A year after finishing medical school in Venezuela, Louis Maxime Edouard’s dream of practicing medicine in his native Haiti began to vanish in 2014 – along with his eyesight.
Edouard first began to lose his peripheral vision. The problem progressed to the point that he could no longer see well enough to handle needles, finally leaving him with partial vision only in his left eye.
His condition, traced to a benign tumor in his head, would leave one of the world’s poorest countries with one less of the many things it needs. The U.S. has 10 times the physicians per capita of Haiti, the World Health Organization says.
Edouard’s condition led him to Charlotte this month, where a team of physicians removed the tumor. They became links in the growing connection between a prosperous city and a struggling nation, their differences vast yet close enough on a map to share a time zone.
Give Hope Global, a Fort Mill, S.C., nonprofit group that works with Haitian orphans, connected Edouard to Charlotte doctors. Novant Health waived its hospital fees to treat him. So did the nine physicians involved in his case.
“This idea of rallying around a patient who needed help speaks volumes about the healthcare community that we have here in Charlotte,” said Dr. Will Caldwell, an ear, nose and throat specialist and Novant senior vice president who volunteers as medical director of Give Hope Global. “I think it’s a pretty special environment.”
For his part, Edouard, 34, said the Charlotte doctors seemed to “take my situation as theirs.”
“It’s hard,” he said of his condition. “It’s hard for me, my family. From the beginning I wanted to be a doctor. I considered that we really need it in the health system in Haiti. I want to use my skills to be a good doctor to help my people.”
Male life expectancy in Haiti is 62 years, the World Health Organization says, compared to 76 years for the rest of the Americas and Caribbean. Malnutrition, while improving, stunts the growth of one in five children. A catastrophic earthquake shook the island nation in 2010 and was followed in 2016 by Hurricane Matthew, which killed more than 500 people.
No safety net
Give Hope Global was founded in 2013 by entrepreneur Roger Braswell and his daughter, Angela Quinn, as an orphan care group in Les Cayes, a city on Haiti’s southern coast. The group partners with another nonprofit, El Shaddai Ministries International, and has received donated equipment and supplies from both Novant Health and Carolinas HealthCare System.
The group’s work with two orphanages quickly spread into the community around them. A documentary on the group’s work recently won two regional Emmys.
The group hired a Haitian medical director, Dr. Junior Osselin, who oversees a clinic and trained a 24-member corps of community health workers, creating jobs and helping establish women as local leaders. The effort helped so many people that Give Hope Global plans to work with Johnson C. Smith University to replicate it in Charlotte.
Give Hope Global takes a holistic, long-range view of its work. Beyond health care, it now supports vocational training, housing renovations, sanitation improvements, chicken and fish farming, water filtration projects and well digging. The group is working with another nonprofit, Partners in Health, and Haiti’s Ministry of Health on plans to renovate the public hospital in Les Cayes.
Caldwell, who’s 45 and a Charlotte native, first visited Haiti in 2013. He’s gone back seven more times, typically for a week four times a year. Other Novant physicians have also volunteered their time there.
“I went to Haiti realizing there were things we could do in Haiti to really have a huge impact on a lot of people that maybe wouldn’t happen if we didn’t step up and do it. There is no safety net there,” Caldwell said. “That’s what really attracted me to it.”
While Haiti has physicians capable of treating Edouard, many hospitals lack the sophisticated equipment his surgery required. Still, he’s only the second patient the group has brought to Charlotte for surgery. In 2015, the group brought in an infant with a tumor on its face.
“Our goal is to build and sustain a system there that’s Haitian-directed, Haitian-run,” Caldwell said. “There’s plenty of expertise in Haiti to run a (community health) system, so we’re down there as their partner. I think it’s a success story that we haven’t brought more people up, because we haven’t needed to.”
‘It’s up to God’
A year ago, Osselin, the Give Hope Global medical director in Haiti, brought his friend Edouard to the clinic for an evaluation by Caldwell. “He said he’s going to make this (surgery) happen,” said Osselin, who traveled to Charlotte with Edouard this month.
“I saw it was so sad for a medical doctor who cannot work and I think about talking to Dr. Will Caldwell about that,” Osselin said in a video produced by Novant. “The program in Haiti, even though we have Haitian neurosurgeons to do it, but maybe no equipment for that.”
Edouard had a pituitary gland tumor at the base of the brain. The tumor pushed on his optic nerve and brain stem as it grew to a mass of about 1 inches by 2 inches, impairing his vision and balance. Doctors thought his vision might improve once the tumor was removed, but after three years of damage were not sure to what degree.
Edouard said his family was against the surgery, saying he might die during it. Some relatives believed devils caused his tumor. But Edouard agreed to the procedure in order to conserve his remaining vision.
In three hours of surgery on Jan. 8, Dr. Hunter Hoover, an ear, nose and throat specialist, and Dr. Jennifer Orning, a neurosurgeon, threaded their instruments up Edouard’s nose to remove the tumor. Others helped evaluate Edouard: Caldwell; Dr. Bob Barr, a radiologist; Dr. Art Cohen, a pathologist; Dr. Bill Flannery and Dr. Lillian Ferdinands, internists; Dr. Don Stuart, an opthamalogist; and Dr. Rashim Gupta, an endocrinologist.
During a followup exam 11 days later, Hoover inserted a small optical instrument called an endoscope into Edouard’s nose. The probe streamed video on a monitor as it traveled up a nostril, through the sinuses and to a cavity the tumor had occupied. Beyond the opening, Edouard’s brain pulsed as blood flowed through it.
With the tumor gone, Edouard said in an interview, so are the morning headaches, nausea and balance problems he’d suffered. But: “I don’t see that I’m getting my vision returned.”
Some of his vision may still recover, doctors say, but neither further surgery nor eyeglasses would help. They gave Edouard a magnifier that will at least help him read.
“To be honest, it’s not as much as we had hoped for” from the surgery, Hoover said.
Edouard, who plans to leave for home this week, insists he’s not disappointed. He believes that his vision will return.
“In life, you need to balance things,” he said. “I don’t have the tumor growing in my head.”
“ I rely on God that the vision will come back, because that’s the only thing we need now, the vision.”