Cancer

Haiti: Battling Cervical Cancer Where Most Prevelant

Cervical cancer screening services officially opened this month at St. Luc Fondation’s Klinik Manitane in Haiti, which Direct Relief, in partnership with Basic Health International (BHI), is supporting to bring much-needed gynecological preventive services to underserved women in Port-au-Prince.

Haiti has the highest incidence of cervical cancer in the Western Hemisphere, seeing rates of cervical cancer 13 times higher than in the United States. Cervical cancer is currently the leading cause of female cancer death for women in Haiti. Implementation of effective screening and treatment methods has shown to have a significant impact in reducing morbidity and mortality from cervical cancer.

Coinciding with the opening of these screening services, Dr. Rachel Masch from BHI and her team of volunteer physicians and nurses traveled to Haiti for the second of three training delegations for local providers in visual inspection with acetic acid (VIA).

VIA is a low-cost and safe alternative for cervical cancer screening implemented in settings where lack of infrastructure and resources make traditional Pap smears inaccessible for most.

VIA uses acetic acid (a low-cost vinegar) to swab the cervix or lower part of the womb. Pre-cancerous cells can be visualized as white lesions and immediately treated with cryotherapy – an 11-minute treatment to freeze the affected cervical tissue.

Women with VIA positive tests are able to go home immediately after cryotherapy treatment with minimal disruption to their daily routine.

In this second delegation, eight midwives from St. Damien’s Hospital in Port-au-Prince were trained by BHI personnel. Midwife trainees received formal instruction as well as hands-on training.

Over the course of the delegation, 362 women from the local community were screened for cervical cancer, many for the first time. Of those women, 19 percent had positive VIA results with 16 percent of women receiving cryotherapy. Five percent of women were also treated for vaginal infections.

The week following training, the midwives put their new skills to work at Klinik Manitane, where they have incorporated two days of rotation for the new VIA/cryo clinic in addition to their delivery duties for St. Damien’s Hospital. In the two weeks since completion of training, 87 women have received screening at Klinik Manitane as well as cervical cancer education by the two community health promoters now employed through the program.

Direct Relief is supporting BHI and St. Damien’s Hospital/St. Luc Fondation with funding and donations of medical equipment and medicines to support the implementation of the program. An additional training delegation will take place in 2014 followed by quality monitoring by BHI to ensure successful implementation and support of the program.

Paulina Ospina, Senior Program Manager

Paulina Ospina joined Direct Relief in 2009 with prior work experience in the pharmaceutical industry and clinical research. Paulina’s background is in public health and she has worked with underserved populations in primary care clinics both abroad and in the United States. Paulina is responsible for the day-to-day operations of Direct Relief’s Replenishment Program which provides an alternative to traditional Patient Assistance Programs for safety net clinics to access medication for their uninsured, low-income patients. Fluent in Spanish, Paulina holds a Master in Health Science in international health from Johns Hopkins School of Public Health as well as a B.A. in biological anthropology and anatomy from Duke University and an M.A. in anthropology from the University of California, Santa Barbara. She is a certified clinical research coordinator and a member of the Association of Clinical Research Professionals.

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