The emergency phase will be "probably two to three months," said Chris Jobe, the head of orthopedic surgery at Loma Linda University of southern California.

Volunteer doctors have treated thousands of people since the January 12 quake hit the Caribbean nation, many of them with severe crush wounds and broken limbs after they were hit by crumbling buildings.

"The problem is that for a femur to heal it takes six months," said Jobe who oversees three foreign surgery teams from the United States, Mexico and the Dominican Republic at the Adventist hospital of Diquini.

The teams "had 150 patients yesterday and 30 of them were potential surgery" patients, he said at the hospital on the western outskirts of the devastated capital, Port-au-Prince.

He was commenting during a joint visit by US Ambassador Kenneth Merten and French Ambassador Didier Le Bret, who were inspecting the hospital being run by US and French teams.

Some 25 French medical teams, each made up of a doctor, a nurse and an assistant, have treated some 2,700 people since the quake.

"We are going to do our best to help Haiti," Merten said, asked about whether the United States was in for the long-term at the hospital.

His French counterpart said he had heard of the need for supplies at the Diquini hospital. "It is going to be a big challenge," he said.

earlier related report
NGO races to help Haiti deal with quake amputees
Washington (AFP) Jan 2, 2010 - Nobel peace prize winning NGO Handicap International is moving fast to help Haiti deal with a distressing new reality: huge numbers of amputees left by the powerful earthquake that rocked the country two weeks ago.

"The first plane-load of short-term DynaCast prosthetics is already in the country," said Wendy Batson, executive director of the US branch of Handicap International.

"We're setting up a database and moving in the medical equipment we need so that as soon as stumps are healed enough after surgery, we can put on DynaCast prosthetics, which last four to six months," she said.

Batson said the disabling injuries in Haiti "surpass anything we've ever seen anywhere else."

The NGO, which shared the Nobel peace prize in 1997 with the International Campaign to Ban Landmines, pulled staff from emergency and long-term programs in China and Pakistan and sent them to Haiti to help with relief efforts.

Twenty expatriates are working alongside 130 Haitians "in the remnants of the medical system and out in the neighborhoods where they identify people with serious injuries and tell them they should get medical care immediately.

"But given the devastation to the medical system, more sophisticated interventions that would allow you to save limbs can't be done, and anyone who can't in the most rudimentary way have their limb saved is having it amputated, so that infection doesn't kill them," Batson said.

Handicap International has already logged 500 amputees in Haiti on its database, and based on information it has received from other NGOs, the number of people who have had to have injured limbs cut off has exceeded the 1,000 mark in two weeks -- a rate of about 75 amputations a day.

And then there are people with serious head and spinal cord injuries sustained in the earthquake, or with burns or compound fractures that "haven't yet led to amputations," said Batson.

"Those numbers, no one's focussed on yet. We're just trying to save lives right now," she said.

The 7.0-magnitude quake on January 12 killed some 150,000 people, left close to 200,000 injured and up to one million homeless.

Given the seriousness of the injuries and the extent of the devastation, Handicap International expects to stay in Haiti for the long haul.

"The needs are now enormously greater than they were before," said Batson.

"They're going to be left with a disproportionate number of amputees per head of population, not to mention the people who are going to be left para- and quadriplegic from this.

"That's long-term; that's not short-term," she said.

For the moment, the NGO's main focus is to set up a facility to produce longer-term prosthetics for Haiti's newly disabled population. It hopes to have production up and running within months.

It has found a Haitian producer of polypropylene, a material commonly used to make prosthetics, and already has bench technicians and one certified prosthetist-orthotist on the ground in the quake-ravaged country, with another due to arrive by the end of the month.

"We are looking at where we're going to set up our production facility in Haiti to begin producing permanent limbs," said Batson.

The aim is to give amputees short-term limbs as soon as possible after surgery, "because most people with amputations, once the stump is healed, are better off with any kind of system that lets you move around," said Batson.

