DESCHAPELLES, Haiti -- Just two days after getting his new artificial leg, Schneily Similien already has ditched his crutches.
The 4-year-old amputee, who lost his left leg in Haiti's devastating earthquake, is walking on his own, only a little wobbly, slowly making his way toward the open clinic door where his new friends wait.
"Yay!" he says when he sees them, raising his arms high, an unmistakable gesture of victory.
Such quick progress is typical of most kids adapting to prosthetic limbs, says Mary Anne Kramer-Urner, a physical therapist from Dominican Hospital in Santa Cruz, Calif.
"Once they start, they're off," says Kramer-Urner, a volunteer for the aid group Physicians for Peace.
For Schneily and other earthquake amputees -- and those trying to help them -- momentum is vital as they work to recover from disaster. At every level, however, from the individual to the institutional, moving forward is precarious in a place where the next steps are anything but certain.
"Ever since the 12th of January, we've been making it up as we go along," says Ian Rawson, the managing director of the Hopital Albert Schweitzer, where the Hanger Orthopedic Group has set up a new prosthetics lab and clinic.
Up to now, that approach has worked. The 80-bed-hospital was packed with as many as 800 patients in the days after the quake that killed an estimated 230,000 people, injured 300,000 and left 1.2 million homeless.
The prosthetics lab hit a milestone this week, logging 100 artificial limbs manufactured in less than a month.
"I looked at the numbers and I counted again," says Jay Tew, the prosthetics expert running the clinic for Hanger. "Wow. I didn't know we'd done that many."
Tew will head home to Baton Rouge, La., by May, but he's already planning to return. In the future, he'll cycle through in two-week stints like other visiting prosthetics volunteers, but he hopes to be involved with the clinic indefinitely.
"People who are coming here are coming with their heart and soul to help," Tew says. "Everybody is going to be tied to this place for the rest of their life."
For amputees like Schneily, the efforts have been life-changing. The preschooler will be running within a week, aid workers say, and accomplishing more after that, avoiding the isolation and social stigma that often plagues the disabled in this country. Simply having a normal-looking prosthetic leg to wear in public goes a long way toward avoiding the stares and scrutinty of strangers.
"He'll do great," Tew says.
Schneily likely will need a new artificial leg every year or so as he grows and adjustments more frequently to keep it working right. He's healed remarkably well so he's more fortunate than many amputees, who often need repeat surgeries to make it easier to wear their prosthetic limbs.
The Haitian Amputee Coalition says it will continue to provide free care for Schneily and others in the future through contributions from individuals and the group's members, including the Ivan R. Sabel Foundation, Hanger's charitable foundation; Physicians for Peace; the Harold and Kayrita Anderson Family Foundation; and Dr. Donald Peck Leslie of the Shepherd Center. Coalition officials have yet to put a price tag on the effort.
It turns out the hospital may help the boy's family in another way as well: by providing a job for his father. HAS has a woodworking program on site, a small center where workers build and repair furniture for pay. Ducarmel Similien, also spelled Cimilien, 40, is a carpenter with years of experience.
"It would only be piecework for now, but it's something," said Rawson, who added that there also might be work nearby for Schneily's mother, Darline, who's a teacher. "They would be such a net positive for the community."
That could mean a completely new future for the Similien family. Schneily's older brothers, 10- and 13-year-olds now living with their grandmother, could come to Deschapelles, too.
"That's very nice," says Darline, 37, through an interpreter. "The family has to be together again."
As satisfying as it will be to help the Similien family, Rawson worries about the needs of so many others. The Haitian government estimates that 500,000 displaced people fled Port-au-Prince after the quake, flocking to rural areas like the Artibonite Valley, where HAS has served residents for 54 years.
Many of them include the amputees now coming to Deschapelles for treatment and more. Soon, Rawson says, he'll run out of room, a situation echoed across the country.
"Our crisis is some of these people are ready to go home, but they have nowhere to go," Rawson says.
The center, which is operated by a local community group, will keep as many people there as long as they can. Possible future plans could include giving amputees who are ready to leave tent kits that include shelter, cooking equipment and other necessities. That would allow them to ask to live on property owned by friends and family without imposing on their hosts, Rawson says.
The broader solution, he says, is a large-scale effort not to rebuild Haiti, but to build a new country from the old, one where education, employment and health care are regionally dispersed and available to all.
Otherwise, he says, many families with needs as great as the Similiens' -- or greater -- will founder for generations to come.
Walking through L'Escale, the housing community where amputees and their families are staying, Rawson greets Luquese Belizaire, an old family friend who runs the compound. Rawson checks with Belizaire about the possibility of Ducarmel Similien's job. Yes, Belizaire tells Rawson, we can use him.
Then Rawson stops and translates Belizaire's concern: "That's one," Rawson says."What about all the rest?"
