Open AccessNational Breast Cancer Chemotherapy Program in Haiti
Author(s) -
Estefania Santamaria,
Jean Ronald Cornely,
Georges Dubuche,
Vincent DeGennaro
Publication year - 2016
Publication title -
journal of global oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.002
H-Index - 17
ISSN - 2378-9506
DOI - 10.1200/jgo.2016.004275
Subject(s) - medicine , breast cancer , cancer , christian ministry , family medicine , health care , nursing , economic growth , philosophy , theology , economics
19 Background: Project Medishare launched a breast cancer program in Port-au-Prince in 2013 at the request of local partners. In 2015, the program was expanded as part of a national breast cancer treatment program with Equal Health International. With the mission of strengthening Haiti’s Ministry of Health (MSPP) cancer care infrastructure, the program seeks to decentralize cancer care for women living up to eight hours driving distance from Port-au-Prince by building hospital capacity for cancer screening, diagnosis, chemotherapy and hormone therapy provision at outlying hospitals.Methods: In 2013, two physicians and three nurses were trained to handle, mix and administer chemotherapy by American nurses and doctors. To expand the national program in January 2015, 20 additional physicians and 32 nurses from all ten geographic regions underwent a three-day training in Port-au-Prince on treatment algorithms and practical training for breast cancer. As patients came in for treatment at the local institutions, Project Medishare nurses were on site to supervise mixing and administration of chemotherapy. Physicians continued their practical training via telemedicine to confirm treatment plans and dosage calculations.Results: By September 2015, onsite practical training and chemotherapy had occurred at the primary public hospitals in Gonaives, Jacmel, and Les Cayes. One physician and three nurses were fully trained at each site and seven patients with breast cancer have been treated thus far at the new sites. Future efforts will focus on quality improvement and continuing onsite training at the other hospitals as well as encouraging more doctors and patients to utilize regional programs instead of coming to the capital for treatment.Conclusion: To our knowledge, this is the first regularly-operating multi-site chemotherapy program in a low-income country. Our experiences may inform others to expand already established protocol-based cancer programs in low-resource settings. Next steps include working with MSPP to expand chemotherapy access to Cap-Haitien and to launch breast reconstruction programs through similar trainings in Port-au-Prince.AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.