A mother torn: Joy for son, grief for daughter (News Feature)

By Mike McCarthy Jan 22, 2010, 5:32 GMT

Port-au-Prince - Oselene Joseph had some glee in her eyes.

Waiting in line at the US evacuation centre in the airport at the Haitian capital, she encouraged her 13-year-old son to talk about what he had been through.

The boy, Vladimir Fotaine, was standing with his broken right arm in a cast. His broken jaw was wrapped up.

Vladimir, however, was unable to speak much English and didn't seem to feel like discussing his ordeal anyway while waiting with his mother for a flight to Miami.

So Joseph spoke on her son's behalf. She explained that he was injured and trapped under the rubble for hours following the January 12 earthquake that tore through the impoverished country and destroyed Port-au-Prince.

Vladimir was pulled from the wreckage by his father and eventually bandaged up. Joseph, who lives in Miami, had come to Haiti to retrieve her son and said she looked forward to bringing him back to Florida, home to the largest population of Haitian immigrants in the United States.

As she discussed the family's plans, her eyes began to sink and her mood turned somber. Slowly, she looked up.

'I lost my daughter,' she said, fighting back tears.

Joseph turned and walked away.

Unlike so many victims of the magnitude-7 earthquake, which has visited unprecedented hardship and tragedy on Haitians who have known little else, Vladimir was lucky.

Lucky that his father found him and freed him from the fallen concrete so quickly. Lucky to still have his arm.

Countless amputations have been performed, often under battlefield conditions.

Victims who were trapped for days under tons of debris, often with complex fractures - broken bones that pierce the skin - quickly suffer severe infections. By the time they reach medical care, the only way to save the patient is to remove the limb.

Two American doctors waiting at the airport to depart after volunteering for a week through the University of Miami, in cooperation with the United Nations, described the horrific process.

Joe Mackey, an anesthesiologist, said because of limited equipment and supplies, the amputations are performed under less than ideal circumstances. A lack of oxygen tanks prohibits him from putting patients completely under during the procedure. Instead, he he uses local anesthesia to numb the limb and adequately sedates the patient.

Hacksaws are the tools of choice.

'What is positive is that they don't have the pain when they wake up,' Mackey said.

Based at Boston University, he performed such surgeries with James Guest, a neurosurgeon at the University of Miami. The two said they performed about 350 surgeries including about 100 amputations during their seven-day stay.

Guest said that it was difficult explaining to patients the fate that awaits them, that to survive they have to agree to have an arm or leg removed. The doctors would often give quake victims time to think about the decision, in some cases overnight, but rarely did patients change their minds.

'People realized and tolerated what was happening quite well,' he said.

In the aftermath of the procedure, they seem emotionally capable of coping, often with the support of loved ones, and just happy to be alive, Guest said.

But he worries that the feeling of calm is temporary, and that eventually the realization will sink in that they will be dealing with the loss of a limb 'over the economics of a lifetime.'

'There was one women who changed her mind' after first consenting to an amputation, Guest said. 'We never saw her again. I assume she passed away.'