Haiti faces many public health challenges, among them treating chronic illnesses like hypertension and heart disease. According to the World Health Organization, chronic illnesses are the leading cause of mortality worldwide, and 80% of the deaths associated with these illnesses occur in low- and middle-income countries like Haiti. [1] These diseases of poverty are a special challenge in a country where there are few cardiologists available.
HAS is working to address this challenge.
“Cardiac care is very limited in Haiti and limited to facilities like HAS,” says Dr. Bob Carraway, former HAS Medical Director, who also leads the hospital’s peripartum cardiomyopathy (PPCM) program. Dr. Carraway serves as one of a few volunteer cardiologists who visit HAS throughout the year to provide cardiac services to patients and training to HAS staff. HAS Medical Director Herriot Sannon, along with Dr. Charles Morris, FACC, cardiologist at California Pacific Medical Center, and Dr. David Markham, Associate Professor of Medicine at Emory University, also volunteer in the PPCM clinic and help with staff training, particularly in the use of diagnostic equipment.
PPCM is a rare disorder in which a pregnant woman’s heart becomes weakened and enlarged. It develops during the last month of pregnancy, or within five months after the baby is born.[2]
The PPCM program was launched at HAS in 1999 by former HAS Medical Director Dr. James Fett, who saw many mothers with this rare form of dilated cardiomyopathy during his tenure as Medical Director. A study conducted by Dr. Fett and Dr. Markham showed that the incidence of this condition in Haiti is among the highest in the world. [3]
According to Dr. Morris, HAS makes a difference in cardiac patients’ lives by providing important medications and diagnostics.
“The ability to obtain EKGs and echocardiograms makes accurate diagnosis and treatment possible,” said Dr. Morris. “The women treated by the [HAS PPCM] clinic do as well as the patients I’ve seen in the best centers in the United States. This is a real feather in HAS’s cap.”
The hospital cares for hundreds of patients with cardiac conditions each year. Since its inception, the PPCM clinic has cared for nearly 300 women. Over the years, the clinic has reduced the case fatality rate from more than 50 percent to around 10 percent, and has increased full recovery rates from less than 5 percent to around 35 percent today.
In a country with very limited resources for quality cardiac care, HAS is an invaluable asset, providing life-saving care for these patients.
[1] World Health Organization. “Chronic Diseases and Health Promotion.” http://www.who.int/chp/en/. Accessed 9/23/15[2] [2] https://www.nlm.nih.gov/medlineplus/ency/article/000188.htm
[3] Fett, James and David Markham. 2014. “Discoveries in Peripartum Cardiomyopathy.” Trends In Cardiovascular Medicine. Retrieved from www.sciencedirect.com.