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Women's
Health - Family Health Ministries in Leogane, Haiti
Since 1993,
FHM has been working in Leogane, Haiti.
Our focus there has been cervical cancer prevention. As time goes on, our
service to the community is expanding.
- The cervical cancer program continues, including follow up treatment for those who test positive
- Another program called Safe Motherhood, recommended by FHM's local women's group, commenced in Summer 2010
- FHM continues to raise funds to build a hospital on 10 acres of land purchased in 2007
.CERVICAL CANCER PREVENTION PROGRAM
Statistics on FHM's Efforts
FHM PATHOLOGY LAB
HAITIAN FHM
HAITIAN IRB
LEOGANE
FAMILY HEALTH & RESEARCH CENTER
LEOGANE WOMEN'S GROUP
LEOGANE OUTPATIENT CLINIC
PORTABLE COLPOSCOPE (CERVISCOPE) DEVELOPMENT
SPONSOR A CERVISCOPE
 
Since the earthquake:
- Debris clean up (pictured above left) from the collapsed second floor the the Leogane Clinic is complete
- Plans are complete for the new second floor; construction is planned to begin immediately (July 2010), creating space for visitors (above right)
- The women's group has resumed in spite of the death during the earthquake of their leader. During Summer 2010, the group advised Safe Motherhood program workers, including Duke Engage students doing "verbal autopsies" to discover the circumstances of maternal deaths.
 
Above - Jackie Ndirangu (left), FHM's research coordinator, ensures that samples are properly labeled. Patients who are waiting complete consent forms and health questionnaires.
LEOGANE FAMILY HEALTH & RESEARCH CENTER
In Summer 2007, Family Health Ministries purchased land in Leogane, Haiti, to build a health center where we will continue the work of the previous 15 years, fighting cervical cancer in under-resourced communities while enhancing our service to women and children in the Leogane community.
A phased plan for the new center with budget and drawings is available at
Leogane Family Health & Research Center
Phased Plan. You can also view the most recent architect drawings by Hite & Associates.
LEOGANE WOMEN'S GROUP
Extending the work started by Dr. Rachel Peragallo and Duke Engage students in Spring and Summer 2009, FHM employee Wilkens Oscar has helped a women's group form in Leogane. The group's purpose is to help Family Health Ministries build and sustain healthy families across the community. Their first projects will be focused on neonatal care and a birth registry.Post-earthquake update: The head of the women's group was sadly killed in the January 12th earthquake. Since the earthquake, the group has met and distributed funds for home repair and rebuilding, thanks to FHM earthquake relief donors. Pictured below are the woman receiving their money.
The first steering team: Violette Jean Baptiste (left above), a laboratory medical technician in Leogane, was elected as the group's counselor. Sonala Louis, (middle above) a local manager and the new coordinator. Merlande Nelson (right above) is a dressmaker and was elected as the group's secretary.
Leogane Satellite Outpatient Clinic in March 2009
(First floor is completed and in use.)
LEOGANE SATELLITE OUTPATIENT CLINIC
FHM's satellite outpatient clinic opened on the 22nd of January 2009. This clinic will be the base for Family Health Ministries until the Health & Research Center is open, after which it will continue to be used for emergencies, evening apointments and other FHM activities.
Haiti's infant mortality rate is very high, the worst in the Western Hemisphere, at 60 per 1000 births, per UNICEF, compared to the US at 7 per 1000 births.
FHM aims to improve these dreadful statistics in the new facility which will provide pediatrics and hospital care as well as prenatal care, deliveries, and FHM's cervical cancer prevention program.
FHM's new satellite clinic marks a major step for the people of Leogane, providing free healthcare to mothers who are indigent. After Hopital St. Croix's closing in January 2008, families had to travel to Port-au-Prince or do without expert care.
In March 2009, the cervical cancer prevention program moved to the outpatient clinic.
After the earthquake: below, left, second floor collapsed into stairway as seen from the first floor. Right - see bright green and white building in top right of picture, with the entire community around the clinic devastated.
 
Below - Dr. Kris McCain, an early responder, with a baby delivered soon after the quake.
CERVICAL CANCER PREVENTION PROGRAM FHM's current collaboration
in Leogane with Dr. Delson
Merisier, OB/GYN has included screening women for
the human papilloma virus (HPV), the primary
cause of cervical cancer, a curable disease in higher resource countries but one
with devastating consequences for untreated women and their families.
In Leogane, women queue for the privilege of being tested (below).
  
