If all the logistical details fall into place, 21-month-old Melissa Chery and her mother, Adimene Exile, will arrive in Delaware on Sunday or Tuesday, following a flight from Port au Prince, Haiti, to John F. Kennedy International Airport in New York City, said Lynn Shapira, president and co-founder of the Haiti Family Initiative, a group founded last year in response to the 7.2-magnitude earthquake that devastated the island nation in January 2010.
Dr. Carol Shields, an ocular oncology specialist at the Wills Eye Health System in Philadelphia, believes the child “has an ocular cancer which could be retinoblastoma, rhabdomyosarcoma, or orbital lymphoma” and that her eye may have to be removed. She offered that assessment in an email to a nurse with Helping Hands and Beyond Inc., a Pennsylvania relief group that treated the child at its clinic in Hinche, Haiti.
Retinoblastoma is a rare cancerous tumor of the retina that occurs most often in children under 6 years old. Shields’ email said that “if she is not treated, I suspect she will die from this malignancy within 1-2 years.”
Dr. Sharon Lehman, division chief of ophthalmology at the Alfred I. duPont Hospital for Children, said that retinoblastoma is the most common intraocular tumor found in children, but there are only about 200 cases each year in the United States, and most of them are caught at an early stage because American Academy of Pediatrics guidelines call for checks of what is known as “red-eye reflex” at every well-baby visit.
Shapira and Carole Downs, also a co-founder of Haiti Family Initiative, learned of the case on Monday night, only hours after Shapira returned from Jacmel, Haiti, where she had been working at a summer camp program operated by her organization. They received an email from Herline Raphael, a nurse and founder of Helping Hands and Beyond, based in East Stroudsburg, Pa. Raphael first saw the toddler on July 12 at her group’s clinic in Hinche, and reached out to the Wills Eye Health System. Haitian doctors said the girl’s condition was too complicated for them to handle, according to an email sent by Raphael to Shields.
Meanwhile, Downs and Shapira contacted the children’s hospital and the Christiana Care Health System, where Shapira’s husband, Nadiv, is a thoracic surgeon.
By Thursday, Shapira said, all three hospitals had agreed to treat the child free of charge.
“We don’t get cases like this often. This is very rare,” Christiana Care spokesman Bill Schmitt said.
Based on Shields’ assessment, which was made after viewing a photo of the child, Shapira and Lehman said treatment of the child will be coordinated among the three hospitals, starting with diagnostic work at A.I. du Pont, followed by surgery at Wills and radiation therapy at Christiana Care.
Mobilizing to help a Haitian child
A.I. duPont Hospital’s Dr. Sharon Lehman on bringing Melissa Chery to the U.S. for treatment. Details of the treatment plan and how long it will take cannot be resolved until the A.I. du Pont staff gives the child a physical exam, takes a tissue sample from a portion of the tumor and administers other tests, Lehman said.
While surgery is the usual first step, some tumors are better treated by starting with chemotherapy, she said.
“In some advanced cases, there is no option but to remove the eye,” Lehman said, but she was hopeful Friday that the child could be treated in time to save not only her vision but her life.
In some cases, Lehman explained, the tumor metastasizes and travels through the ocular nerve and eventually into the circulatory system.
While waiting for approval to enter to the United States on an emergency medical visa, Melissa Chery has been staying at St. Damien Hospital in Port au Prince, Haiti’s capital and largest city. Raphael, who is still in Haiti with Melissa and her mother, was spending Friday making the rounds of Haitian and U.S. diplomatic offices in Port au Prince to complete the visa paperwork, Shapira said. (The child’s father, Pierre Chery, was killed in the January 2010 earthquake.) One of the requirements for securing an emergency medical visa, she said, is providing documentation from the hospitals that they will assume responsibility for the costs of her care.
The group has reservations on American Airlines flights from Port au Prince to New York for both Sunday and Tuesday — depending on when the visa paperwork is completed, Shapira said.
Although both their organizations have been working regularly in Haiti for the last 18 months, Shapira said she has never met Raphael. They have communicated regularly via phone and email to discuss their mutual needs and how they can help each other.
The Haiti Family Initiative has concentrated its efforts on Jacmel, a city of about 40,000 some 30 miles south of Port au Prince. Last summer, the group sent about 100 volunteers to the earthquake-devastated Jacmel to operate a summer camp and health clinic for the city’s residents. Operating this summer with a smaller number of volunteers, the camp concluded its second season on Thursday. Helping Hands and Beyond works primarily in Hinche, a city of about 50,000 about 80 miles northeast of Port au Prince.