On the morning of Dec. 22, Winnie Henri called a former classmate, a young Haitian like herself, and asked him to come to her Roxbury apartment to talk.
“She said, ‘You are the ones I need the most,’ ’’ recalled Frantz Sousky Etienne, an 18-year-old survivor of the 2010 Haiti earthquake. “Instead, I told her I had to do something else.’’
Hours later, Henri, who had been brought to Boston to save her life, lay dead, prone on the floor in a simple room where she lived alone.
To friends and teachers, Henri’s mysterious death reflects the pain - economic, social, and emotional - that young Haitian emigres, uprooted by natural disaster and personal hardship, often suffer in silence in the United States.
And for Partners in Health, one of Boston’s highest-profile charities, her sudden death under its supervision has prompted soul-searching and questions about whether Henri, who received medical care here two years ago, later tumbled through the cracks toward a lonely and unattended death.
“Everyone associated with the case is devastated,’’ said Ted Constan, chief operating officer of Partners in Health.
Henri’s death startled educators, who saw promise in her hard work and ambition in her desire to return to Haiti as a caregiver.
“It is a terrific shock,’’ said Nicole Bahnam, headmaster of Newcomers Academy in Dorchester, where Henri studied after surgery at Children’s Hospital Boston to remove cancerous adrenal glands. “I’m distraught. The more I think about it, the more it bothers me. Why in America should someone die alone?’’
The question has yet to receive a clear answer.
The cause of Henri’s death is unknown, and an autopsy will be conducted, but critics such as Bahnam are asking how a 20-year-old woman with known medical problems could die on her own while in a Partners program.
That program, Right to Health Care, uses hospitals and physicians in the United States and elsewhere to offer critical treatment not available in the patient’s home country.
Constan said Partners will reexamine Henri’s case.
“Any time we have a bad outcome, we look to ourselves and our programs as to how we can prevent that,’’ Constan said in a telephone interview from Rwanda. “Everyone associated with the case is devastated and is looking back to see how we could have changed.’’
A Partners spokeswoman said she knew of no red flags that would have indicated an imminent threat to Henri’s health. But teachers, friends, and Henri’s landlord described a woman who had begun to lose weight, missed many days at school, and often rubbed her stomach to indicate the source of nagging pain.
An administrator at Boston Adult Technical Academy in Mattapan, where Henri had transferred in September, said she was shocked by Henri’s appearance a month ago. “I looked at her and said, ‘Oh, my God,’ ’’ recalled the administrator, who asked not to be named.
Under Partners in Health, Henri left Haiti for cancer surgery at Children’s Hospital in 2010. Afterward, Partners provided Henri a place to stay, transportation to doctor visits, and necessities, such as rent, food, and clothing.
Henri received her medical care from Children’s and Dana-Farber Cancer Institute, Partners officials said, and was supplied regularly with endocrine replacement hormones she would need for the rest of her life.
Since 2010, Henri had been in frequent contact with care coordinators, according to Partners officials. Staff phoned twice a week to check on her condition and visited once a week at her Hutchings Street room, officials said.
A care coordinator visited Henri the night before her death to deliver Christmas presents, according to Kria Sakakeeny, a Partners spokeswoman. At that time, nothing seemed alarming, Sakakeeny said.
Henri had established a reputation as a smiling, hard-working student at Newcomers Academy, quickly making friends, many of them survivors of the Haiti earthquake.
“If you were mad, she would say, ‘Don’t be sad; live life and be happy.’ She was always smiling,’’ said Yveline Amazan, 16, a former classmate and earthquake survivor.
But outside school, Amazan and other friends said, her life was lonely. Her family remained in Haiti.
She had few, if any, friends outside school. And she felt shunned by the other four families of earthquake survivors on her floor at the spare, wooden home, said her landlord’s family.
“She was always by herself. She was always in the room,’’ said Gaslaine Jean, 24, who lives a floor above Henri’s room and is the landlord’s sister-in-law.
“She didn’t have anybody with her,’’ added Mary St. Fort, Jean’s sister.
Amazan said her friend masked her struggles.
“She didn’t really talk about her personal life, but sometimes she would say, ‘I’m alone, guys. I’m by myself,’ ’’ Amazan said.
“We were her family here,’’ said Bahnam. Like many earthquake survivors who arrived by coincidence about the same time, Henri remained in Boston under an extended visa.
Through it all, Henri rarely complained, said Sheila Azores, headmaster at Boston Adult Technical Academy. “Winnie always held her head up high,’’ Azores said. “Winnie did not wear a sign that said, ‘I’m sick; treat me like an invalid.’ ’’
To Azores, Henri did not appear desperately ill, although she would frequently rub her stomach and speak of pain. Constan said the next step for Henri would have been an ultrasound.
“She didn’t present as someone who was in imminent danger,’’ Azores said. “She was incredibly independent, and she took care of herself beyond her age.’’
Children’s Hospital officials, citing confidentiality restrictions, would not comment specifically about Henri’s medical care. But a statement released by the hospital underscored the depth of her health issues.
“Winnie Henri had a serious and complex illness that required extensive treatment by physicians in several clinical specialties in the two years she was cared for at Children’s Hospital Boston,’’ the statement said.
Jean and St. Fort said Henri often failed to take her hormone medication. “They kept telling her to take the medicine, and she didn’t take the medicine at all,’’ St. Fort said.
Azores said that Henri’s independence and quiet resilience, traits that might have hidden her condition from some, are typical of young Haitians here.
“Our immigrant students suffer silently. They keep their pain - their social pain, their language pain, their poverty pain - they keep that to themselves,’’ Azores said.
Partners will pay Henri’s burial expenses in Haiti. Its staff also will wrestle with the what-ifs of her case, a brief life that flickered brightly in the classroom but ended mysteriously, and out of view, on a modest apartment floor.
“We believed at the time we had the appropriate accompaniment plan in place,’’ Constan said. “But we accept the moral responsibility here. We wish things had been different, and they would have been if we had foreseen the outcome.
“We will regret this for the rest of our lives.’’