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Miami's Little Haiti joins global effort to end cervical cancer

Valentine Cesar, a community health worker at the Sylvester Comprehensive Cancer Center at the University of Miami, demonstrates items used in the HPV self-test at the Haitian Research Center, a clinic in Miami’s Little Haiti neighborhood. (Verónica Zaragovia / WLRN)

Worldwide, more than 300,000 women die from cervical cancer every year. In the United States, Haitian women are diagnosed with the disease at a higher rate than the general population. This disease is preventable, however, due to vaccines and effective treatment of precancerous diseases. That’s why healthcare workers and even the World Health Organization are focusing on Miami’s Little Haiti to try and save lives.

Cervical cancer incidence rates in Little Haiti according to a study published in Cancer Causes and Control in July 2018 The cancer rate was 38 per 100,000 people, more than four times the rate in Florida overall, or 8 per 100,000.

One of the authors, Erin Kobetz, associate director of population sciences and cancer disparities at the Sylvester Comprehensive Cancer Center at the University of Miami, proposed that the The idea of ​​HPV testing being brought to the Miami area — Dade County women are less likely to get regular cervical cancer screenings at a gynecologist’s office. Human papillomavirus is thought to be responsible for approximately 50% of cervical cancers.

Kobetz and her colleagues’ work with recreational vehicles has been called a game-changer, sparking a World Health Organization Notice. The World Health Organization announced a lofty goal in August 2020: to eliminate cervical cancer by encouraging countries to fully vaccinate 90% of girls against HPV by age 15; 70% of women by age 35 and 45 HPV screening; and treatment of 90% of women with precancerous disease. WHO believes that if countries meet these goals by 2030, cervical cancer can be eliminated in the next century.

In Miami, WHO relies heavily on the public health infrastructure already in place, including efforts initiated by Kobetz . In Little Haiti, the work is taking place at a medical clinic called the Haitian Research Center on a high street in a rapidly gentrifying immigrant neighborhood.

Outside the building, “CHS-Health” is written in big blue letters. There are a few small convenience stores and a tax service nearby, but the surrounding shops are mostly clothing boutiques and trendy cafes or restaurants.

On a weekday morning, the clinic’s street-facing windows flood the waiting area with sunlight, community health worker Valentin Cesa Valentine Cesar spoke cordially with patients in Haitian Creole as they waited.

The patient has a good relationship with Cesar, who works at the Sylvester Center at the University of Miami. At the Haitian Research Center, she teaches people to prevent cervical cancer by focusing on HPV. Specifically, Cesar showed women how to test themselves using the kits she handed out at the clinic. “We have a small jar, which is a cotton swab,” she said.

This process is the same as using a tampon, and certainly easier than doing a pelvic exam, which is another way to detect HPV. Self-collected samples are sent to the laboratory. If it turns out to be a positive, Cesar will use her pretty good people skills when it comes to breaking news.

She admits to panic when she tells people they have HPV. “We explained to them that you’re HPV positive, it doesn’t mean you have cancer,” she said.

This does mean that women need to be vigilant about their health and need to be monitored for cancer, precancerous lesions and other conditions that may be caused by HPV The problem. Cesar and her colleagues will encourage HPV-positive patients to seek treatment at the Haitian Research Center or other federally qualified health centers. The clinic is the main referral partner of the Sylvester Center in Little Haiti due to the cultural and language skills of the staff.

Sylvester Center’s game changer supports educational efforts at the Little Haitian Clinic and stops on scheduled days at behind it. On other days, the car brought a similar message to different communities in Miami.

“We were able to go out and talk about our work through our various community health workers, hand out flyers, and provide educational materials,” said Dinah Trevil, former director of the Sylvester Center’s Office of Outreach and Engagement. “All of these help us understand and recognize our services and what we do.”

On Game Tour Changing vehicles, Trevil pointed to videos being played about HPV and brochures that people can use to learn about the virus. The vehicle has a main seating space, as well as an area for private inspections or consultations.

Trevil understands why Haitian women sometimes avoid doctor visits. “They have this belief, ‘If I go to the doctor, I’m going to find some bad news,'” Treville said. “‘I’d rather not go.'”

As health educators, Treville and Cesar try to convince people to get rid of this avoidance-motivated fear.

Research shows that HPV self-testing could help more women receive other tests that benefit their reproductive health, Trevil said. “So we started using this test to address some of the sensitivity and some of the reluctance that women have about actually having a Pap test,” Treville said.

Patient Nicole Daceus had an HPV self-test this year after noticing the name of the Game Changer vehicle and the Sylvester Center. Health concerns aren’t the only obstacle, Daceus said. “Without health insurance or immigration papers, people avoid doctors,” Daceus said.

A photo shows Nicole Daceus speaking to Valentine Cesar from across a desk.
Nicole Daceus , who was recently tested for HPV through the University of Miami Sylvester Comprehensive Cancer Center, talks to Community Health Center Valentine Cesar (right) worker. (Verónica Zaragovia / WLRN)

No Clinic’s One would ask the patient about their immigration status, though Cesar and Trevil tried to make sure the patient knew that.

Sylvester Center staff educate mothers on this to encourage them to vaccinate their young teens against HPV . Children’s vaccines were administered in another RV parked a few feet from the game-changer (University of Miami Pediatric Mobile Clinic). It focuses on caring for uninsured children and is set up near public schools, houses of worship and community centers.

“We work together because mobile clinics are able to deliver vaccines, so we can make HPV prevention a family affair,” Kobetz said. “Vaccines are available to both boys and girls of appropriate age.”

Richard Fever, who works in the Office of the Director-General of the World Health Organization Liman, who toured the vehicle behind the Haitian Research Center earlier this year. Freeman said the work is critical to WHO’s efforts to eliminate cervical cancer worldwide. Freeman added that no one should die from a disease that tests and vaccines can prevent.

can actually be eliminated,” Freeman said. “We have the tools, it’s just a choice if we want to use those tools. If we catch this cancer early and catch it in time, it can be cured. So we want to see all these interventions coming, not just in Miami. We would like to see the availability of the HPV vaccine available and affordable in countries with a high burden of cervical cancer. ”

This story is part of a partnership that includes WLRN, NPR and KHN.



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