Haiti has one of the world’s highest cervical cancer rates, but it doesn't have to. This slow-developing disease, which affects women in their prime, is perfectly preventable if we can reach them.
Haitian women also carry a
high burden of breast cancer,
lacking a system to diagnose
and treat the disease.
Ede Tèt Nou, whose name
means 'Helping Ourselves,'
takes the fight against these cancers to the countryside, bringing HPV self-testing and self breast exams to 1600 rural women.
Already we've screened 800 women using the HPV self-test and found an astonishing rate of positive high risk results --26%. This is the highest rate of positive cases in Haiti so far collected.
A network of community health workers is key to this effort, dispelling fears about women's cancers as trusted neighbors rather than scary foreigners.
HHP's Nurse Musak is treating all of the positive women with a new technology called thermocoagulation. Women with suspicious breast masses are examined by ultrasound by our partner doctors in the region. Women in need of a higher level of care are referred to our partner, Innovating Health International (IHI), in Port-au-Prince for treatment.
Our gratitude to IHI for providing the test kits and training; and to the Conservation, Food and Health Foundation and Women International Leaders of Greater Philadelphia whose generous support made this program possible.
HHP has been screening women for cervical cancer since 2013, using "see and treat" technique, testing over 2000 women in the region. “See and treat,” a means of testing and treating precancerous cervical changes in low resource settings, was developed by WHO in the nineties. Acetic acid applied to the cervix allows acetowhite changes to be observed by the examiner using a headlamp. Treatment with cryotherapy is offered at the same visit, which addresses the common problem of a follow-up encounter. In 2013 HHP Executive Director Louise Lindenmeyr began screening women in the region at 2 Ministry of Health clinics. A Haitian assistant was trained in the procedure, allowing extension to 8 different sites. The program expanded in 2014-17 with the training of 12 local nurses and doctors and supplied 3 clinics with the equipment to perform the procedures independently.
Ede Tèt Nou continues to use visual inspection with acetic acid with the added tools of HPV self-tests and thermocoagulation in effort to bring the highest standard of care possible to our women in the region.
A 27-year-old mother of four came to the clinic last year with breast cancer, shown above, that had metastasized to her chest wall. When asked how long she'd had this, she said she had been to a consultation a few years ago where a mastectomy was suggested. Fearing the stigma, she left, hoping it would go away.
A woman with a massive breast lump was finally able to get it diagnosed -- benign -- and removed by HHP medical director Roberto Peigne.
Such cases are why we undertook Ede Tèt Nou.
For reasons not well understood, high blood pressure is the most common diagnosis in our southeast Haiti.
Even in young people, the numbers are often staggering, threatening the entire family structure with the real possibility of death or debilitation of breadwinner or caregiver.
HHP's own Dr.
Antoine created Wi Memn
La to help communities
understand this disease
and its impact.
Dr. Antoine tapped our well-
established network of
community health workers to educate and screen 1,500 people in the most isolated villages. Over 300 of them were hypertensive.
He and a nurse will follow up with these patients, starting them on medication and continuing monthly with further blood pressure checks. Thanks go to our partner Americares for supplying the meds.
Much rests on our community health workers to make sure people follow up. If successful, the results of this project will be used to create an efficient model for reaching rural people with hypertension nationwide.
We would love to extend Wi Memn La to more villages in our region in 2019.
Dr. Antoine offers a hand-crafted GPS of his offensive against
hypertension, showing where the team has been and where they want
to go next.