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Amputations become the defining injury of the earthquake in Haiti

JIMANI, Dominican Republic — At the public hospital in this border town, no one can say how many amputations have been done since the earthquake. One surgeon says he did 32 yesterday. Another says 22 in the two days before. Mostly legs. Mostly from infection.

They come in truck beds, the backseats of taxis and police vans. Tuesday, a tap-tap, one of the small colorful Haitian buses, showed up full of people, most of them from Petionville, the exclusive enclave of Port-au-Prince.

The vehicles line up, waiting for their broken cargo to be unloaded to dusty gurneys. Unless they are critical, the victims line the entrance on the floor for days.

The lucky ones have crushed arms and legs but keep their limbs. They lie in body casts, whole. They may limp. They may need canes. But they do not belong to the burgeoning class of Haitian amputees.

This is the signature injury of the catastrophe. In medical tents and operating rooms across the disaster zone, surgeons saw without ceasing. They work in conditions their forebears from battlefields of 150 years ago would find familiar. Without power, sometimes with instruments sterilized in vodka, they struggle to keep pace with the implacable advance of gangrenous rot that has turned treatable injuries into life threatening ones. The wails of the wounded testify to the physical and psychological scars that these amputations will leave on the whole society.

"There is no place in Haiti for people like me," says Joaz Nancie, 27. "Without my leg, I am a freak. Cripples are rejected here."

A third-year nursing student, she was at the Louis Pasteur Nursing School in downtown Port-au-Prince when a wall fell on her. Three days later, with no treatment, her leg turned black.

"I am a good student. I knew," she says.

She has no husband, no children. Her future career was everything.

"I was going to be the first person in my family to make it out of poverty," she said. "But now, that's over. An amputee is not allowed in school."

The seven surgeons at this hospital — all living in the Dominican Republic — work from 6 a.m. to 1 a.m. every day. The hand saws they use look like files.

Saturday, they got anesthesia and pain medication. Before that, they used novocaine and aspirin. They still need many things to keep up with the unending stream of earthquake victims — steam sterilizers, a sonogram machine and strong antibiotics.

A young man tells Dr. Eric Thierry that he needs his feet to feed his family. A young woman tells him that she will no longer be lovable.

Thierry, a thoracic surgeon, tells them both the same thing: "Don't worry. You will get a beautiful prosthesis and be fine."

But later he says he wishes he could believe his own words: "I hope so," he said.

Mona Isma, 38, lies on a mattress on the floor in an orange sun dress. Rescuers dug her out Thursday in Petionville but couldn't find her 12-year-old son, Wanclef. Surgeon Hector Aquino sawed off her left leg Monday.

"Will I still be pretty," she asked a visitor that night.

The next day, he told her that her infected right leg also had to go.

"Infection will eat you if we don't," he told her.

She stared at the ceiling, saying nothing.

In the operating room, a surgeon slathers iodine on a 50-year-old woman's upper thigh. He readies the saw. Blood spurts. The nurses gather around her, blocking a visitor's view. In an hour, this convenience store clerk from the capital will be a different person, joining thousands across Haiti who have had arms and legs amputated in the past week.

In the room next door, Milanda Cherie, 5, wails in agony,

"Help me, Lord."

Next to her, another 5-year-old girl, Mailine Noelle plays with a naked Barbie, slipping two fingers of a latex glove onto her feet.

"Socks!" she squeals, holding the doll up for the nurses.

Both little girls were in separate parts of Port-au-Prince playing outside with their dolls, when walls fell on them. In this unfathomable place, with broken legs and smashed pelvises, but still intact, they are the face of hope.

Amputations become the defining injury of the earthquake in Haiti 01/19/10 [Last modified: Wednesday, January 20, 2010 3:14pm]
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