Cervical Cancer Prevention in Haiti: "See and Treat" Method
Cervical cancer in Haiti is the # 1 cause of cancer death for Haitian women. Haiti has the highest incidence of cervical cancer in the world - a preventable disease in developed nations, but an agonizing death sentence in low-resource countries. Despite the obstacles found in low-resource settings, much can be done to decrease the incidence of this cancer, by identifying the precancer stage and treating it before it progresses. (In the US, and other developed countries, we have gone a step further, with prevention in the form of the HPV vaccine. But while this is being piloted in undeveloped countries, the cost and lack of infrastructure in these areas makes widespread immunization a yeoman's task.)
Preparing for our trip to Haiti, I spent months researching the needs of haitian women (and they are many.) As a gynecologist, I was drawn to their desperate need for a comprehensive approach to cervical cancer prevention. I found that David Walmer, MD from Duke University had long been working in southern Haiti with the same goals. He was extraordinarily kind to meet me, when I flew to NC to plan for the trip. I learned many things from Dr. Walmer, perhaps the most important message was to "under-promise and over-deliver."
Many studies in India and Africa have shown that inexpensive techniques, "screen and treat" in a single visit, can markedly reduce the likelihood of women in impoverished countries from dying from cervical cancer. Several well-established organizations (including Paul Farmer, MD, PhD's Partner in Health, pih.org, from Harvard and David Walmer MD, PhD's Family Health Ministries from Duke, famhm.org, are in different cities and villages in Haiti right now, working with Haitian physicians and nurses to reduce this preventable disease. These gifted physicians are fighting for equity in care for the women of haiti. we hope to join them in this battle.
After some fund-raising, as well as some crafty "borrowing", my colleagues at handsupforhaiti.org and I we were able to bring some medications and tools that we take for granted in new york and connecticut hospitals, that could make all the difference in preventing cancer, by treating early disease. Our primary goal was to support and offer tools to train the Northern Haitian gynecology residents about cervical cancer prevention and how it can be achieved in low-resource settings. We were able to get all the necessary equipment there, screen about 120 women and treat about 22 women with precancerous lesions with cryotherapy.
Handing over the equipment after my presentation felt like handing over a "torch" to the chief of gynecology, Dr. Cyril LeConte, a well-respected, talented physician. His residents in Northern Haiti's largest teaching hospital, Justinien, were open and enthusiastic about the project. I felt like a little candle was lit. I felt like i achieved what i hoped to in my first visit.
"Women's empowerment is intertwined with respect for human rights."
~ Mahnaz Afkhami
Cervical cancer in Haiti is the # 1 cause of cancer death for Haitian women. Haiti has the highest incidence of cervical cancer in the world - a preventable disease in developed nations, but an agonizing death sentence in low-resource countries. Despite the obstacles found in low-resource settings, much can be done to decrease the incidence of this cancer, by identifying the precancer stage and treating it before it progresses. (In the US, and other developed countries, we have gone a step further, with prevention in the form of the HPV vaccine. But while this is being piloted in undeveloped countries, the cost and lack of infrastructure in these areas makes widespread immunization a yeoman's task.)
Preparing for our trip to Haiti, I spent months researching the needs of haitian women (and they are many.) As a gynecologist, I was drawn to their desperate need for a comprehensive approach to cervical cancer prevention. I found that David Walmer, MD from Duke University had long been working in southern Haiti with the same goals. He was extraordinarily kind to meet me, when I flew to NC to plan for the trip. I learned many things from Dr. Walmer, perhaps the most important message was to "under-promise and over-deliver."
Many studies in India and Africa have shown that inexpensive techniques, "screen and treat" in a single visit, can markedly reduce the likelihood of women in impoverished countries from dying from cervical cancer. Several well-established organizations (including Paul Farmer, MD, PhD's Partner in Health, pih.org, from Harvard and David Walmer MD, PhD's Family Health Ministries from Duke, famhm.org, are in different cities and villages in Haiti right now, working with Haitian physicians and nurses to reduce this preventable disease. These gifted physicians are fighting for equity in care for the women of haiti. we hope to join them in this battle.
After some fund-raising, as well as some crafty "borrowing", my colleagues at handsupforhaiti.org and I we were able to bring some medications and tools that we take for granted in new york and connecticut hospitals, that could make all the difference in preventing cancer, by treating early disease. Our primary goal was to support and offer tools to train the Northern Haitian gynecology residents about cervical cancer prevention and how it can be achieved in low-resource settings. We were able to get all the necessary equipment there, screen about 120 women and treat about 22 women with precancerous lesions with cryotherapy.
Handing over the equipment after my presentation felt like handing over a "torch" to the chief of gynecology, Dr. Cyril LeConte, a well-respected, talented physician. His residents in Northern Haiti's largest teaching hospital, Justinien, were open and enthusiastic about the project. I felt like a little candle was lit. I felt like i achieved what i hoped to in my first visit.
- As David Walmer, MD, PhD, of Duke Medical Center said when presenting at the Haitian Ob/Gyn Society Meeting: “Haiti can be a leader in the development of protocols for cervical cancer screening in low resource countries."
- for more specific data and citations, please see the alliance for cervical cancer prevention: nccc-online.com.
"Women's empowerment is intertwined with respect for human rights."
~ Mahnaz Afkhami
|
Susan Malley, MD
Pediatric, Adolescent & Adult Gynecology |
Summit Health
3030 Westchester Avenue Purchase, NY 914.848.8800 |
Summit Health
1 Theall Road Rye, NY 914.848.8800 |
"Courage doesn't always roar. Sometimes courage is the little voice at the end of the day that says I'll try again tomorrow." MA Radmacher