Trip Report November, 2016

Urology Workshop Report – Hopital St. Francois de Sales, Port-au-Prince, Oct.31-Nov.2, 2016

US Urologists: Drs. Joe Babiarz, Joe Costa and Henri Lanctin
Haitian Urologists: Drs. Bernard Brutus, Pierre-Alix Nazon, Youry Dreux, Reginald Valme, Jean-Marie Aubourg, Jory Desir, Mitelot Clerivil
Haitian Residents: 3rd and 4th year

Following the Global Association of the Support of Haitian Urology (GASHU) meeting at the Hotel Karibe in Petion-Ville, a workshop was conducted at Hopital St. Francois de Sales. A recent agreement was signed between the Haitian Society of Urology and the hospital administration to establish a Urology Center of Excellence. This agreement includes provisions for the safety and maintenance of donated equipment and supplies, the ability of the GPC funded urology nurse and residents from the state university urology residency program to function in the hospital, and access to the hospital by the public patients HUEH and throughout the country.

The objectives for this session were a VVF workshop in one OR room and a ureteroscopic workshop in the other. The latter would include lectures on laser safety with “laser certification” of the Japhare Joseph (GPC funded nurse) as the laser tech and 2 urologists as the initial laser endoscopic urologists.

The number of cases was hampered by a number of factors: the hospital is new and unprepared for large number of cases, including nursing and anesthesia personnel (which we were relying on for this session), the recent resolution of the strike at HUEH which essentially shut down the residency program for over 6 months, Hurricane Matthew which was another devastating blow to the country, and the fact that Nov. 1st and 2nd are religious holidays in Haiti.

Despite this, 3 VVF cases were performed, 1 case which was a repeat from a large obstetric fistula which was primarily operated on by the Haitian physicians. Two of the 3 were challenging cases however, no significant early post op complications were encountered.

On the endourological side, we did 3 large distal ureteral calculi, ranging in size from 12 to 20mm. One stone unfortunately migrated to the renal pelvis and accordingly a stent was placed for later intervention. The laser functioned well and the urologists demonstrated good skills and knowledge of the laser function and settings.

On the last day we performed a dismembered pyeloplasty and resection of a large bladder tumor with the Haitian urologists. Pyeloplasties for UPJ obstruction are uncommonly performed in Haiti.

Observations and Conclusions:

1. HSFDS promises to be an ideal site for the establishment of a urological center of excellence in Haiti. A lot of the obstacles that were encountered on this trip were identified by the Haitian urologists who resolved to have further discussions with administration. The OR nursing staff are engaged and want to learn. They will need education and encouragement with issues like the establishment of case cards, post op urology care, care of the equipment, etc.
2. Japhare Joseph is perfect for her role, however, needs more training re. instrument care, laser safety and as we don’t have a dedicated x-ray tech, radiation safety.
3. Including a US Urology OR nurse and anesthesia provider to future teams would be advantageous, however, not a requirement.

 

Submitted by Henri Lanctin, MD

Posted in Uncategorized.

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