As a powerful earthquake struck southwestern Haiti, Felix Pierre Genel’s home collapsed. He was rescued from the rubble the same day and received treatment at a local hospital. He was still unable to escape the common calamity of amputation.

The doctors initially told the 36-year old that they would save his right arm. To stabilize the fractured bone, he had to have surgery. An infection followed by a second surgery.

Genel stated, “Instead of dying,” from his bed at Les Cayes’ General Hospital, where Genel had his right arm bandaged and was able to see that doctors had amputated his arm above the elbow. “From where I am coming from, in the mouth of death it’s best to have the arm cut off.”

In the aftermath of devastating earthquakes such as the one that struck the Caribbean country on Aug. 14, broken bones can cause open wounds. This combination increases the risk of infection.

Dr. Christopher Colwell, chief for emergency medicine at Zuckerberg San Francisco General Hospital, stated that the risk of infection increases the longer you wait before getting care.

He said that fractures and broken bones associated with open wounds can lead to severe infections. These can cause amputation or even death.

At least 2,207 people were killed and 12,268 others were injured by the magnitude 7.2 earthquake that struck under the country’s southwest Peninsula. Around 130,000 homes were destroyed or damaged. Affected were also hospitals, schools, offices, churches, and other public buildings.

The pandemic had already put pressure on health care facilities. Many injured people had to wait in the heat for treatment, even at airport tarmacs. One hospital had to place patients in corridors, verandas, patios, and hallways because it was overwhelmed.

A tropical storm also made it difficult to access medical care. It followed the earthquake and closed a major hospital in Port-au-Prince for two days to protest the kidnappings of two doctors, one of which was an orthopedic surgeon.

Colwell, who was not present in Haiti, stated that natural remedies can be successful to varying degrees. However, some are not helpful and can even cause infection.

Hospitals admitted only the most seriously ill patients within the first few weeks following the Haiti earthquake in 2010. Many patients with simple fractures that didn’t expose the bone through their skin were discharged without consulting a doctor. However, many of these patients returned later with serious infections and complications.

Humanity and Inclusion, a nongovernmental organization, concluded that amputations accounted for an extraordinary proportion of surgical procedures. They also added that “some amputations performed in extremely difficult conditions required corrective surgery.”

According to the organization, there were between 2,000-4,000 amputations with at least 1,000 individuals who required a prosthesis for their lower limbs.

This time, far fewer people were injured than in 2010, when at most 300,000. Haitians were hurt. The government also claimed that the death toll was similar.

Now, the group has a Haitian team that assists health care personnel and assesses patients’ needs. They are able to examine and treat scarring and stumps, give exercises to patients and help with stiffening of the joints. They can also provide psychological support.

Virginie Duclos, a rehab specialist, said that traumatized people can feel sad and depressed. However, some are also in denial and believe their lives will be the same.

Other governments have also sent aid to southwestern Haiti. This included the U.S. military’s USS Arlington, which arrived with a medical team.

A week after the earthquake, Samaritan’s Purse, a non-governmental organization, also opened a Les Cayes emergency field hospital.

Melanie Wubs was the medical director of the field hospital. She stated that “when we opened, many people were seeking care for their first time — and this was already a week following the earthquake — with broken bones, with wounds.”

She stated that others had been “hurriedly patched up right following the earthquake, but now required more care, whether it is surgery or debridement.

Wubs stated that her team has performed only one amputation to date.

Robenson Perjuste, a couple of beds from Genel’s, lay Wednesday with his eyes closed, his left leg bandaged, where doctors had to amputate it just above his knee. Ricardo Lavaud was his older brother and fanned Robenson Perjuste with a small piece of cardboard.

Lavaud, a student in agronomy, was not at his apartment in Les Cayes when the earthquake hit. Perjuste, a student in agronomy, was on vacation and had been staying with Lavaud. Lavaud ran home to find his brother, aged 15, buried under rubble. A heavy concrete beam had broken his leg.

Passersby assisted Lavaud to lift the beam high enough to pull Robenson free. Lavaud was told by doctors that his leg could not be saved. His brother believes he was the first victim of the earthquake to have surgery at the general hospital.

Robenson has nurses who change his leg bandages every two days. However, no one has ever spoken to Robenson’s brothers about the need for physical therapy or whether Robenson could be fitted with a prosthetic.

Lavaud, 22 years old, said that his brother believed in spirits. “No matter what happened, he believed in the will God and that this was the path God had destined for him.”