue with the Laconia Women's Health Center until March 31 and is working on finding primary care doctors for her clients.
After that, her company, which will continue on in the same Union Avenue location as Travel Health of New England will be doing only travel vaccinations and advisories.
Each visit, she said, lasts and hour and, unfortunately, most of her vaccination services won't be covered by insurance. She said a couple traveling or a family traveling will be counted as "one visit" although they will have to pay for each vaccine.