University Hospital Resident Finds Calling in Oncology, Leads Department

Unlike many physicians, Dr. Joarly Lormil did not have a desire to become a doctor from a young age. In fact, he thought he would study engineering or economics because of his exceptional talents in math and physics. During university, he took some time to think about what he wanted to do, and he landed on medicine.

He stuck by this choice and went on to attend medical school at Université Notre Dame d'Haïti in the capital, Port-au-Prince. Initially unsure of his specialization, Lormil discovered his interest in oncology while participating in clinical rotations at Hôpital Universitaire de Mirebalais (HUM), a 350-bed teaching facility, home to one of Haiti’s largest medical residency programs and supported by Zanmi Lasante (ZL), Partners In Health’s sister organization in Haiti.

“I really liked it because it’s one of the departments where you can see your results,” he says. “When you succeed, even with palliative care, you make so much of a difference. It’s really life or death and I liked oncology because of that.”

As the end of his residency neared, a position opened in the oncology department. He filled it just one week after completing his residency in September 2017. Now, he’s the care coordinator in the department—a position he says is a 24/7 job, because time is of the essence, especially for patients undergoing chemotherapy.

“I knew from the beginning that to achieve a certain level of standard of care, to get as close as I could to that standard of care, ZL was the place to be,” says Lormil. “Of course there are a lot of challenges, but I think it’s a goal worth fighting for and it is achievable. My new position as care coordinator put me in a good spot to aim for that.”

HUM as it’s known locally, is one of the only facilities in Haiti that provides free cancer care and psychological support for adults—services that otherwise would be out of reach for families who live on less than $2 a day. Demand for cancer care remained steady throughout 2020, Lormil says, despite ongoing political unrest in the country and fears of contracting COVID-19. From January through July 2020 alone, more than 200 patients were in cancer care each month and attended to by Lormil and three other physicians, seven members of the nursing team, and four members of the psycho-social team.

Lormil wasn’t surprised by his department’s steady flow of patients: “The demand is so disproportionate compared to the care offered in the country that we will always find patients seeking care here.”

“There Is Care Available”

One of the patients Lormil examined during his first month as an attending physician in October 2017 was a young woman with advanced stage 4 breast cancer that had spread to her bones and liver. He was shocked to learn the mother of three was only 29—just a few months older than he was.

“It was sad to see a person my age, who I had so much in common with, diagnosed with cancer,” says Lormil. “What was even sadder is that she felt she needed to go to another country to get care and it did not go well.”

The woman originally underwent surgery at HUM, then chose to go elsewhere for follow-up care. A couple months later, she returned in worse condition and was confined to a wheelchair.

“It was really moving that she came back. We managed to give her good care with the expertise of our cancer partners and she improved,” says Lormil.

She was no longer in a wheelchair and was overall more active and happier. “I want to get the word out there that there is care available in Haiti,” says Lormil. “We are here and we are doing something.”

When the woman passed away in 2020, Lormil found himself thinking about the what ifs. Perhaps if she sought out their care earlier, she would still be alive today, he wonders.

Growing to Meet Demand

Like that young mother, approximately 80 percent of patients Lormil and his team care for have breast cancer. The remaining patients have gastrointestinal cancers, chronic myeloid leukemia, and gynecological cancers, including cervical cancer. Typically, the team sees between 25 to 30 patients per day, but that number is steadily increasing.

In 2013, the oncology team conducted 843 consultations. Within six years, that number had tripled, and it became clear the department required more space for patient care and consultations. In April 2018, the oncology team moved to a newly renovated space on hospital grounds, the Roselene Jean Bosquet Center, named after one of the first cancer patient ZL clinicians cared for in Haiti.   

Lormil predicts the number of oncology patients will rise even more, as the team continues to improve their skills through training, increased opportunities for cancer screenings at the hospital, mobile clinics and other patient centered programs, as more people become aware of the care available at HUM. And yet, he acknowledges how far they have come.

“It’s rewarding when you forget about a patient because they need to come less frequently, say every six months. Then, when they come, they’re cancer-free,” says Lormil. “After three years, it’s starting to happen to me a lot. I see patients that I took care of in 2018 who are now healthy and happy.”