New Alliance Aims to Improve Cervical Cancer Care and Prevention in Haiti

Although cervical cancer is highly preventable, it’s been a devastating health burden in Haiti for many years. The rate of cervical cancer in Haiti is 13 times higher than that in the United States.

For more than two decades, associate global health professor and OB/GYN physician David Walmer and his wife, adjunct associate professor Katherine Walmer, have been working to reduce the prevalence and severity of cervical cancer cases in Haiti. In 2000, they founded Family Health Ministries (FHM), a non-profit organization that supports Haitian communities in building and sustaining healthy families. FHM is also one of Duke Global Health Institute’s priority partners. 

And now, the Walmers have extended their efforts to fight cervical cancer through Haiti sans Cervical Cancer, a non-profit organization they co-founded that has helped bring together some of the world’s foremost NGOs to revolutionize cervical cancer care in the country.

Collaboration is Essential for Success

The UN has estimated that Haiti has more non-governmental organizations (NGOs) per capita operating within its borders than any other country in the world, and despite their best intentions, these isolated health care initiatives are rarely coordinated with each other or the Ministry of Health. This lack of coordination usually results in inefficient, ineffective efforts to solve public health challenges.  

However, with persistence and a commitment to developing successful partnerships, progress is certainly possible—even in the toughest of places. Walmer hopes HsCC will help create a new paradigm, changing the way that NGOs work with each other and Haitian health care leadership.

Patience and Persistence Lead to Haiti sans Cervical Cancer

In 2013, Walmer, and the Family Health Ministries team presented their cervical cancer research to the Haitian government and made a case for using HPV testing as the preferred primary screen in hopes of working together to create a national cervical cancer prevention effort. The Haitian Ministry of Health embraced the idea, but efforts to initiate the program and to were not successful.  

In October 2015, not willing to give up on their dream of an integrated nationwide cervical cancer prevention and treatment program, Walmer and his colleagues at Family Health Ministries took a different approach. They invited representatives from 15 NGOs involved in cervical cancer prevention, along with Phil Castle, a global expert in cervical cancer prevention, to Durham, North Carolina, to discuss possibilities of working together on an integrated program in Haiti.

And with that, Haiti sans Cervical Cancer (HsCC) was established. 

HsCC Hits the Ground Running in 2017

Four of the 15 founding partners comprising HsCC, including Walmer, took on a leadership role within the alliance. They began to work on growing the consortium, getting the buy-in of major healthcare providers in the country (Zanmi Lasante, GHESSKO and FOSREF), establishing plans with Haitian medical leadership and conducting one-on-one meetings with key players in Haiti. 

In April 2017, the full HsCC membership headed to Haiti to meet with the Ministry of Health, the Haitian OB/GYN Society and Jhpiego to discuss plans to improve cervical cancer prevention and care.  

HsCC is currently focusing on four major initiatives:

• Partnering with Haitian medical leadership to develop a national cervix registry
• Establishing standardized cervical cancer prevention, screening and treatment protocols  
• Developing the health care infrastructure that is vital to providing successful cervical cancer prevention and treatment services (e.g., building HPV labs)
• Developing a national HPV vaccination program in collaboration with Partners in Health 

Partnership Is at the Heart of HsCC

In all of HsCC’s diverse projects, partnership is the foundation, with the goal of creating ways for Haitian medical leadership, NGOs and health care professionals to provide safe and comprehensive cervical cancer care to their own people.

“Our mission is, first, to find ways to deliver healthcare in a low-resource setting, and secondly, to partner with other organizations to scale up those solutions,” said Walmer. “We’re finally at the ‘scaling-up’ phase, and I’m very excited about this. I’ve been going back and forth to Haiti for more than two decades and this is the most important thing that I’ve ever accomplished in those 24 years.”

The HsCC network has grown to 29 partners. As the HsCC alliance continues to expand across Haiti, dissemination of vaccines and other health care solutions and services will become more efficient and more consistently delivered across the country.

“We hope Haiti sans Cervical Cancer will become a model for changing the way NGOs work in Haiti,” Walmer said. “We’d love to see them working jointly, rather than independently and in isolation from one another, especially in the healthcare world.”