A Witness to Tragedy, Rehab Doctor Returns to Haiti

In 1995, Andree LeRoy’s life changed when her aunt in Haiti chose death over amputation.

Her aunt’s diabetes had led to a foot ulcer, and she didn’t want to become an amputee. She didn’t want to be called “kokobe,” a pejorative Haitian Creole term for a disabled person. In Haiti, poverty has led to stigma around disability. People who are missing limbs cannot contribute to household income through manual labor but still require family support.

Her aunt’s needless death inspired LeRoy, a Haitian-American, to become a rehabilitation doctor. She hoped to help disabled people function to their potential, and fight the idea that the disabled bring others down. LeRoy attended the University of Illinois College of Medicine, and was selected for a residency at Boston’s Spaulding Rehabilitation Hospital, a teaching hospital of Harvard Medical School.

It’s actually how we integrate all members of society that allows us to rise above our economic difficulties. You can’t leave people behind.

Then, in 2010, she watched the news of the earthquake in Haiti on television, reliving her feeling of powerlessness when her aunt chose death over amputation. She worried about the amputees, who she knew would need help regaining mobility and battling the stigma of being disabled.

“Here it is, I’m looking at the television, and 15 years later people are saying they’d rather die than have an amputation. That’s when I said, ‘I have to do something,’” LeRoy said. “Oftentimes people with disabilities are marginalized. They’re not integrated; they’re living on the fringes. For the most part, they’re the most vulnerable of the poor.”

LeRoy went to Haiti with a team from Spaulding Hospital just a month later. They assessed the country’s need for rehabilitation care and found many gaps. There are no full-time, practicing rehabilitation doctors. Without specialty training programs, Haiti has no occupational or speech therapists, who, in the U.S., help patients with cognitive damage in cases such as Roseline’s, a University Hospital patient who recovered from a three-story fall. Nor are there residency programs to allow doctors to specialize in physical therapy.

“I realized I have to spend time on the ground, training others,” LeRoy said. “It’s not my goal to be in charge forever; we just don’t have Haitian physicians who are trained.”

LeRoy believes that with more access to medical training, Haiti can build its workforce of rehab health specialists and provide care to people who are disabled, helping them make the most of their lives. With care, she believes, stigma will lessen, just as it did when treatment became available for tuberculosis and HIV.

University Hospital in Mirebalais, where the rehab program is now based, is a hub of this training. The hospital and its staff can refer patients to the rehab program for care. There, patients can regain their cognitive and physical abilities. In cases of permanent disability, the rehab team offers physical therapy and mobility devices such as prosthetics, walkers, and wheelchairs. These services both help patients in need and allow health professionals to learn to provide rehab care.

“We’re trying to create a transnational movement to reintegrate people after a temporary or permanent disability,” LeRoy said. “It’s actually how we integrate all members of society that allows us to rise above our economic difficulties. You can’t leave people behind.”