  
Among resource-poor nations, Haiti has one of the highest incidences and
mortality from cervical cancer. Similar findings prompted
FHM to partner with the community of Leogane to develop a cervical
cancer prevention program in 1993, most recently working out of
Hopital St. Croix and Hopital Cardinal Leger. In March 2009, FHM moved the program to their new outpatient clinic.
Today FHM’s program is developing and testing novel screening strategies
with the goal of expanding access to preventive
therapies and reducing the morbidity and mortality of cervical cancer in
Haiti. These novel strategies include liquid-based cytology, HPV DNA
screening, and portable colposcopy with a device that FHM invented
called the CerviScope.
The importance of these efforts was recently emphasized by
a study sponsored by PAHO & the CDC, which estimated that without better
screening strategies, cervical cancer deaths may double in the Caribbean
by 2030.
Statistics on FHM's efforts -
Since Fall 2007, FHM has screened more than 8000 women for HPV. About 18% test positive. Followup, including colposcopy, cryogenic treatment and hysterectomies are all being provided by Dr. Delson Merisier, FHM's OB/GYN in Leogane, and Dr. Junior Duliepre, FHM's OB/GYN at the Blanchard Clinic.
Team members from the Blanchard Clinic, the Cite Soleil Clinic, and volunteer Elizabeth Pritts, MD, Ob/Gyn
collaborated to screen 2100 women in record time in June-July 2009
Read more about the Blanchard/Cite Soleil Project
In March 2009, Duke medical student Michelle Graziano (below left) helped advance the clinical trial for another 1000 women. In June 2008, volunteer Dr. Elizabeth Pritts worked in Cite Soleil Clinic with Jackie and her team. FHM also collected samples in the Blanchard Clinic for several weeks, adding 2100 more women to the screened group. (updated July 2009)
HAITIAN FHM
May 19, 2009 marked
the first board meeting to form Misyon Sante Fanmi Ayisyen (Haiti
Family Health Ministries in Creole). The purpose of this new foundation is to expand the US
Family Health Ministries' ability to serve more patients in Haiti.
Board members include several Haitians, several Americans, and one Haitian
American. The office for Misyon Sante Fanmi
Ayisyen
is
located in Leogane, Haiti.After the foundation is established, FHM plans to pursue NGO status in Haiti.
HAITIAN IRB FOR FHM
An IRB is a committee of physicians, statisticians, researchers, community advocates, and others that ensures that a clinical trial is ethical and that the rights of study participants are protected. All clinical trials in the U.S. must be approved by an IRB before they begin. FHM's Haitian IRB will ensure the same consideration for Haitians. The IRB continues to meet, approving new protocols and reviewing the progress of past approvals. Agreed projects include a survey of the women of Leogane to ascertain their health needs (see story below).
ASSESSING HEALTH NEEDS IN THE LEOGANE COMMUNE
One of the projects approved by FHM's Haitian IRB (above) is third year resident Rachel Peragallo's community survey in March 2009. The survey aimed to obtain the women's assessment of their own health care needs, and the needs of the community. Rachel's assistant and translator is FHM employee Wilkens Oscar (standing below).
In June and July 2009, Duke Engage students advanced the local assessment by interviewing more women and by mapping the healthcare facilities in Leogane. Returning in Summer 2010, they remapped the healthcare facilities since their data was now obsolete, given the earthquake. And, they began the Safe Motherhood program by doing verbal autopsies to assess the circumstances of maternal deaths.
PORTABLE COLPOSCOPE DEVELOPMENT - FHM'S CERVISCOPE
Another
significant area of FHM's research in Haiti is the
development and testing of the portable
colposcope. The colposcope is used to diagnose cervical cancer.
This tool, typically large and
requiring electricity to run, is too expensive to operate
in low-resource clinic settings. However, the
colposcope is critical to diagnosing and treating cervical cancer.
Therefore,
FHM collaborated to develop a portable colposcope that is both
lightweight and able to run on batteries. FHM calls the portable colposcope a "CervisScope."
July 2009 CerviScope model
In
early July 2008, FHM received its first sponsor for a colposcope to be used in a
clinic in Langano, Ethiopia with the generous donation from a family in Rochester, NY. The first unit was shipped in early September to nurse practitioner Kim Scheel, of Serving in Mission. FHM's second colposcope was sold to Kristina McCain MD, of
Health Talents International, Guatemala, who has since used it in many other countries, including in Haiti where she trained FHM's Ob/Gyn in Blanchard, Dr. Junior Duliepre .
CerviScopes are also being used in Haiti, India, Kenya, Nigeria and other locals.
The first of the latest models of the CerviScope (picture above of the improved version) was shipped to Haiti in July 2009 for use in FHM's Blanchard Clinic.
In December 2009, FHM received a large grant from Goldman Sachs to produce both 200 CerviScopes and to do colposcopy education.
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