Fighting Cancer Among the Bottom Billion


Meet our guest bloggers: Jenna Kohnke, Program Manager, Global Access to Pain Relief Initiative (GAPRI) and Devon McGoldrick, Director, Community Programs & Engagement at the LIVESTRONG Foundation. Here they speak to an important partnership that’s making inroads toward cancer care in Haiti.

Tonight, PRI continues its series on global cancer, this time delving into one of the world’s poorest settings. Haiti has experienced its fair share of national tragedies over time, making it one of the least developed countries in most need of community-based programs and services. Recent disasters only have added to widespread impoverishment, and compound local health emergencies at the societal and individual level. In response, resources have flooded the country intended to address both immediate and protracted crises. While most of those rightfully have gone toward traditional development needs and infrastructure, LIVESTRONG Foundation has joined other organizations in supporting local cancer initiatives also critical for Haitians currently living with the disease.

Dr. Gueilledana Paul, a first-year family medicine resident, practicing cryotherapy during the HSN-Marimed Training. Photo by Dave Higgins

After seeing increasingly more cases of cancer in his clinic and having no capacity to treat these patients, Partners in Health founder, Dr. Paul Farmer, committed to expanding his agency’s pioneering medical services to include cancer screening and basic treatment. In October 2010, the LIVESTRONG Foundation awarded Partners In Health (PIH) and their sister organization in Haiti, Zanmi Lasante (ZL), a $1M grant to build a cancer care program in Haiti. The goal of this three-year grant is to build upon PIH/ZL’s existing health programs and partnership with the Haitian Ministry of Health to launch the first comprehensive and integrated cancer program across their clinical catchment area in Haiti’s Central and Artibonite  departments. PIH/ZL’s oncology program is now firmly established on the ground and led by a dedicated team committed to providing cancer education and screenings for the communities. Now entering the third and final year of the grant, the program already has screened and treated hundreds of patients; trained doctors and nurses in skills vital to the success of cancer detection and treatment such as breast exams, chemotherapy, and palliation; and integrated cancer awareness activities into community health and women’s health education efforts.


Social Worker Oldine Deshommes leads support groups for patients and their families. Photo: Partners In Health / Zanmi Lasante

Education and outreach activities build cancer awareness and sensitization, and are especially important in enabling earlier detection of cancer in the community and reducing stigma surrounding the disease. Local support groups have been instrumental in giving patients a comfortable forum to discuss their illness and support one another. The support groups have been incredibly successful, not only from a psychosocial point of view, but also in a community outreach capacity, as many of these patients become unofficial educators in their communities where they share their experiences and counter stigma and misinformation.

A new, three-year partnership between PIH and the Global Access to Pain Relief Initiative (GAPRI) will expand the ongoing cancer initiative to further address pain management and palliative care. GAPRI and PIH are working together to implement the Pain-Free Hospital Initiative, a hospital-wide quality improvement initiative to integrate pain treatment into service delivery by providing education for patients and staff, raising motivation and awareness, documenting pain levels, improving access to essential pain medicines, and communicating impact. With support from LIVESTRONG Foundation, the initiative will launch in January at St. Marc’s and Cange hospitals. GAPRI and PIH will work with local ZL staff, Ministry of Health representatives, training partners from Harvard Medical School, and local palliative care experts to tailor the program to the needs of each hospital and establish hospital-wide goals and objectives. The initiative will focus on motivating clinicians to evaluate and treat pain by using campaign-style materials and routine pain assessments by staff nurses. Project staff will offer continuing medical education programs for clinicians and nurses and distribute reference and training materials, including pain treatment guides and prescribing information, to equip each clinician with the tools to effectively apply standard treatment guidelines for pain treatment. The goal of this 3-year follow-on initiative is to achieve lower average pain scores among hospital inpatients and improve knowledge and attitudes about pain treatment among staff clinicians. More broadly, the project will address the issue of pain for the thousands of Haitians living with cancer or other chronic conditions like HIV/AIDS and build a case for replicating the model across the country.

Join tomorrow’s Facebook chat with PRI and foundation partners for a discussion about treating cancer among the world’s poorest of the poor.

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