By David Weigel August 19 at 5:49 PM

CAP HAITIEN, Haiti — Eighteen hours earlier, Maitre Rose’s world was black with useless, blurry flashes of light. She was 75, blinded since 70 by a dime-sized cataract, unable to make any more money as a seamstress. Then she learned about the free eye surgeries at Vision Plus Clinique. On the appointed day, she was walked onto a bus, then into a series of waiting and observation rooms, then onto the surgery table of Sen. Rand Paul (R-Ky.), then sent home eye-patched.

Early Tuesday morning, the ophthalmologist-turned-presidential candidate removed those patches. He placed his right hand on Rose’s face.

“Look down,” he said. “Look up.”

Rose blinked. She looked down at the medical chart and supplies she’d been given. Then she raised her arms in delight.

“I can see!” Rose said, through a translator.

“Tres bien!” said Paul, twanging out one of the French phrases he’d memorized for the trip. He turned to the NBC News cameras that had pulled in close, and to the cameraman for the Moran Eye Center, and to the benefactors pointing their iPhones and GoPros.

“She’s reading the chart,” a translator said.

“I can’t even do that,” Paul said.

Over 15 crowded minutes, Paul and a team of Moran Center surgeons removed the eye coverings of more than a dozen elderly Haitians, powered by a rhino-sized generator that could go out for minutes at a time. It was Paul’s second foreign trip with the University of Utah-based eye center, a journey away from the campaign trail just days before Kentucky Republicans would decide whether to let him seek the presidency and a Senate reelection simultaneously. It was happening while stateside pundits asked if Paul was no longer a relevant candidate, and filled airtime with news about Donald Trump — who, Paul kept reminding people, donated to the Moran Center.

“As a philanthropist, I would commend him,” said Paul. “But I don’t think it’s enough for me to discount the craziness of his policies, or think he’d be good running the country.”

Rose, meanwhile, was rattling off the livelihoods that had been stolen by age and restored by Paul. “I can mend shirts,” she said. “I can read my Bible again.”

Paul’s second annual journey to the third world went as smoothly as could be hoped. He was accompanied by a videographer for the Ohio-based, conservative The Strategy Group, who was also recording video for the Moran Center. Reporters from NBC News, the Associated Press, IJ Review and The Washington Post were invited to monitor the surgeries and interview Paul, under the condition that nothing be published until the senator had left the country.

Paul was happy for the work. “There are things I love about trying to spread the message about the underpinnings of what makes our country great,” he said in an interview. “But it’s more of an indirect result. Medicine is a direct result. You’re working with a team, you have a goal, you execute it, and you get close to people. It’s a lot like being on a sports team or [in] a locker room.”

Yet the 2016 campaign was never fully absent. Paul had arrived in Haiti on a Learjet 60XR, compliments of the multimillionaire founders of the women’s gym franchise Curves. Gary and Diane Heavin, who had been coming to Haiti for charity work since the 2010 earthquake near Port-au-Prince, spent hours talking with Paul, visiting orphanages in advance and watching his patients open their eyes.

The cigar-chomping Gary Heavin potentially had a lot to offer Paul. He had given $1 million to Karl Rove’s American Crossroads, and he made it clear that former Texas governor Rick Perry, his 2012 candidate, would not play the same role in 2016.

In an interview on the blockaded street outside the eye clinic, Heavin said that he’d taken a 45-minute phone call from Rick Santorum and a dinner with Sen. Ted Cruz. He had ruled out donating to either. America, he said, was “on a precipice,” and, separate from any campaign, he had written a movie, “AmeriGeddon,” dramatizing how freedom could die.

Paul alone had the record and character that might be worth a seven-figure donation. Might be. Heavin was trying to figure out if Paul could get there.

“I learned that he’s complicated,” Heavin said. “Because he’s complicated, it’s difficult for him to interpret advice. Process it. Listen to it. It’s difficult for him to explain his message. We were talking about the Middle East, and he’s right on the points, but he tried to explain things and it was just convoluted. You’ve got to explain things on the back of a napkin.”

Heavin had constructive criticism for Paul; Paul had only praise for Heavin. “He turned a little money into a fortune, and he gives back a significant amount of it,” Paul said. “He represents a lot of what’s great about our country, both the ability to create wealth and jobs, and giving it back in a good way. In 2014, Americans gave privately $840 billion. You can only really be generous if you create wealth. We have to understand how we create wealth, and not stymie that, and not make ourselves into a failed state.”

