HsCC's 2nd Annual Meeting

I’d like to start my remarks this morning from a place of gratitude. I’m grateful to the organizers of the HsCC 2nd annual conference and to all of you for being here.  In this room today, we have the extraordinary opportunity to create change and to make a difference in the  lives  of  Haitian  women  and  girls  by  taking  action,  setting  high standards and dreaming big in order to free Haiti from cervical cancer.  

That’s what we are here for, right?  

Haiti is among the countries with the highest cervical cancer incidence in Latin America and the Caribbean, with an estimated 94 cases per 100.000 women and a death toll of 1,500 women per year (GHESKIO data). These are unnecessary deaths that have great impact on individual families and the economy of our country. According to the World Health Organization (WHO), the death of a woman has to be multiplied by a factor of 5 to 10 to measure the impact on their family and the local economy. In Haitian society women are the pillars – the POTO MITAN that carry the burden of families.  

Imagine the socio-economic and psychological impact on the children’s lives? School drop out, trauma, malnutrition, neglect, becoming restavek among other things.   Who are these women that could die or are dying from cervical cancer? They are the Ti-Machan buying and selling goods to feed their families, to pay rent and to send their kids to school. They are the Madan-Sara travelling on the roof of big trucks, putting their lives at risk to support the economy. They are also our sisters, aunts, neighbors, friends, colleagues. They can be our mothers and daughters too.    

Cervical cancer has been of great relevance to me. You definitely see things differently when  they  affect  you  firsthand.  Over  the  course  of  my  life,  I’ve  had  both  a  deep personal and professional connection with Cervical Cancer. My mother succumbed to cervical cancer after a 2 year battle, leaving behind 4 children; the oldest being me, age 14 at the time, and the youngest being my 3 year old sister. I’ll spare you the details of the health system failure with regards to my mother. She suffered till her last breath.  After her death, I can tell you that things were not easy for me as the eldest daughter. I fully stepped into adult responsibilities at a very young age running our household and raising my siblings as my father worked outside of the city where we lived. My oldest daughter  always  jokes  that  I’m  too  much  of  a  perfectionist  as  I  favor  order  and structure;  that  I  always  take  on  too  much  responsibility  and  take  everything  too seriously. My answer to her statement is that growing up, Je n’avais jamais droit à l’erreur. Or I’d be punished. 

Although the loss of my mother at such a young age was a traumatic and life-altering experience, it’s an experience that isn’t uncommon. I was privileged to join Partners In Health‘s efforts in Rwanda in 2005 where I met children who struggled with the same circumstances that I had as a child years back in Haiti. They had lost their mothers to cervical cancer at one of the hospitals we were supporting in rural Rwanda. For some their fathers had also passed and they were left completely alone. Annonciata, the youngest girl of a family of five, was 5 years old. Today she is 18y and at risk for cervical cancer without intervention.  

My biggest concern is how are we protecting the lives of the new generation of girls in our own countries?   

We CAN PROTECT our Haitian teens now for the future and YET WE ARE NOT DOING SO! 

My two sisters and I consider ourselves lucky now that we benefit from the health systems of the countries in which we live and their efforts to prevent these cancers. My daughters are also lucky because they have already received the HPV vaccine at a young age.    The  equity  agenda  for  girls  in  both  hemispheres  should  be  pursued.  The Sustainable Development Goals should look at preventing cervical cancer in girls as well.   

The  barriers  and  challenges  to  effective  cervical  cancer  care  delivery  in  Haiti  are institutional and structural. They are related to the followings: tardy diagnosis, health insurance coverage barriers, high out of pocket expenditures, Loss to follow-up, limited resources  and  adequate  health  infrastructure  and  equipment  for  preventive  and treatment  services,  high  health  care  spending  for  the  health  system  to  address individual   patient   needs,   difficulties   coordinating   patient   care,   skilled   providers, 

Availability of data management, political commitment and funding allocation. The list goes on. 

To create CHANGE, we need to INVEST IN CHANGE because it is no longer acceptable for Haitian women to keep dying from cervical cancer. We need to invest in actions that foster policy and access to services that focus on 4 major areas of intervention:  

-Prevention with HPV vaccine for adolescent youth 

-Early detection though HPV screening  

-Treatment with the availability of high quality services   

-End-life support and palliative care 

And of course research, advocacy and funding. 

Health is a human right. But there is a need to also focusing on solidarity and equity. We are  living  in  a  world  that  often  values  transactional  interventions  that  threaten solidarity.  The  key  actors  are  in  this  room:  Ministry  of  Health,  multi  and  bilateral partners, development partners, civil society organizations, I challenge you to direct your  efforts  towards  pragmatic  solidarity  and  the  development  of  policies  that  will improve service delivery, bringing hope and humanity to the people suffering in building their health, families and communities. 

Girls’ empowerment has been my priority for the past 10y. The Girls of today are the mothers of the next generation, therefore the future of humanity. I want all girls to have the same chances as my 2 daughters. Let’s make sure that girls are including so a virus won’t stop a generation from pursuing their dreams. 

Towards a Haiti without Cervical Cancer! Vers un Haiti sans Cancer du Col! 

THANK YOU, MESI ANPIL. 

BIOGRAPHY

Wingdie Didi Bertrand MA, DEA, DESS is a medical anthropologist and community health specialist who has worked in Haiti, France and Rwanda. Born in Port-Au-Prince Haiti, Mrs. Bertrand studied social science, community health, and health systems management in Haiti and in France. For the last 15 years, she served as a community organizer, program developer and implementer, activist for women and girls' rights, and researcher. She worked as the Director of the Community Health Program and headed the Biosocial Research and Social Development Programs for Partners In Health Rwanda Inshuti Mu Buzima from 2005 to 2015, supporting the Rwandan Ministry of Health. She has been principal investigator on studies focusing on community health, reproductive health, traditional healing and health system strengthening evaluation in rural Rwanda. Mrs. Bertrand also Chaired the Haiti-Rwanda Commission, initiated in the aftermath of the 2010 earthquake that devastated Haiti, to promote South-South cooperation and exchanges between the two countries. She currently serves as Senior Adviser on Community Health for Partners in Health and leads The Women and Girls Initiative founded in 2009, with empowerment programs targeting marginalized adolescent girls both in Rwanda and Haiti. She is a visiting Research Scholar at the University of Miami and is also the mother of 3 wonderful children.