Connect

Along the steep, rubble-strewn alleyways of Haiti, into the mountains above the city of Cap Haitien where he lives, Ernst Pierre carried his daughter, Schnydrine, on his back for miles each day. He used his limited funds to pay for a taxi to transport her to school each day. And he took precious time away from work to find her the best possible medical care.

At the age of 7, Schnydrine fell 20 feet off of a wall into a ravine, where Pierre found her unable to move. Schnydrine’s hip had been dislocated — an injury that, despite early treatment by local physicians, continued to worsen over time. “When I first met Schnydrine, she was 13 years old,” says University of Virginia Health System radiologist Gia DeAngelis, MD. “She was in severe pain and walked with a limp due to early avascular necrosis, or deteriorating bone tissue, in her hip.”

DeAngelis has traveled to rural Haiti more than 20 times as part of a mission group, providing medical care to men, women and children who otherwise would have limited access to even the most basic treatments. “The Haitians are extraordinary people with a resilient spirit,” she says. “With Schnydrine, there was a personal connection. I identified with her father’s dedication and drive — he did everything for his daughter and he knew she could have more, so he didn’t give up.”

Where There’s a Will
Pierre visited eight Haitian hospitals in two years, including those in distant Port-au-Prince, yet none offered treatment for Schnydrine. Many of these encounters tested his will. “They asked me, ‘Do you have a ton of money?’ and if I said no, then they said they could not help me,” Pierre says. “So I bended God’s ear until He got tired of me … and then Gia stepped into our lives.”

Like Pierre, DeAngelis was tenacious in her pursuit of the best possible care for Schnydrine. She exhausted all avenues to get her the treatment she needed in Haiti, arranging meetings with local doctors as well as those visiting from the U.S. “The orthopedic surgeons they visited told Pierre that the resources did not allow for a relatively difficult procedure on a young patient,” says DeAngelis. “They could only offer her a hip fusion, which limits what you can do in life and I knew she would not be happy with that.”

It was her colleagues at UVA who reassured DeAngelis that Schnydrine should not have to settle. Orthopedic surgeon James Browne, MD, reviewed Schnydrine’s x-rays and was confident that a hip fusion was not the only option for her. “It’s rare to do a hip replacement on a teen, but I felt it was the best option for her to restore function and improve pain,” he says.

Browne volunteered to travel to Haiti to perform the surgery, however the resources available in the Haitian hospital were not adequate for a complex procedure of this kind. It became apparent to DeAngelis that the only way to provide Schnydrine with the help she needed was to get her to the U.S. and into a UVA operating room.

To make that happen, DeAngelis turned to Executive Vice President for Health Affairs Richard Shannon, MD, for help. Shannon agreed that helping Schnydrine walk again was a cause UVA could support. From that point on, the pieces quickly fell in to place. Browne scheduled the procedure and, in just a couple of months, Schnydrine and her father were on their way, accompanying DeAngelis on a flight from Haiti to her home in Charlottesville.

One Surgery, Many Lives Changed
UVA orthopedists perform hundreds of hip replacements each year, however 16-year-old Schnydrine was a special case not only because of the distance she traveled to get to UVA, but also because of the complexity of her condition. “Her condition was more advanced than we typically see in the U.S., with severe destruction of the joint; she was also more disabled than the typical patients we see,” says Browne.

Yet in late July, Browne defied the odds and successfully performed a total hip replacement. “The procedure was challenging due to the longstanding nature of her condition, but the surgery went well and she recovered very quickly, bouncing back like you would expect a young person to do,” he says.

Schnydrine spent almost two months recovering at DeAngelis’ home, where her days included outpatient physical therapy and other activities to get her moving, including swimming and pushing a cart through the aisles of the grocery store. When Schnydrine took her first steps without a walker or crutch, it was tears of joy that lined her cheeks and fell from the eyes of her father. “I am overjoyed to get rid of the pain and suffering,” she says.

Without this burden of compromised mobility and constant pain, Schnydrine was suddenly free to focus on simply being a teenager. She beaded a bracelet for a friend back home who stood by her and encouraged her to have faith that she would have a happy, productive future; she learned how to Skype with her family back home; and she rediscovered her love of dance, something she never thought she’d do again. “UVA hospital has done a great thing and it will impact this girl’s life profoundly,” says DeAngelis.

In fact, the impact of this surgery goes beyond just helping one girl walk again — it affects the lives of an entire family and the community in which they live. Pierre can now focus less on his daughter’s health and more on finding work and supporting his wife and children. This will give them all more opportunities to thrive.

While Schnydrine’s smile was reward enough for DeAngelis and all of those involved in caring for her, Schnydrine wanted to leave them with her own words of gratitude, written in English: “If thank you so was water, I will offer the oceans; if it was sand, I’d give the Sahara desert; but since it is a feeling from my heart, I offer you my heart as a thank you.”

Haitian Girl Gets Hip Replacement