Helping Haitian amputees a long-term effort for Seattle foundation

Winfried Danke has traveled around the world to bring new limbs to victims of wars, natural disasters and accidents.

But never before has the 41-year-old Renton man faced a challenge as daunting as Haiti, where a monstrous earthquake left behind a "generation of amputees" in a country least able to help them.

"What is happening in Haiti looks very much like a war zone," said Danke, executive director of the downtown Seattle-based Prosthetics Outreach Foundation (POF). "The magnitude of the devastation and the logical challenges of serving the amputees are huge."

Danke's foundation is working with a dozen other international relief agencies to help an estimated 4,000 Haitians who lost a leg or an arm in the Jan. 12 earthquake. It's a startlingly high number, and one that threatens the future of the small island nation of poor subsistence farmers who typically travel on foot or by bicycle.

The goal of the relief effort is to connect each amputee with a basic but durable artificial limb for about $200 or less. Materials will include custom-made, plastic sockets to connect to the residual limbs, leglike bars, plastic webbed-feet, and, if the amputation is above the knee, metal-spring knee joints.

The foundation, a 20-person organization with an annual budget of just $700,000, will not set up a factory to manufacture limbs, Danke said. Instead, it will work with the other agencies in training doctors and aid workers to manufacture and fit prosthetic limbs.

The 21-year-old organization has helped 15,000 amputees in Vietnam, Sierra Leon, Liberia and Bangladesh, said Danke, sitting in the foundation's crowded conference room, surrounded by maps of Third World regions and color photographs of smiling men, women and children with prosthetic limbs.

The foundation's Haiti effort is likely to last a long time. Most amputees must do four to six months of physical therapy on crutches to keep muscles functioning before they can be equipped with an artificial limb. Adults will need a new one every three to five years, while children will need a new one every six to 12 months.

"It's not a one-time deal," said Wendy Batson, U.S. executive director of Handicap International, which is leading the effort to help amputees. "You're going to need that limb refitted, repaired and replaced for the rest of your life."

Unique challenges

Bellevue orthopedic surgeon Robert Veith, 59, just returned from a week in Jimaní, Dominican Republic, a border city which has seen scores of Haitian refugees.

Representing the foundation on the trip, Veith worked with 20 other doctors, including Lowie Gilman of Valley Medical Center. The pair saw firsthand the difficulty of the relief effort.

"It's amazing how many amputees have come from this disaster," said Veith, who said he slept in the operating room after 15-hour days of surgery on crushed limbs. "We were trying to get people back home as soon as possible, but unfortunately there's not much to return to."

Before the earthquake, Haiti existed as the poorest country in the Western Hemisphere, with a poverty rate of 80 percent and an illiteracy rate of 35 percent. It also had a high disabled population — some 800,000 in a country of 9 million — because of a lack of access to basic medical care.

The quake multiplied those problems. Poorly constructed buildings collapsed, crushing those inside. Because the epicenter was near the capital, Port-au-Prince, the quake paralyzed much of the local infrastructure, including the medical industry. Lack of medical care turned treatable injuries into causes for amputation.

Nearly a month into the relief effort, officials don't know exactly how many amputees there are. Handicap International and other groups put the number at about 4,000, but other experts estimate up to 40,000.

"It's election night right after the polls closed and we have 1 percent reporting," said Fred Jacobs, 44, of Seattle, development director for the prosthetics foundation. "We're dealing in estimates."

In a nation where males farm to provide for their families, prosthetics will be critical. But the lack of public transportation means aid workers will have to go to the amputees, not the other way around.

And they're essentially starting from scratch.

The only prosthetics company in the country, Healing Hands for Haiti, saw 80 percent of its facilities destroyed in the quake, said Executive Director Eric Doubt. Even when it was operating at full capacity, the company produced only 20 prostheses per month.

Since the quake, donated materials have poured in, Danke said. But because prosthetics must be custom-fit, aid agencies need more than materials. They need trained doctors.

And most of all, they need money.

"This will require sustained support," Jacobs said. "If you want to help, the best thing you can do is have a bake sale."

An international effort

The response to the earthquake has been overwhelming, said Doubt, calling it one of the largest relief efforts ever.

The Northwest is well represented, through the foundation and larger groups like Portland-based Mercy Corps and Federal Way-based World Vision.

In dealing specifically with disabilities, Handicap International is leading a team of about 15 nonprofits, including the foundation. The groups are currently in hospitals and clinics showing amputees how to do physical therapy and keep their wounds clean. Eventually, they'll rebuild the old Healing Hands for Haiti facilities and build at least one new factory, Batson said.

But aid workers are afraid that, as in past disasters, the world may soon forget about Haiti.

"We're hoping the world's attention stays focused," Jacobs said.

As for Veith, he said he plans to return to the island early next month. The surgeon promised one of his patients, a 36-year-old man who lost his left leg when his house collapsed on him, that he would track him down and bring him to a clinic where he can start the process of getting a prosthetic limb.

"Tragedy has struck these people, and yet they persevere," Veith said. "It's hard for us to fathom the depths of the tragic loss for these people, yet they persevere."

Brian Rosenthal: 206-464-3195 or brosenthal@seattletimes.com