Marvel

One could say that Republicans are all about the so-called "watered-down" legislation lately -- their own versions of what are thought to be Democratic initiatives, tailored to their base's passions and prejudices. (Marco Rubio's DREAM Act doesn't count; he's watering down what was originally a bipartisan initiative.)

House Republicans voted on and approved on one such bill yesterday, their watered-down Violence Against Women Act (VAWA). As much as the conservative base seems to care about making normally procedural votes into cultural battles, you'd think that they're doing it to gain favor with the majority of Americans. The cynical amongst us might wonder why any politician would do anything that wasn't somehow directly related to the maintenance of their own personal station, control and power in politics.

To explain why, I have to first apologize to another host on our network for "going meta," which I consider one of the more annoying rhetorical tactics in our political lexicon. But it seems that Republicans are doing their very best to cater to their own political advantage by not catering to their own political advantage. (How else to explain this, for instance?)

Let's start with the bill that embodies that notion, the budget Republicans voted for overwhelmingly (and symbolically) in the Senate yesterday: the Paul Ryan budget. When it comes to the Ryan budget -- which President Obama wouldn't sign even if it had passed -- by now, you know the drill. TPM's Brian Beutler summed it up well in his recap of the 41-58 vote: the Ryan budget kills Medicare in its current form, replacing it with a privatized voucher program that calls itself "Medicare." You know all those speeches the President has been giving lately about student loans? He's trying to keep the student loan interest rate from doubling...and the Ryan budget would double it. It would also cut food and nutrition programs for the poor, all in the service of giving really wealthy people incredible tax cuts. Ryan's budget does everything but kick your dog, it seems.

Considering how unpopular it was with voters the first time around, you'd think Republicans would be treating Congressman Ryan like, well, like they treat George W. Bush. Yet, he's being talked about as a VP candidate. And his budget, despite recent Republican concerns, keeps getting voted upon. Beutler offers an interesting theory:

It’s a governing agenda many Republicans would like to wash down the memory hole. But over the past year it’s become a Kryptonite touchstone for conservative purity — a plan most Republicans feel compelled to support, but which they understand to be politically deadly.

I'd employ a different comic book metaphor. The Hulk, a raging, green behemoth with the mind of a child (above), became the Hulk when his human alter ego absorbed a normally lethal amount of radiation. Adherence to conservative purity has become so paramount to most in the party that even when legislation that is utterly radioactive to voters is pushed, they vote for it anyway. They absorb all the radiation these bills offer under the belief that they somehow make them stronger, when all it does it make them look more savage and brutish. And unfortunately, their version of the VAWA opens the door to real-life monsters.

Rep. Gwen Moore (D-WI) argued vociferously against the act in her testimony on the House floor yesterday, recounting her own experience as a survivor of sexual assault (video here):

“I took a ride with a guy I thought was a friend…and he decided to take a detour behind some buildings to rape me and choke me almost to death. I went to the hospital, was examined, they could see I had been raped. When we got to court I was on trial…what I wore that night was on trial and he was found not guilty,” Moore said.  “This was 20 years before had the Violence Against Women Act, before we gave law enforcement to the tools to know what the circumstances are. As a woman of color I am particularly aggrieved this bill ignores the circumstances of women who are minorities.”

Indeed, the GOP version of the VAWA takes the version Senate Democrats passed and excludes from it notable groups -- LGBT Americans, undocumented immigrants, and Native Americans -- from  protection under the bill. And it's not just minority groups at risk here, as Rachel Maddow noted in her A block segment last night (there's a reason why a mail-order bride firm was lobbying for the Republican VAWA). Rachel also noted the fact that at the same time, local Washington D.C. politicians are being bullied into supporting anti-abortion legislation. Restricting women's reproductive rights hasn't really helped out Mitt Romney with women voters. No wonder Republicans want to continue making it an issue.

Click below the jump to see our daily reads, and Rachel's interview with Del. Eleanor Holmes Norton, who represents the District of Columbia.

• As unpopular as Romney may be in the polls, he raised nearly as much money as the President did in April.
• House Republicans also have gay troops in their sights.
• House Speaker John Boehner is threatening the debt limit again (more radioactive politics), but he's making it clear that while the President's budget has to be offset by spending cuts, Paul Ryan's budget gets a pass.
• It seems Trayvon Martin did have a fight with his eventual killer, George Zimmerman, after all. (I'm with Ta-Nehisi on this.)
• Chuck Brown, the godfather of "go-go" music, passed away yesterday.
• Does the rise in female rappers have anything to do with gender?
• And yes, we've heard about this. Much more about that later today.
• As promised, Rachel's opening segment last night on the VAWA passage.

Schneily Similien barely remembers life before the earthquake. He was not quite 4 when the massive temblor struck last Jan. 12, destroying his home and shattering the child’s left leg.

For the young amputee, the reality of post-quake Haiti is the only world he knows. It’s a place where families live in tents because the houses are too broken. It’s a place where there’s little food and not enough money, and where wearing an artificial leg is just what you have to do.

Schneily, who turns 5 on Feb. 4, has grown an inch and a half in this world, and sprouted two shoe sizes. He learned to ride a bike through rubble, and to kick a soccer ball while balancing on a prosthetic limb.

Still, in many ways, his family is more fortunate than others. They escaped many of the miseries that descended on the nation even after the dust from the quake settled. No friends or family contracted cholera and the violence that shattered Port-au-Prince after the country’s failed election didn’t reach here.

Mostly, Schneily’s family has been trying to move on, to build a new life slowly from the remains of the old. His father, Ducarmel, 41, and mother, Darline, 38, rise each morning at 5 a.m. to get their older sons, Scarcely, 13, and Schmeider, 10, ready for school.

