Cervical Cancer Screening Sites in Northwest Haiti
Cancer of the cervix is both preventable and curable. However, it remains the leading cause of cancer-related deaths in women in the developing world. Data from the Pan-American Health Organization indicates that Haiti has the highest cervical pre-cancer and invasive cancer rates in the Western Hemisphere, and one of the highest in the world. Facilities for the treatment of advanced cervical cancer, the stage most cancers are detected in Haiti, are limited and essentially non-existent for rural Haitians. Haitian women suffering from cervical cancer are relegated to an inevitably cruel and painful death. Further, Haitian women are the “poto mitan” (central pillar) of the society, and it is particularly devastating for the family and community when they fall sick, or die. They care for the children, the elderly, and the sick. They are often the “bread winners”, and their work of selling in the market place goes on in spite of earthquakes, hurricanes, political unrest or a failing economy.
Since the opening of the MFP women’s health clinic at Alma Mater Hospital in May 2010, we have evolved a cancer screening program which is a model for hospital based screening programs in Haiti. What began as a cervical screening program has evolved into a women’s health initiative that screens for other sexually-transmitted infections (including HIV, syphilis), other gynecological disorders, breast cancer, and hypertension, and has incorporated an education program to instruct patients on behavior for healthy living.
We have screened 2,200 women in the single-visit screen and treat program at the Alma Mater Hospital in Gros Morne ("A" on map). Approximately two years ago, we began seeing patients at the dispensary at Pendu ("B" on the map), approximately one hour north of Gros Morne by van. The dispensary at Pendu is the model for the development of our mobile cervical cancer detection program. We transport supplies and equipment to Pendu once or twice per month. The program is promoted among the women in Pendu by Madame Marcelle, the community health worker (nurse), and has been enthusiastically supported by local women.
In October 2012, we expanded the program to the dispensary at Decostiere ("C" on map), which is located midway between Gros Morne and Gonaives. The program is championed among the women in Decostiere by Miss Marie Joseph, the nurse who runs the dispensary. Both Pendu and Decostiere dispensaries have gas-run electricity generators which enables us to do colposcopy. We bring a nitrogen oxide tank with us for cryosurgical procedures, as well as the necessary instruments and equipment to conduct the clinic. All women receive a full examination as described for the women’s health initiative at Alma Mater Hospital.
Working closely with Haitian health workers, we plan to open other cancer screening sites in the northern Haiti (see arrow on map), so that rural Haitian women may have the opportunity to live full and meaningful lives.