Above: Marian's surgical team wore red bandanas, while Michelle's wore yellow ones as they worked in an HUM operating room on Friday, May 22.
Thank you for supporting Partners In Health and University Hospital in Mirebalais, Haiti. Below is a summary of an incredible story that we are thrilled to share with you, and I strongly encourage you to click the link at the bottom of the page to read the full story.
Partners In Health and Zanmi Lasante, its sister organization in Haiti, are proud to announce that 6-month-old conjoined twin sisters were successfully separated on Friday, May 22, at University Hospital (HUM) in Mirebalais and are in stable condition within the hospital’s intensive care unit.
A national and international team of surgeons, anesthesiologists, nurses, and other specialists collaborated on the twins’ case from the time they were in utero through planning, surgery, and post-operative care. Dr. Christophe Milien, HUM’s director of obstetrics and gynecology, provided prenatal care to the mother and delivered the babies, who have a healthy fraternal triplet sister, by cesarean section on November 24, 2014.
Drs. Henri Ford and James Stein, of Children’s Hospital Los Angeles, led the international team of surgeons during the separation and were joined by their colleagues and others from Bernard Mevs, Florida Hospital, Cornell Weill Hospital, Children’s Hospital Oakland, Boston Children’s Hospital, PULSE, Loma Linda Hospital, and others.
The babies shared a liver but no major vasculature, and represented one of the least complex variations of conjoined twins. Surgeons separated the pair during a seven-hour procedure without any major complications. Their recovery has been rapid; both are breathing on their own and have taken their first bottles.
Full story: http://www.pih.org/blog/conjoined-twin-sisters-successfully-separated-in-haiti
Thank you so much for your generous support of our work to continue improving access to quality health care in Haiti. With your partnership, Partners In Health and our Haitian sister organization, Zanmi Lasante, now provides comprehensive cancer services at University Hospital in Mirebalais. Below, you'll find an update on this work as told through an interview with oncology program director Dr. Ruth Damuse.
Dr. Ruth Damuse, oncology program director for Partners In Health's Haitian sister organization, Zanmi Lasante, helped establish PIH/ZL's formal cancer care in Haiti. Zanmi Lasante's oncology program started at its hospital in Cange in the Central Plateau and now serves patients at University Hospital in Mirebalais. The hospital sees an average of 22 oncology patients each day, and patients receive care free of charge. To mark World Cancer Day, Feb. 4, we asked Damuse a few questions about PIH/ZL's cancer care.
Before Zanmi Lasante started offering oncology services, what was likely to happen to a person with cancer in rural Haiti?
Before ZL officially offered oncology services in our network, people in rural Haiti didn't have any chance to have access to cancer care. A few patients would try to get the services in the capital, Port-au-Prince, but the cost would be so high, they would start a treatment and stop in the middle of the process.
Why is it important for patients at University Hospital to have access to oncology services?
Because it was our promise to the community. University Hospital was built to become the center of excellence for quality care in Haiti and to be the place where the next generation of Haitian health professionals would be trained.
How has cancer care evolved at University Hospital?
Since the oncology services moved from Cange to Mirebalais, the number of cases has more than doubled and continues to grow every day. Our diagnostic capacity continues to expand, and we routinely perform biopsies (mostly core needle biopsies) as well as CT scans in order to diagnose and stage patients. In November 2014, an oncology rotation was added to the internal medicine residency program for second-year residents. So far, two second-year internal medicine residents have completed a four-week rotation in the oncology service.
The first patient who had surgery at University Hospital was a breast cancer patient. We are working to integrate oncology care with surgery, and we even have a surgical oncology clinic each week. Oncology cases make up a significant portion of the surgeries performed at University Hospital. Our diagnostic and staging capability has significantly increased since moving to University Hospital, and we can use the CT scanner for staging as well as for procedures such as CT-guided biopsies, something not available anywhere else in the public sector [in Haiti].
Through our integration with internal medicine and our collaboration with other teams throughout the hospital (surgery and mental health, etc.), we are able to offer comprehensive services to patients with a variety of cancer diagnoses.
How has PIH’s partnership with Brigham and Women’s Hospital and the Dana-Farber Cancer Institute helped improve cancer care?
The partnership with the BWH and DFCI is the key to our success. I like to tell our patients that even though they can only see our local team, there is an even bigger team of experts working on their cases. The BWH/DFCI provides ongoing support to our program. The pathology lab of the BWH processes all our samples with no cost, which is vital for the diagnosis and treatment of patients. This level of pathology services is not available anywhere in Haiti.
We hold weekly calls with DFCI-affiliated oncologists to discuss patient care. Each week we review individual patient cases to determine care plans and monitor progress.
DFCI also allowed us to extend our psychosocial team by supporting the salary of an assistant social worker. They continue to support us financially, providing essential tools and programmatic support. They also facilitated the process to have another internist working in the program.
What makes this program unusual?
We are the only center in the country to provide free cancer care and also the only hospital to offer comprehensive cancer care, including palliative care and psycho-social support. We provide the highest quality of cancer care anywhere in the country, and we do so for free.
(MIREBALAIS, HAITI - MAY 2014: A busy afternoon in the University Hospital emergency room.)
