Print edition: 
Brian Hakala of Wichita landed in Haiti at 3 a.m. on Jan. 24, and went to work salvaging crushed human limbs by 7:15 that morning.
The sun was up by then, he said, "and we saw the magnitude of destruction and human suffering."
"We had no time to feel anything emotionally," said Hakala, a pediatric orthopedic surgeon. "There was a task to be done, and we had to do it as efficiently as possible, as best as we could with what we had."
In the University of Miami tent hospital in Port-au-Prince, he went to work. He worked 14 hours a day for six days, surrounded by doctors from across the U.S. He tended to 75 children's cots and about 125 cots holding adults, nearly all of the patients suffering from what he called "severe crush wounds."
In six days he performed 55 surgical procedures and made rounds with 75 severely injured
children every day.
"We had a lot of external fixators, where you stick pins through the skin into bones to hold them in position,'' Hakala said. "We did some grafting of muscle to cover the bones; we moved muscle to cover the bones so the bones aren't exposed and get infected."
Infection was everywhere, privation was everywhere, decay was everywhere.
"The majority of open fractures were infected,'' Hakala said. "Many of the patients had already had amputations, and the amputation wounds were infected. The muscle around many of the wounds was dead tissue and had to be removed.
"In most trauma accidents here, you might have a broken leg from a traffic accident, but while the bone might be broken, the muscle around it is fine. But in Haiti people had been untreated for so long that the muscle from the crush wounds had deteriorated."
Most of those wounds were infected because brick, concrete and rafters had fallen on them in the earthquake 12 days before; and most of the children and adults had lain on the ground, untreated, eating no food, drinking little or no water as they suffered.
"I did no amputations myself, but I treated infections," Hakala said. "Most of what I did was try to save limbs.
"If you lose a limb in a country such as Haiti, it's a much greater loss than in the USA; it's harder to get prosthetics, it's harder to get work, harder to get around. In Haiti it is death to lose a leg; and what you see there now is an entire generation that has lost arms and legs."
Hakala has practiced in Wichita for years. The tent hospital he worked in was run by Project Medishare and the University of Miami School of Medicine. It was adequately stocked and secure from lawlessness because it was supported by the U.S. Army's 82nd Airborne Division.
After he came back, Hakala said, the sights and the suffering deeply touched him. It was hard to leave because there is such a need, but he took comfort in knowing that other doctors were there to take his place.
He took comfort in working shoulder to shoulder with medical staff from Boston, from Nebraska; from meeting other medical personnel in other tent hospitals nearby who had flown in from Portugal, Israel, Australia.
He hopes doctors and others who can help in Haiti will look up the organizations that got him there or have arranged much of the aid: the Community Coalition for Haiti, the Pediatric Orthopaedic Society of North America, Project Medishare.
He wants to go back.