And when the DynaCast prosthetics reach the end of their useful lives, "We should have a production facility in place to begin looking at permanent fitting alignment," Batson said.

earlier related report
Hard labor for Haiti's mothers
Port-Au-Prince (AFP) Jan 26, 2010 - When the screams of women giving birth die down, you can hear the subdued cries of those babies who made it alive into the chaotic post-quake suffering of Port-au-Prince's general hospital.

The women lie atop mattresses on gravel in the sweltering heat of tents erected in the hospital courtyard. Some have limbs amputated, others pelvic fractures. In Haiti, the joy of parenthood must wait, sometimes forever.

"Women give birth after being pulled from the rubble, their legs or arms amputated, some have deep wounds," Jean Herby Lafrance, a Cuban-trained Haitian doctor who flew in with a group of Cuban medics last week, told AFP.

Before the January 12 quake, thought to have killed 150,000 people, the impoverished Caribbean nation had the highest rate of maternal mortality in the western hemisphere -- 670 deaths per 100,000 births.

Fifteen percent of births involved hemorrhaging or other complications requiring operations, according to the United Nations Population Fund (UNFPA), with an estimated 63,000 pregnant women among Haiti's affected population.

Doctors, nurses and mothers alike labored long. Parents cradled newborns in their arms, some nursed. Most faces were expressionless, stuck between awe at the destruction and the joy of survival. Others smiled in spite of it all.

So far Lafrance had delivered 20 babies, including five by Cesarean section and two premature births brought on by stress from the earthquake.

"We've had eight women miscarry, some three or four months pregnant," said the 33-year-old, who has two children of his own at home in Santiago de Cuba.

"We have problems with equipment, particularly for Cesareans," said Lafrance. "The situation for operations is very critical, we don't have the material, but we operate anyway. It's very difficult."

He said there were no doctors in maternity when he arrived. Today, with volunteers from around the world in Haiti, he said there were enough doctors, but almost everything else was lacking.

"We have nothing to prepare the women, no compresses, sometimes no anesthetic and the operating tables are incomplete. We need material."

Some women can't make it to hospital and give birth without assistance in the many makeshift camps that have sprung up in and around Port-au-Prince. Conditions beyond the capital can be much worse.

"Around 7,000 women are expected to give birth in affected areas over the next month, with another 1,000 expected miscarriages," the UNFPA's Jemilah Mahmood told AFP.

The UNFPA is trying to get basic "reproductive health kits" containing a plastic sheet, a sterile blade to cut the umbilical cord and a clean string to tie it, plus a blanket for the newborn, to pregnant women in Haiti.

"Midwives and health centers, when they see someone who is visibly pregnant and about to give birth, they hand this out to them so that if they deliver in the middle of the street, they have a clean delivery kit," Mahmood said.

More advanced kits are being distributed to the hospitals and health centers that survived the earthquake. Some contain emergency Caesarean section equipment, others things ranging from kidney dishes to gloves.

But while the kits might be a step towards providing slightly more sanitary conditions to women as they give birth, they do nothing to preserve something else that was also taken from Haitian women and girls by the quake: dignity.

Joane Kerez, 20, gave birth to her first child a week and a day after the quake struck in the middle of a square in Port-au-Prince where thousands of displaced Haitians have made their homes, a CARE worker wrote on the NGO's website.

Kerez had only a tarpaulin for privacy, her mother to help her through labor -- and a crowd of onlookers gawking as she brought her baby into the world.

"I would have rather been somewhere else, in a cleaner place without all those people looking at my body," Kerez said.

"One of the things that is talked about very little is dignity," said Mahmood, explaining that UNFPA has begun distributing "dignity kits" to Haitian women.

The kits contain sanitary towels, hygiene materials, underwear.

"Women and girls are still menstruating, in spite of living outside in very horrible conditions, and having your clothes soiled could mean you are unable to get to food or water distribution points. And that can really impede survival and recovery," said Mahmood.

"Put yourself in the same position -- going to a supermarket and your clothes are soiled" by menstrual blood, she told reporters on a teleconference in the United States.

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