By: Tadia Toussaint
MIREBALAIS, HAITI – Marie Melone Cadeau was diagnosed with stage three endometrial cancer. She traveled from her home in Les Cayes to Zanmi La Sante’s Hopital Universitaire de Mirebalais (HUM) for an operation in November 2015. The doctors promised her the results in five weeks. Instead, she received them five months later in April.
“It was draining, everyday we called and never got answers,” Cadeau’s daughter said. “If there was a lab right there, that would’ve made life so much easier.”
Cadeau’s case is not an anomaly at a hospital considered the best in Haiti’s fragile health care system. Her case is too familiar to many Haitians, who are unable to deal with the most mundane health care issue, let alone complicated surgeries.
Haiti’s porous health care system is the number one reason that the United States State Department continues to include the troubled Caribbean nation on a “no travel list,” according to a top diplomat in Port-au-Prince.
The lack of medical resources prohibits tourists from receiving urgent care should they encounter a medical emergency.
The patients living here with terminal illnesses have had it the worst; however a new lab is coming to answer all of their prayers.
Specimens from HUM no longer have to be sent to Boston, Zanmi La Sante (Partners in Health) headquarters, for analysis. A unique partnership with Brigham and Women’s Hospital, Newton-Wellesley Hospital, and Farber Cancer Institute in Boston allows HUM’s patient biopsies to be analyzed and diagnosed.
“We rely on travelers to manually transport specimen,” said Eva O’Brien, program associate for Partners in Health. The Center for Disease Control gave them a permit to transport blood but nonetheless she says “it’s something that customs (at the airport) is not used to.”
“Some specimen spend a day here, some spend 2 weeks,” head nurse of HUM’s oncology department, Yolande Nazaire,who has been working at the hospital since its opening, said. “We look for someone going to Boston and send it with them.” There are designated HUM employees who carry the specimen over to Boston.
Instead, HUM will be carrying the specimen across the parking lot to Mirebalais’ Reference Laboratory for Diagnostic and Research, an advanced laboratory building, scheduled to open this summer, where technicians will be able to process specimen and blood. Build Health International, a Massachusetts-based construction company and Haiti’s Ministry of Public Health and Population is building the facility.
It’s the only public laboratory of its kind in the country.
The existing laboratories at the hospital don’t have the capacity to test specimen. They lack resources, the instruments aren’t reliable and materials are often out of stock.
Initially, they started transporting up to 100 specimen a year; now, more than 2,000 specimen a year are collected for processing.
“The volume is drastically increasing,” O’Brien said. “People are realizing that they can get a different level of care at HUM that they can’t get anywhere else.”
“Some exams we sent since February, we still never received the results,” Nazaire said. And in some instances “the sickness gets worse on them because we don’t have the results to decide what medical procedures or treatment they need.”
Nazaire said more than 10 patients a day complain about the results not being available in a timely fashion. This week, she said the oncology department stopped taking specimens altogether.
“This is a very important milestone for us,” said Daniel Orozco, director of the prospective lab. “Coming to the US with a suitcase with 300 biopsies, it’s not an easy thing.”
Orozco said that Zanmi La Sante was issued permits to allow traveling abroad with the specimen however, “it is always an issue with the authorities to explain what we do, where the samples are from and where they are going.”
“Haiti is not the place to be sick,” Dr. Maxi Raymonville, director of HUM said.
Resources and physicians are very limited.
Earlier this May, a number of public hospitals including Port-Au-Prince’s L’Hopital de l’Universite d’Etat d’Haiti (General Hospital) joined to strike against the under-resourced hospitals and refusal of salary.
HUM is one of 34 in the country that trains medical school graduates (residents) while caring for patients.
“The new lab — if it keeps up with its promises, we’ll have the information when we need it,” resident Philippe Dimitri Henrys said. Henrys is one of the 200 residents of Haiti’s 400 graduating medical students who were accepted into a residency program.
“Eighty percent of young professionals leave the country,” he said. “I’ve always believed that people bring change. This is more than a duty for me, it’s a mission.”
HUM, one of Haiti’s largest non-governmental operating hospital, located an hour away from the nation’s capital served 100,000 patients last year. It opened in March 2013 and now has 12 service departments including outpatient, women’s health, surgery, emergency, mental health, pediatrics, adult inpatient, medicine, rehab, TB isolation , oncology, community health and maternity.
HUM is expanding vastly and is expected to be running to its fullest capacity by 2017.
Two Haitian pathology technicians are being sent for training in Boston for about a month, and will return to work in the new lab. Technicians from the states will regularly visit the hospital to provide the other Haitian technicians with additional training.
Specimen will be taken from the hospital, and the lab techs will then put them into paraffin slides and upload digital images of the specimen so that technicians from all over the states can help with the diagnosis.
The engineer of the new lab says the laboratory is scheduled to open this September. Like in the states, O’Brien says, the new lab will aim to get results to the patient in under 11 days.
The new lab will create opportunity for original research to take place in Haiti, broadening awareness and education on chronic and terminal illnesses. It will also create new jobs for technicians and other medical personnel.
If the experiment is successful- this lab will be the catalyst for improving Haiti’s healthcare system.