Cancer Patient Receives First Surgery at University Hospital

For Dr. Ruth Damuse, the opening of Hôpital Universitaire de Mirebalais (University Hospital) in Haiti is like looking into a mirror.

The Haitian physician and her team have worked to provide top-quality care to poor breast cancer patients since 2011, when she helped start a weekly clinic in Cange, Haiti, with PIH sister organization Zanmi Lasante. Now, the new hospital in which she works reflects that high standard of excellence.

On May 23, Damuse’s breast cancer patient was the first to receive surgery in one of University Hospital’s state-of-the-art operating rooms. A Haitian surgeon and an American surgeon worked side-by-side to perform the lifesaving mastectomy. Since her operation, more than 150 surgeries have been performed at University Hospital.

“It’s like a dream, because we have worked in Haiti for a long time, and we have done a lot, but we haven’t had something like University Hospital,” Damuse said. “It’s good for the patients to have their surgery in such a beautiful and organized space.”

The 60-year-old patient, Isemelie Bazard, described it as a miracle.

"Madame Damuse is someone who really understands people,” said Bazard, a mother of four who lives in Port-au-Prince. “It's hard to believe that in a hospital this big there are doctors who understand people. They listened to me, they did surgery for me, and they really looked after me. Even my child was able to be here with me. For me this is tremendous support."

In March, Bazard came to the PIH/ZL hospital in Cange to seek care for a lump in her left breast. A biopsy was taken in Cange, and PIH academic partner Brigham and Women’s Hospital diagnosed the cancer. Then, physicians from the Dana-Farber Cancer Institute in Boston worked with Damuse to develop a treatment plan. PIH/ZL's oncology work in Haiti is supported by the Avon Foundation and the LIVESTRONG Foundation.

The patient will continue to receive follow-up care and chemotherapy at University Hospital, which will now be the center of cancer care for PIH/ZL.

The Haitian surgeon who worked on the case, Dr. Michelson Padovany, was born in Mirebalais, but had been working at another ZL facility in the Central Plateau before relocating to University Hospital after it opened in March. When the surgery team told him he had been chosen to perform the first operation at the new hospital, he trembled with excitement.

“It was an historic event,” Padovany said. “The hospital means a lot for Mirebalais, for the Central Plateau, and for the country.”

While the procedure itself was fairly routine for the ZL clinicians—they’ve performed surgeries for many years in Cange—the experience of working in University Hospital’s operating room was something entirely new.

University Hospital has six operating rooms, two of which have opened to handle the first phase of surgeries. They’re fully equipped: A sterile processing department cleans surgical instruments after operations, sterilizes them, and stores them for future operations, and special surgical lamps light any procedures while staying cool and minimizing shadows cast by surgeons’ hands. The hospital’s ventilation system keeps the operating rooms cool and creates positive air pressure, which blocks airborne bacteria from entering the room and reduces the risk of infection. The operating rooms are nearly twice the size of those in Cange, which allow them to accommodate surgical residents on rotation.

Successful surgeries depend on many other parts of the hospital to be equipped and operational—the lab and radiology for diagnosis; housekeeping to clean and cook for inpatients; anesthesiology; and a specially trained nursing staff, which received instruction by Operation Smile nurses to care for patients pre- and post-operation.

“All the different departments stepped up their game to make sure they were ready for the opening of surgery. It’s a collaborative effort, a lot of little pieces coming together and functioning as one,” said Dr. Ainhoa Costas, who performed the surgery with Padovany.

Costas, a Harvard Medical School global surgery fellow from Puerto Rico, has been working in the PIH/ZL surgery program in Haiti for the last two years. For the last few months, surgical residents from Harvard Medical School’s program in global surgery and social change have been traveling to University Hospital to join her in setting up the operating rooms.

“It was so amazing to see all of that finally coming to bear fruit,” said Costas, who completes her fellowship this summer.