Treatment delay leaves no choice but amputations

FOR two days, Ticia Vital refused doctors’ pleas to allow them to amputate her festering left leg, even as the gangrene spread and the alternative became death.

But after a sleepless night filled with pain, the 19-year-old agreed – becoming one of scores of Haitians to lose their limbs to the magnitude-7 earthquake.

In a country where life was already difficult, a future without an arm or leg is especially dismaying.

“What will I do? How will I manage to survive on my own with just one leg?” Vital asked, lying on a metal bed frame at Renaissance Hospital.

Doctors in Port-au-Prince say they have performed numerous amputations of hands, arms and legs.

“We have had to perform dozens of amputations, including many double amputations,” said Dr Diana Lardy of the Los Angeles-based International Medical Corps. “The problem is people haven’t gotten medical care soon enough, so wounds are very infected. Some of them are coming in with bones just sticking out from the rest of the leg.

“We have dozens and dozens of patients waiting for surgery, including dozens of amputations, and people are still coming in.”

Ward space is short. Some buildings at Port-au-Prince General Hospital suffered earthquake damage.

Doctors performed 45 amputations at Renaissance in three days, said Dr Olga Maria Delgado of Havana. Most were done outside on a white-tiled counter under a tin roof. She said sterility was less of an issue than usual because most of the wounds are already infected.

At first, patients refused to come inside the hospital for fear of aftershocks. But the operating room finally moved indoors on Monday.

“She repeatedly refused to have her leg cut,” said Vital’s cousin, Chantal Felix. “But I talked her into it, and she had to accept it after the doctors told her the gangrene was spreading and that she would die.”

Vital and Felix sell secondhand shoes in the Bel Air slum, sharing a room with Felix’s daughter, 11.

“What will we do now?” Vital cried. “What will we do?”

Unfortunately, her worries about the future may not matter. After the operation, surgeon Dr Frank Diaz said Vital was severely infected and suffering scepticemia. “She’s not been responding well to all the antibiotics we’re giving her,” he said. “I think she has a 90% chance of dying.”