Sites: Leogane, Haiti

transparent image to hold imagemap coordinates

Duke Formalizes Partnership in Haiti/Celebrate Haiti Event May 2

Location: Léogâne, Haiti

Facility: Misyon Sante Fanmi Ayisyen

Organizational Affiliation: Family Health Ministries, Inc.

Site Preceptor: Delson Mérisier, MD; Director of Family Health Ministries Cervical Cancer Prevention Program in Léogâne

Background: In 1993, Dr. Jean-Claude Fertillien (affiliated with the now closed Hôpital Sainte Croix) and Dr. David Walmer (Duke University) began a collaborative effort to prevent cervical cancer in the Léogâne Commune of Haiti. As part of this effort, Drs. Fertillien, Noel, and Mérisier from Hôpital Sainte Croix received colposcopy training at Duke. For the first nine years in Haiti, this program was a part-time effort within the women's health care clinic. In 2002, support from Family Health Ministries (FHM) allowed the program to acquire a dedicated clinic site and staff to begin full-time screening and treatment for women. As of April 2005, the medical director, Dr. Mérisier, had screened 1,642 women and identified 64 advanced cervical carcinomas (3.9%).

Clinical Opportunities: Opportunities exist for faculty, residents, and medical students to participate in the cervical cancer prevention program at the new Misyon Sante Fanmi Ayisyen facility (opened January 2009), under the mentorship of Duke-trained physicians. The center is an outpatient facility housing a maternal child clinic, a cervical cancer prevention program, and pathology lab.

Research: Research in reproductive health and obstetrics and gynecology is encouraged. The Haiti-based doctors' evaluation of the limitations of care at the site inspired the development and testing of a portable battery-powered colposcope through collaborations with Dr. David Katz in Duke's Department of Medical Engineering. These data were published in the Journal of Acquired Immune Deficiency Syndromes 2004;37:S167-170. Drs. Walmer and Mérisier continue to investigate the effectiveness of single-day screening and treatment strategies for premalignant lesions of the cervix in Haiti, as well as the relationship between HIV and risk for contracting the human papillomavirus.