Global Scholars: Dr. Pascale Yola Heurtelou Gassant

Optimism, dedication drive Heurtelou Gassant in service to Haiti

Dr. Pascale Yola Heurtelou Gassant, the first pediatric oncologist in Haiti, was standing in her backyard on the afternoon of January 12, 2010, when the earth began to shake.

 She had just returned from work, just picked up her boys from school. Her sons were inside the home with her husband, her parents, and her brother and sister. Like a lot of people that day, it took her a moment to realize that this was an earthquake.

 “Everybody was in shock,” she says. “Then we reacted and did what [we] had to do, followed the procedures, slept outside. We sacrificed and did what we had to do to survive. We were in survival mode.”

 The 7.0 magnitude earthquake struck Haiti shortly before 5 p.m. local time. It was catastrophic, claiming the lives of more than 200,000 people and destroying an estimated 250,000 homes.

 In the aftermath, Dr. Heurtelou Gassant’s two boys went to live with relatives in the United States for a time. Meanwhile, she and her husband spent months living in a tent in their backyard. She felt a calling to stay, to help.

“I could not leave the country in such a difficult time,” she says. “At that time, I think that my presence here in Haiti was very important. It was necessary to be in the field to see how we [could] change things — in general, and for the children with cancer in Haiti.” 

There were a lot of issues that required attention that year: food distribution, cholera, upper respiratory infections from the dust, children who had lost their parents, amputations, violence. At the same time, Dr. Heurtelou Gassant was trying to confront the issue of childhood cancer in her country. 

It was a balancing act. And the impacts of that year, she says, continue to be felt today. 

“This episode in the country marked me a lot,” she says. “We learned a lot because the country was not prepared to [confront] these types of problems.” 

Originally a pediatrician, Dr. Heurtelou Gassant had trained herself to work in the oncology unit for the six years preceding the 2010 earthquake. She had seen the dire need for oncology care in her country. “There was no structure … in the country to provide cancer care to adults and children,” she says. “So most of these children remained in Haiti and died without the appropriate care that their condition required. This was a big challenge in the country.” 

In the wake of the earthquake, Dr. Heurtelou Gassant connected with St. Jude for the first time — a connection that led to a full collaboration, including a fellowship in Guatemala. Eventually, she says, she was able to help “change the image, the picture, of childhood cancer in Haiti.” 

In 2012, she became the first pediatric oncologist in Haiti. In 2014, she helped found the Haitian Childhood Cancer Foundation. She served as head of the pediatric oncology unit at Saint-Damien Hospital in Port-au-Prince, and then this past May, she became the national director of the hospital. 

“There have been some advances …” she says, pointing to a residency program that is training doctors in early diagnostics. The country now has access to platelets. Through increased awareness, the hospital has increased referrals. And a collaboration with St. Jude has significantly cut down the time for pathology reviews. 

“We’re not taking strides, but we’re making baby steps,” Dr. Heurtelou Gassant says. “And we’re making changes.” 

She laughs now when asked what a typical day looks like, noting that "typical" doesn’t really exist. “Each day has its own characteristic,” she says. Still, she strives to bring a consistent approach, maintaining structure in her days, to define priorities and maximize efficiency. She carries a notebook with her everywhere, trying to stick to the agenda and to achieve the day’s objectives. After time with her family each night, she typically closes her days with hours of scientific reading. 

Dr. Heurtelou Gassant applied for the Global Scholars program with the goal of addressing challenges and making improvements at Saint-Damien. Once there, she says, “I saw that I can also have an impact on the health system.” 

Indeed, after spending 10 years in Cuba, from 1991 to 2001, while earning her doctorate in medicine — and later her degree in pediatrics — she says that seeing the differences between Cuba and Haiti’s health systems was jarring. 

“It is two different health systems,” she says. “It was a violent shock for me to see how the health system is in Cuba; it is like a universal health system. And here in Haiti it was so different.” 

The disparity was driven home by her first assignment back in Haiti, from 2001 to 2002, when she spent a year as a pediatrician in a remote part of the country. During that time, she worked to address infectious diseases, malnutrition, vaccinations, and health promotion and education. 

“Nobody showed me the health system in Haiti,” she says. “I had to learn by myself, by reading a lot, by trying to ask, by trying to understand how our health system was functioning.” 

Two decades later, Dr. Heurtelou Gassant hasn’t stopped trying to push things forward — for children with cancer, and now for Saint-Damien patients as a whole. 

She’s working with the Haitian Childhood Cancer Foundation and Saint-Damien to implement a national cancer plan. And with an eye toward addressing chemotherapy-related infections and minimizing risks, she has focused her Scholars Project on improving the system for preparing and administering cytostatics at Saint-Damien. 

“I’m not pessimistic, I’m always optimistic,” she says, looking ahead. “But it’s a question of hard work, stick-to-it, working together to meet our vision … and get our goals accomplished. To do what we need to do to make it better.” 

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