Odette Joseph lives in Bourdet in the Sud department. For more than five years, she has been living with the aftereffects of breast cancer, for which she underwent surgery. After her surgery, she began hormone therapy and regularly attended follow-up appointments at the oncology department of Mirebalais University Hospital.
Before the temporary closure of HUM, Ms. Joseph was among the patients who traveled long distances to receive specialized care. She lives far from Mirebalais, but she had maintained her follow-up appointments regularly. For a patient with a history of breast cancer, this continuity is crucial. These appointments allow for an assessment of her clinical condition, the renewal of medications, the scheduling of necessary tests, and the early detection of symptoms requiring medical attention.
This routine of care was disrupted after March 31, 2025, when the deteriorating security situation in Mirebalais led to the suspension of activities and then the temporary closure of HUM. The difficulties had begun before this closure, with roads being gradually blocked. For Ms. Joseph, getting to Mirebalais became increasingly difficult, and eventually impossible.
Her situation illustrates one of the most serious consequences of HUM’s closure for patients living far from Mirebalais. When a referral hospital ceases to operate, the patients who depend on it lose a central point of access to specialized care. People with chronic illnesses or those requiring regular follow-up are particularly vulnerable. They may find themselves without medication, without follow-up evaluations, without check-up appointments, and without a nearby facility capable of meeting their needs.
In the Greater South, options for specialized oncology care remain very limited, particularly for women living with breast cancer. Ms. Joseph tried to manage on her own. She sought to purchase the medications she had previously received at HUM. These medications were difficult to find. Their cost was also beyond her means. This reality placed Ms. Joseph in a situation where her determination to continue her treatment was no longer enough. Access to care depended on the availability of medications, cost, road conditions, safety, and the existence of a facility capable of providing follow-up care.
Her situation was eventually brought to the attention of Zanmi Lasante officials. Since late January 2026, discussions have taken place between HUM’s Executive Board and Zanmi Lasante’s clinical coordination team to identify a realistic solution to a concrete question: how to provide follow-up care for a patient living far from Mirebalais, with ongoing medical needs, in a situation where travel to the HUM was no longer possible?
The solution took the form of a medical outreach trip to the south, conducted from June 2 to 7, 2026, between Les Cayes and Torbeck. The mission aimed to reach Ms. Joseph and other patients facing significant difficulties in accessing care. It is part of a broader effort to maintain patient care when standard facilities become inaccessible.
On Friday, June 5, 2026, Ms. Joseph was seen at the Fond-Fred Health Center in the town of Les Cayes. There, she received a comprehensive package of care. The team conducted a specialized medical evaluation, provided six months’ worth of medication, established a plan for follow-up laboratory tests, scheduled an appointment at the Port-Salut Community Referral Hospital, and set up a system for the regular refilling of her primary long-term medications.
For Ms. Joseph, this care allowed her to resume follow-up that had been interrupted for several months. It also established a pathway for continuity of care closer to her home, with a clear medical plan and a designated follow-up location. For the Zanmi Lasante teams, this intervention serves as a reminder that an effective medical response often depends on precise coordination between clinical leaders, healthcare facilities, operational teams, and those who are familiar with patients’ situations on the ground.
The temporary closure of HUM continues to affect patients living far beyond Mirebalais. Some traveled from the Centre, Artibonite, or other departments to receive specialized care. Their geographical distance exacerbates the effects of the crisis. Blocked roads, insecurity, a scarcity of specialized services, and economic hardships turn a medical appointment into a major obstacle.
The tour conducted in the South demonstrates how care can be brought closer to patients when circumstances prevent them from reaching a referral facility. It also serves as a reminder that continuity of care depends on practical decisions: identifying the patients most at risk, understanding their constraints, organizing the deployment of qualified teams, providing the necessary medications, and planning follow-up care.
Ms. Joseph remains committed to her care journey. Her treatment at Fond-Fred demonstrates what becomes possible when teams tailor their response to patients’ actual needs. In a context where crises disrupt services, this ability to reach out to patients becomes essential to protecting their health and dignity.
The temporary closure of HUM continues to affect patients who already lived far from specialized care. Ms. Joseph is one of those for whom a medical appointment requires time, resources, accessible roads, and a facility capable of meeting complex needs. To support this work, you can make a donation here