Clinic in Haiti for People with Albinism Grows in Reach and Effectiveness

People with albinism in Haiti stand out not only because of their lighter skin, but also for their heightened risk of skin cancer in a country where many physicians are unaccustomed to diagnosing and treating the malignancy in their skin type.

“They are getting a lot of sun damage and very early skin cancers. The degree of skin cancer that we are finding among people — even kids who are 10 or 12 years old — is surprising,” said Brian W. Morrison, M.D., a voluntary assistant professor in the Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine.

The basal cell carcinoma and squamous cell carcinoma lesions are typically those seen in much older people here in the United States, Morrison said.

Morrison travels to Haiti for the Oculocutaneous Albinism (OCA) clinic every three months, often accompanied by a UM resident or medical student. Their goal is to help people with albinism, to train the local doctors and clinicians, and to support a broader message that educates the public about albinism and its associated health risks. Morrison has recognized the great need for dermatology services since visiting Haiti as a medical trainee. The OCA clinic is part of a long-standing relationship between the Miller School of Medicine and Hospital Bernard Mev’s Medishare in Port-au-Prince.

Morrison lends his expertise and is clearly a champion of the outreach initiative, but he emphasized that the clinic is driven and staffed by local clinicians, including Haitian dermatologists, ophthalmologists and other specialists.

Helping Local Doctors Make a Difference
There are many dedicated doctors in Haiti who are motivated to help their community, Morrison explained.

“We basically are training the local doctors how to identify and treat skin cancer in white skin,” he said. “Our main mission is to teach the local doctors how to take care of these patients themselves. That way they can do it on their own, and they won’t need us.”

Part of the strategy is to teaching the Haitian physicians how to perform minor excisions so they no longer have to refer patients to general surgery.

“The general surgeons tend to be a little overly aggressive,” Morrison said.

Protecting Patients
“A lot of these patients don’t have the means to receive medical care. Some can afford to see a doctor; most of them cannot,” Morrison said. However, the unmet need for these services stems from more than their socioeconomic position. “Some of the people don’t even know they have albinism — they think they’re just light — and they don’t realize they’re at extremely high risk for skin cancer.”

A lot of time is devoted to educating people about albinism, including its genetic inheritance. They also learn strategies to reduce their risk of skin cancer, including the wearing of protective clothing, hats, sunglasses, sunscreen and more.

A Growing Popularity
The efforts are paying off and attracting patients beyond the Port-au-Prince city limits.

“Every time we hold an albino clinic, we double the number of patients we see, because more and more people are coming from more distant sites as word spreads,” said Morrison.

Last month, clinicians saw 65 albinism patients, two-thirds of whom came to the OCA clinic for the first time.

“All of our patients received education regarding their condition, a full body skin exam and a care package that included sunscreen, protective clothing/hat, sunglasses, SPF lip balm and Heliocare (for adults). Kids also got a small toy,” Morrison said.

The patients presenting that day included 13 who underwent surgery and 27 who were examined by a volunteer ophthalmologist.

“The clinic far exceeded my expectations,” Morrison said.

The next OCA outreach is scheduled for September.

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