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Hope in Haiti for Better Cancer Care

The IAEA is working to support proper treatment of cancer patients in Haiti, who hold out hope that their illness can be detected and treated in time. (Photo: N. Whalen for IAEA)

Port-au-Prince, Haiti -- Aubry Jean Roberts is one of many women with cervical cancer who fill the hot, airless obstetrics and gynaecology ward at the General Hospital in Haiti´s capital, Port-au-Prince. Outside the ward, cancer is a little-known disease in this country, and there are few options for treatment.

Softly spoken, Aubry says she is very hopeful that surgery can cure her. Her husband nods and reaches for her hand. The couple have a newborn daughter and a three-year-old son.

"Often we´re forced to send patients home to die. They die in a very bad situation. You can say an inhuman situation," says Dr. Jean Cornely, a gynaecologist who will perform Aubry´s surgery for free at the hospital.

Cutting out tumours is Dr. Cornely´s mainstay. There are no radiotherapy facilities in Haiti. "It´s frustrating," exclaims the doctor. He knows when combined with radiotherapy, it could give patients like Aubry a true fighting chance. The cure rate for women with cervical cancer is 65% when treated with radiotherapy. Even for advanced cancers, half the women can be cured.

While national data is sketchy, the incidence of cervical cancer in Haiti ranks among the world´s highest, according to the Cancer Atlas produced by the World Health Organisation and other cancer control bodies. The Atlas estimates the incidence of cervical cancer to be three times that of island neighbour Dominican Republic and 12 times higher than the US. In affluent countries early detection through screening has effectively combated the disease, with patients typically offered simple and effective treatment.

However, the reality for Haitians is that women are rarely screened, diagnosis comes too late, and adequate treatment is just not available. Aged 35 and a mother of three, Roseline Fleuristene has cervical cancer. She wishes to go to the Dominican Republic for radiotherapy -- to fight to stay alive. She cannot afford it.

"We say to patients the three M´s -- Maison, Manger, Mort -- Home, Eat, Death," says Gustave Dabresil, a young doctor who works in a clinic in the country´s South. He estimates that only 10% of cancer sufferers can afford to go abroad to countries like Cuba or the Dominican Republic for treatment.

Gustave is eager to learn to use radiotherapy technology to save lives. "It´s my country, my people, I want to help, not send people home," he says. The IAEA is organizing support to young local doctors like Gustave and Frantz Claveus to undertake three years training as medical oncologists at specialised hospitals in Canada.

Training the necessary staff is a first step. It´s part of wider IAEA efforts to support Haiti to establish a national cancer treatment centre, capable of delivering radiation therapy. Dr. Cornely is spearheading the construction of the centre –- to screen, diagnose and treat patients like Roseline and Aubry. An architect has drawn up the plans, free of charge. And the IAEA stands ready to help equip the facility with radiotherapy units and diagnostic equipment when the hospital is built. The radiotherapy machine will be used around the clock to keep pace with demands for treatment. The number of patient referrals to the centre would be around 2000 a year -- of these, about half would be women with cervical cancer.

Nurses Myrmonde Amazau Pierre, Marie Odile Betina Jeune and Jean Panyauty Cornely will also be trained as radiotherapy technicians in Canada, with IAEA support, as part of larger efforts to ensure the effective, safe and secure use of the equipment at the new facility.

Radiotherapy also offers significant pain relief to patients with advanced cervical cancer. Even a short dose of radiation can stop the bleeding, help patients to control their bladder and relieve severe pain.

"Cancer is seen as a disease of the rich, the aged; a disease of Europeans and Americans, but not here. More than half of new cancer cases occur in developing countries, where it is a leading cause of morbidity and mortality," the Head of the IAEA´s Programme of Action on Cancer Therapy (PACT), Massoud Samiei, said. Some 200,000 women in developing countries die each year from cervical cancer.

IAEA Deputy Director General and Head of Technical Cooperation, Ms. Ana María Cetto, recently visited Haiti to speak with President René Préval, Prime Minister Jacques Edouard Alexis and Health Minister Dr. Robert Auguste about reinforcing the technical cooperation programme of Haiti. Ms. Cetto expressed the IAEA´s commitment to providing support to training professionals for the re-establishment of radiotherapy in the country as part of this comprehensive national programme for cancer control.

"Haiti is making important steps in the planning and design of what will be a very complete cancer facility that will be used not just for treatment, particularly for radiotherapy, but also for diagnosing cancer. We have been having serious talks with the various authorities to make sure they take the decision as early as possible to go ahead with the comprehensive integrated approach on cancer therapy which involves national financing to construct this facility," Dr. Cetto said.

It is unlikely the national cancer centre will be built in time to help Roseline and Aubry fight their disease. But for Aubry´s newborn, and the country´s youth, it´s a small investment for their future.

Last update: 27 Jul 2017

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