Thanks for your support of Partners In Health/Zanmi Lasante and our work to provide high-quality care at University Hospital in Mirebalais, Haiti! I am delighted to share the following update on our increased capacity to provide emergency care at the hospital's Emergency Department:
PIH/ZL is committed to making sure that every patient benefits from timely and effective care. We know that poverty puts Haitians at greater risk of needing emergency medicine – unmanaged chronic conditions, farming injuries, and increasing traffic accidents on newly improved roads are responsible for the high number of ER visits.
That is why PIH/ZL designed an integrated emergency department with the capacity to respond immediately to critically ill medical and trauma patients 24 hours a day. PIH/ZL recently introduced triage to the emergency room so that patients are prioritized by acuity rather than complaint. Staff are being trained to reassess patient flow and bed management to ensure maximal efficiency. Beginning just last month, University Hospital began offering its first residency and certification programs in emergency medicine.
The capacity of University Hospital to respond swiftly to emergencies is an indication of the overall health of University Hospital’s systems. The emergency department is a test of system functioning because it requires collaboration with blood banks and other specialists across departments. If trained staff and triage systems are not in place, the increasing number of patients with complex, trauma-related injuries, like Guerrier, will not survive.
Guerrier, 21, from Mirebalais
“I was in a tap-tap [local informal bus] on the way to PAP when the brakes stopped working. The car flipped on its side and during the crash I broke my neck. An ambulance arrived and brought me to the ER at University Hospital. I was in the ER from Thursday to Monday. On Monday afternoon I went down to PAP in an ambulance with Dr. Ward and Dr. Jacky. They put the collar on me and I returned to University Hospital the same day. I was able to return to my house the next day.
Now I sometimes get headaches on my right forehead but overall I don't have too much pain. I come for a consultation once a month and will take the collar off after three months, or earlier, if Dr. Luther says it is okay.
You never expect an accident like that to happen. I found really good care here, and I think this collar will help me return to the way I was before the accident. I'm in my last year of high school and hoping to go to university next year. I also love to play soccer and am hoping that one day I'll be able to play again.”
Guerrier came to University Hospital with severe spinal injuries. The emergency department quickly diagnosed his injuries using a CT scanner and determined that a halo collar was needed; but, University Hospital did not have the halo collar needed to begin treatment on hand. PIH/ZL procured two collars from Boston Children’s Hospital and located a Haitian neurosurgeon in Port-au-Prince (PAP) that could perform his life-saving surgery.
With support from partners and generous donors, Hôpital Universitaire de Mirebalais, in Mirebalais, Haiti, provides primary care services to about 185,000 people in Mirebalais and two nearby communities. But patients from a much wider area—all of central Haiti and areas in and around Port-au-Prince—can also receive secondary and tertiary care. We see as many as 700 patients every day in our ambulatory clinics. The hospital fills a huge void, locally and nationally, for people who previously had limited access to quality health care.
We invite you watch this short video for an inside look at the fully-functional teaching hospital here: http://www.pih.org/media/video-an-inside-look-at-hopital-universitaire-de-mirebalais
Thank you for accompanying Partners In Health in our work to improve health care for people in Haiti and around the world.
Patients with Broken Necks Heal at University Hospital in Haiti
Below is the story of a 48-year-old farmer who fell out of a tree while he was cutting a branch to sell as firewood. Because of your support, he was able to seek the care that he needed at University Hospital in Mirebalais. Thank you.
Marcenne Desanm, 48, from Savanette Cabral
I am a farmer who lives in Savanette Cabral. I have a wife and eight kids—seven are in primary school and one is in secondary school. I grow grain, corn, and plantains, and sell wood.
The accident occurred when I climbed a tree to cut off a branch to sell the wood. I stood on a lower branch and was sawing a branch above me. When the branch broke, it didn't fall on the ground; instead, it fell on me and crushed me in between the two branches. My stomach was bleeding and I was completely stuck. My wife saw me and cried for help; my neighbors then rushed to my assistance. They climbed the tree and pulled the branch off of me, but when they did this I fell backward onto the ground and broke my neck. I lost consciousness.
I live a two-hour walk from the closest road, so my neighbors had to put me on a stretcher and carry me to the road where the ambulance could meet them. I came to HUM and spent 13 days in the emergency room. They put a catheter in me and took care of my wounds where the branch had crushed me.
I went down to Bernard Mevs with Luther and Jacky and had the collar placed on my neck. I came back to the hospital and stayed for four more days. For the next few months while I am recovering I am renting a house in Cange, because my house in Savanette is too far from the road for me to walk to return for consultations. An ambulance now comes to pick me up at my rented house whenever I have an appointment and takes me home afterward. Two of my kids and my wife are staying with me too.
They took great care of me from the moment I arrived. God put me here with these doctors. I don't feel too bad anymore. I used to have problems sleeping, but now I just sleep sitting up or leaning on my hand, and it doesn't feel too bad. I can also now stand up from a chair by myself! I hope to return to work after the collar is taken off, but I will follow whatever instructions the doctors give me. I have so much hope in life now. I just hope that I will be able to continue working so that I can provide for my family.
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