30168: Hermantin(News)UM, Haitian healthcare providers strive to save lives (fwd)

[Bob Corbett <corbetre@webster.edu>]

From: leonie hermantin <lhermantin@hotmail.com>


Posted on Thu, Mar. 08, 2007
UM, Haitian healthcare providers strive to save lives

By TANIA VALDEMORO

There are many reasons Eulogia Dorvil, 56, of Little Haiti, has not had a 
mammogram recently. She admits, ''I am a little afraid of getting one. I don't 
feel any pain, you know?'' And she doesn't have health insurance to pay for the 
test.

Martine Lifleur is hoping to change the minds of Dorvil, her mother, and 
Haitian women like her. Lifleur is one of three community health workers 
canvassing Little Haiti with a mammography survey -- a new research 
collaboration between University of Miami doctors and Haitian healthcare 
providers. They hope to change a sobering trend: When Haitian women 40 years 
and older are screened for breast cancer, those found to have the disease are 
already battling an advanced form of cancer.

The work is part of a nationwide trend in ''community-based participatory 
research,'' where leaders of minority communities work hand in hand with 
doctors to design a culturally specific medical study that can lead to changing 
social habits and better health.

Currently, two such high-profile projects are under way in Miami. One is the 
Overtown Diet, where doctors from UM and Florida International University are 
helping people figure out how to cut salt and fat. The other is Partners in 
Action. Erin Kobetz, an assistant professor of epidemiology at the University 
of Miami's Miller School of Medicine, sought help from the Haitian community 
after she saw statistics that showed Haitian women who develop breast cancer 
are more prone to being diagnosed with late-stage disease.

''I wanted to figure out what was going on. Haitian women are not more prone 
[than others] to develop breast cancer,'' Kobetz said.

According to the American Cancer Society, breast cancer is the second leading 
cause of death among women. This year alone, about 178,480 women in the United 
States will be found to have the disease, and about 40,460 women will die from 
it.

Recent studies show 45 percent of Haitian women with breast cancer have a 
late-stage diagnosis compared with 44 percent for black women and 34 percent 
for white women.

''People believe the absence of symptoms equals the absence of disease. And we 
come from a place where prevention is a luxury. Finding food, clothing and 
shelter is the priority,'' said Larry Pierre, executive director of the Center 
for Haitian Studies.

Kobetz created a community advisory board in 2004. Haitian leaders then advised 
her on what to study and how to frame health questions in a culturally 
sensitive manner. After receiving more than $200,000 in federal grants last 
July, Kobetz partnered with Pierre, who trained Lifleur and two other Haitian 
health workers to conduct 1,500 quick surveys about mammography.

So far, Lifleur has spoken to more than 100 women at the clinic at the Center 
for Haitian Studies, in laundromats and at health fairs. The results have been 
mixed, she said.

Some, like Anita Pierre, 76, of North Miami, told her they've undergone 
mammograms recently because their doctors ordered the test. Many others, 
however, said they never had mammograms because their main health problems are 
hypertension and diabetes.

Women like Dorvil commonly rely on herbal remedies, such as teas, or prayers to 
alleviate their pain instead of visiting the doctor.

And then, some Haitians believe illness is an expression of Voudou.

'Sometimes, when the doctor tells them they're sick, [the women] will say, 
`Someone put a Voudou spell on me.' They'll say prayers or they will protect 
themselves from the sickness with holy oil,'' said Lifleur.

Even though Pierre admits, ''It's hard to teach an old dog new tricks,'' he and 
other community leaders are promoting the collaboration through Creole radio 
and in Haitian churches.

''We just have to explain to people that just because you don't see a disease, 
you can't skip prevention,'' he said.

Once the surveys are completed, Kobetz will conduct in-depth interviews with a 
few Haitian women. The community advisory board will analyze the findings.

''If we can show there is a problem, we can get funding for mammograms. All the 
other immigrant groups in Miami are taking advantage of the funding dollars,'' 
said Pascale Auguste, project coordinator with the Haitian American Association 
Against Cancer. Cuerna Blot, vice president of the Haitian American Nurses 
Association, thinks women will respond now even if they previously rebuffed 
breast cancer awareness campaigns.

''People have changed their minds about screening because of family and friends 
who have died from breast cancer,'' she said. ``Women should not have to die of 
something they can prevent.''





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