The legacy of a "generation of amputees"

Yesterday's post addressed the need to rebuild Haiti's devastated infrastructure. There is, of course, a more urgent need and that is to help rebuild its people. It strikes me that someone should at least be thinking about how some of the money being raised to help in the Haitian relief effort could be used to establish a program to provide prosthetics to those who have lost limbs.

I admit that I have no idea what the costs or logistics of doing something like this would entail, but the concept of developing a state-of-the-art medical center that would address this problem that has implications for generations should at least be under consideration. Maybe/hopefully it already is. (GW)

Now Haiti must bear burden of generation of amputees

By Kim Sengupta in Port-au-Prince
The Independent
January 29, 2010

In a nation where manual labour is the main source of income, life just got harder

Marie Guerduy was selling bread on the street when the earthquake struck, and the wall of one of Port-au-Prince's ramshackle buildings fell on top of her. She lay, trapped, overnight. When they found her next morning, it might have seemed things were getting better. Now she sits in a makeshift tent, amid the chaos of the city's hospital, and mourns the life she says she has lost. For Marie Guerduy has lost her leg. She will sell bread no more.

"My life is over," she says. "I have nothing but fear for the future. Who will feed my baby, who will look after my poor father and mother? Why has God done this to me?"

Ms Guerduy, 40, is not the only one facing such a bleak future. As well as mourning the dead, Haiti must now face the legacy of a "generation of amputees" as a result of the terrible injuries suffered by thousands in the devastating earthquake.

The number of people left with crushed limbs was one of the highest in recent times in a disaster. And the overwhelming number of cases faced by the medical services in the aftermath of the tremors meant doctors often had little choice but to amputate arms and legs which could have been saved in a Western country.

The task of coping with the huge numbers of disabled falls on one of the poorest countries in the world, where manual labour is the only form of income for the vast majority of the population. Many of the victims, who will no longer be able to work, were sole breadwinners.

The only place in the country which produced prosthetics is now under rubble. International aid groups are attempting to organise imports but, given the huge problems they face with bringing in essentials such as food and water, that is seen as very much a long-term goal.

There were already around 800,000 Haitians with disabilities before the earthquake. It is not known how many more there are now but officials say there will be a massive increase. Eric Doubt, executive director of Healing Hands for Haiti International, said: "The handicapped in Haiti have been largely unattended to or abandoned by their governments, and there are very few medical organisations who attend to them. So you can see the scale of the problem we are facing."

At Port-au-Prince's overflowing hospitals, medical staff are having to carry out repeat operations on many of the amputees. Discharged from hospital the first time, they ended up contracting infections on the streets because their homes have been destroyed. "This is worse than a war zone, believe me - I have worked in war zones," said Dr Beat Kehrer, a surgeon coordinating the Swiss medical team, standing next to the wreckage of the nurses' quarter which collapsed killing 153 staff.

"In a combat situation you have rushes of injured coming in, but there are gaps in between. Here it has been never-ending. We have had to save people in the quickest way and that has meant amputations.

"In the future you can see almost two countries developing here, a generation of amputees and others who suffered bad injuries, and those who got through the earthquake all right."

Dr Bruce Mintz, 53, from New Jersey, in the US, said: "We have had to deal with hundreds of amputations here. I have been involved in 200 myself. There are certainly more limb damages here than in other natural disasters that we've come across. What's called the guillotine method is used for the operation, but then there is revision because of infection. It's pretty desperate. I've worked in Third World emergencies, but I've seen nothing like this."

Marie Guerduy is still coming to terms with the consequences. She has a three-year-old son, Jean-Charles. Her 22-year-old daughter, Dassy-Marie, says she will now have to look after the extended family of eight. "That will be for the rest of my life, but I do not even have a job, so I do not know what to do," she said.

Nor does her neighbour on the next bed, Girold Morancy. He looked after his family of seven out of the meagre income from his stall. He, too, has been brutally disfigured, losing his left leg below the knee. Deaf since boyhood, the new disability means his chances of finding employment are effectively over at the age of 18.

Mr Morancy's 28-year-old sister, Claudette, said: "We have a little brother who is 11 months old. His name is Jameson. Our father is 70 years old. I have to somehow find money for everyone now and also look after Girold, he is helpless. How am I going to do this?"

In another part of the hospital, Angelie Basson was fanning her 11-year-old son, Louis, who has lost part of his left arm. "He was in much pain. It was such a bad thing to happen but I am just so glad he is alive," said Ms Basson, 36 , who suffered cuts and bruises to her head when part of the ceiling at their home collapsed.

The hospital has faced a deluge of injured since the "day of catastrophe", as the Haitians call it, two weeks ago, and it is now overflowing with dispossessed humanity. Several hundred patients have refused to stay indoors because of fear of aftershock and have dragged their cots and mattresses outside to a "ward" which has become known as the "Forest". Semi-naked men and women wash themselves in the open, with no space for privacy. Among all this move international medical teams; armed troops from US Airborne and scientologists in yellow T-shirts hugging startled relatives of patients.

Beatrix Moran, a nurse of Haitian descent based in New York who returned to the island to help, was looking after the tent with amputees. Putting her arm around the weeping Ms Guerduy, she said: "One of the worst things is that there are no social workers here. There is no one to comfort these people, so we have to try to fulfil that role as well. I try to tell them things will be all right, but you know just how hard life will be for these people."

Ms Moran had been paying for the education of a young orphan girl for the last five years with the aim of adopting her and taking her back to the US. But the orphanage where 14-year-old Laura was staying has been destroyed and her fate is unknown.

Wiping tears from her eyes, Ms Moran said: "I know I shouldn't cry, and I should be strong for the others. But I am very worried. We are all suffering here, this is a terrible, terrible situation. We live in a cursed land."