Surgery was harder than politics, yet not convoluted at all. Sitting in the operating room, Paul worked quietly, asking 55-year-old translator Mildred Olivier to help him tell patients not to jerk around or touch the numbed region around their eyes. A Bluetooth speaker, tuned to the Mumford & Sons station, played guitar rock that jangled without breaking anyone’s concentration. When walking the patients out, some of the attendants shimmied with the music, forming two-person conga lines.

Most of the patients were elderly. “I don’t think we’ve had anyone under 70,” Paul mused at lunch on day two. Some came from the city. Some were helped off buses that came from two-hour drives across dirt and bald hills. At least two children, brought by family members or friends who’d heard about the clinic, arrived but could not be treated immediately. Walky Joseph, 12, came with a guardian who remembered when he used to enjoy school and play soccer. His needs were just too complicated for the week-long clinic’s setup.

He could be helped anyway. The Moran Center’s ophthalmologists would spend part of the week training Haitian doctors in the newest and most efficient method of cataract removal. The trip was over not just when the surgeries were done, but when more Haitians could help themselves.

That was how Paul saw the whole country. After a quick Tuesday lunch, he decided to visit StreetHearts, a home and school for boys on a hill across town. As he rode, markets and slum life bustling through his window, Paul mused about the benefits of foreign aid. He had called for ending all aid to “countries that burn our flag,” and Haiti did not qualify. But he’d criticized the idea that hearts and minds could be changed with checks to governments.

“After the earthquake, our military dropped off water and food,” he said. “There’s definitely a role that government can play to help. But the ultimate answer to all of this isn’t really even a health problem. It’s an economic problem. How do you get 10 million people working? There’s a lot of good farmlands, good tourist area. Stability of law is one of the first things you need to have, and then you need to have the rule of contract. If I’m a big employer and want to employ 10,000 people, I have to be guaranteed they’re not going to take my profit. There’s an enormous amount of money around the world that would come here if that was settled.”

The legacies of misguided or misused investment were everywhere. It was a short drive from the city to the Caracol Industrial Park, built in part by the charity of Bill and Hillary Clinton, but not living up to its job creation promise. Paul’s plane, like all planes, had landed in Hugo Chavez International Airport, named in honor of the late dictator after his oil-rich country plugged $1 billion into Haiti. Paul’s surgeries were taking place in a clinic with a plaque that thanks Venezuela for key aid.

Paul was not impressed. “They’re in the decline stage of socialism,” he said. “What we are great at is buying selling, trading and making stuff. We should try to export that wherever. I do want to be engaged with places like Haiti in both charity and trade. But if you dump 10 million pounds of rice here, you’d ruin the rice farmers. As I drive through the streets, what I think is: What would be the one business I could start in Haiti that would employ 10,000 people? There are ways to do that. The problem is that the government is not friendly to business.”

The SUV rolled on, past one of the many United Nations outposts built in Haiti since the earthquake. Paul had said he’d be happy if the U.N. simply “dissolved.” In Haiti, he saw a role for blue helmets.

“I think that to have growth, you have to have stability,” Paul said. “Through the last 100, 200 years, there’s been a lot of times we’ve been invited by one group and not really invited by the public. They still have memories of us being supportive of governments they weren’t fond of. I’m not sure it always has helped. But there seems to be such disarray, having an international presence seems to have provided some stability. It seems there’s an inability of providing that, then that’s why the U.N. is here.”

Later, asked about the U.N.’s role in bringing cholera to Haiti, Paul demurred. Plenty of politicians were demanding that the organization make restitution for the disease, brought by Nepalese soldiers. Paul needed to know more.

“I’m not sure if cholera is spread from me to you,” he said. “I don’t think you catch it from people. My first suspicion is that cholera is unsafe drinking water, sewage and things like that. I don’t think you get it off of a ship.”

But before that, there was the visit to StreetHearts. Paul’s SUV pulled up a hill where children were playing in the dirt, and men were beating metal into patches for their roofs. More SUVs arrived, loaded with soccer balls that the Fox News personality Eric Bolling had purchased after hearing about Paul’s trip. The senator was game, kicking balls back and forth — the kids in donated T-shirts, him in his medical scrubs. Then it was back to the clinic, where by day’s end 42 people would be rescued from the dark.