Helping Haitian Women Access Cervical Cancer Screening

By Paulina Ospina

January 23, 2014

Through Direct Relief’s partnership with Basic Health International (BHI) and the Fondation St. Luc, earlier this month nearly 600 women in Haiti were screened for cervical cancer and three more local providers were trained to screen – both essential steps in reducing the number of deaths from the disease.

Haiti has the highest incidence of cervical cancer in the Western Hemisphere, and most Haitian women have never been screened, according to the Pan-American Health Organization (PAHO).

Direct Relief launched the screening and training program in collaboration with BHI and St. Luc last year. This month’s training was the third course led by BHI and volunteers, who trained local providers in Haiti to screen for cervical cancer using Visual Inspection with Acetic Acid (VIA).

In an effort to provide a low-cost and efficient method of cervical cancer screening, BHI volunteer physicians trained Haitian providers from St. Luc Foundation and their affiliate, St. Damien’s Hospital, to use acetic acid (white vinegar) to highlight precancerous lesions; if present, the lesions are treated by freezing the affected area.

This method shifts the identification of precancerous cells from the laboratory, where the infrastructure of lab equipment and trained pathologists may not exist, to the clinic. A range of medical providers can be trained effectively in this method.

The training coincided with Cervical Cancer Awareness Month, which is intended to raise awareness of the importance of regular screening to identify and treat precancerous changes to cervical cells. Cervical cancer was the leading cause of cancer death for U.S. women until widespread testing was instituted, which resulted in a significant decrease in the number of deaths from cervical cancer over the past 40 years.

Sadly, in developing countries, where widespread screening is either not available or not affordable, cervical cancer remains a leading cause of cancer death for women; in fact, 88 percent of deaths from cervical cancer occur in the developing world.

In total, the program has trained 18 Haitian providers from St. Luc Foundation and St. Damien’s, ranging from Ob/Gyns, family practice physicians, midwives, and nurses, who screened 1,490 women over three week-long training courses. Through the program, two health promoters were also hired and trained to provide information on basic anatomy, cervical cancer, human papillomavirus, VIA and cryotherapy to women in their local communities. More importantly, St. Luc’s Klinik Manitane is now offering cervical cancer screening services to women in their community twice a week with a rotating staff of the newly trained providers.

The program will conclude later this year with a quality assurance visit by BHI Director of Haiti Programs, Dr. Rachel Masch, to observe and test the health providers performing VIA to ensure adequate comprehension of the material and delivery of the services.

Direct Relief has been pleased to provide funding and medical equipment to BHI and Foundation St. Luc to support the implementation of this program.