Until last week, Schneily had to stay home. He was asked not to return to the local kindergarten until his parents could come up with the equivalent of $875 in tuition payments. Thanks to donations from msnbc.com readers, he’ll be able to attend for the rest of the year.

One reader’s donation of $500, made through the nonprofit bank Fonkoze, also paid a year’s rent on a small roadside store, dubbed “The Schneily Store,” where the Ducarmel and Darline are starting to sell snacks and drinks to passersby.

Schneily has put a lot of wear on his artificial limb, which was provided by the prosthetic clinic at the Hôpital Albert Schweitzer in Deschapelles. In the last year, the clinic operated by the Hanger Orthopedic Group has provided limbs for more than 700 amputees, company officials said.

Last weekend, Jay Tew, the Louisiana prosthetic expert who started the clinic, reunited with Schneily and his family in Leogane. Tew adjusted Schneily’s leg and took measurements for the future.

“In the next months, we’ll swap it out and get a new one,” he said. “I told his parents to just let him be a kid.”

Amid a growing cholera epidemic, two weeks after a hurricane threat and 10 months after losing his left leg in an earthquake, 4-year-old Schneily Similien was turned away from school.

It happened last week, when school officials stopped the Haitian amputee and his father, Ducarmel, at the entrance of a local kindergarten in Leogane, 20 miles from the nation’s capital.

Schneily’s family owes the school money for tuition, about 35,000 Haitian gourdes, or the equivalent of about $875 U.S., and the principal said the boy couldn’t return until it was paid.

“I thought he was joking,” Ducarmel Similien, an unemployed carpenter, told msnbc.com through a translator.

He wasn’t.

That’s just the latest challenge of grinding life in post-quake Haiti, where the aftermath of the Jan. 12 temblor has been exacerbated by further disasters. Msnbc.com has followed Schneily and his family since March, when the boy received a prosthetic limb to replace his left leg and foot, which were crushed by falling concrete.

Ducarmel took Schneily home from the school, back to the ragged tent shared by the family of five. The boy didn’t mind; for him it simply meant more time to run and jump and ride his yellow bike with the training wheels. For Schneily, disaster is just the backdrop of his childhood.

But for Ducarmel and Schneily’s mother, Darline, the struggle to forge a new life for Schneily and his brothers, Scarcely, 13, and Schmeider, 10, goes on.

Their tent was damaged when Hurricane Tomas barely bypassed Haiti in early November, brewing vicious winds that lashed the makeshift house and floods that sent scorpions swimming in with the water.

So far, the Similiens (the family name is also sometimes spelled Cimilien) have avoided the cholera epidemic that has now killed more than 1,100 people and hospitalized nearly 18,400 across Haiti. Ducarmel says they make sure to treat drinking water from a local pipe with chlorine, but he’s concerned.

“I’m worried,” Ducarmel said. “I don’t want me or my family to have it.”

Meanwhile, Schneily’s artificial leg is much worse for wear: cracked on the bottom, making it hard for the boy to walk straight. When he takes it off, it stinks inside, his mother says.

And there’s still too little money. Jobs remain scarce. The family is pinning hope on selling groceries and water from a small roadside store. Ducarmel was able to pay rent on a tiny shop, thanks to a donation from an msnbc.com reader.

Still, for now, there’s no way to pay for supplies to sell, and certainly no way to pay for Schneily’s education. “Since the earthquake, I think a lot of things,” Ducarmel said. “Sometimes I look at my son and I cry.”

Schneily Similien is taller now, a growing boy in a country still reeling more than six months after Haiti’s devastating earthquake.

He has sprouted about half an inch since March, when experts first fitted the 4-year-old with an artificial limb to replace his left leg and foot, which were crushed in the collapse of his family’s home. That’s when msnbc.com began following Schneily and his family, tracking the boy’s journey as one of what’s now estimated to be 2,000 to 4,000 amputees who lost limbs in the quake.

Schneily’s growth spurt has troubled his parents, Ducarmel and Darline, who have watched uneasily as their youngest boy began to outgrow the new leg. Even as they’ve continued to grapple with life in an increasingly ragged tent, no jobs, and a daily struggle to feed Schneily and his brothers, Scarcely, 13, and Schmeider, 10, the adults also have worried that Schneily might not actually get the care he’ll need to mature normally.

This week, however, prosthetics experts from the U.S.-based Hanger Orthopedic Group will travel to Port-au-Prince, about 20 miles from the family’s tent in Leogane, and Schneily will get a tune-up, said Anna Avakian, the 29-year-old new leader of the clinic based at the Hospital Albert Schweitzer in Deschapelles. Avakian, who usually works in Bethesda, Md., replaced the clinic’s founder, Jay Tew of Baton Rouge, La., for a three-month stint. It’s part of the sustained care planned at the clinic, which has fitted more than 400 amputees with new legs and arms since February.

"Schneily looks great. He’s running around giving people high-fives," said Avakian, who examined the boy last week so that she could fashion his new components.

Ducarmel Similien, 40, a former carpenter, told a translator he is glad for the continued help. But in a country where disappointment is a daily reality, he’s not counting on anything.

By JoNel Aleccia

Six weeks after Schneily Similien received his artificial leg, the 4-year-old amputee and his family are finding that life in post-quake Haiti is one step forward, two steps back.

Schneily's father, Ducarmel Similien, remains grateful that his youngest son was fitted with a prosthetic limb to replace his crushed left leg and foot.

"He is doing good with his leg," Ducarmel said through a translator, adding that the boy can run, jump and even kick a ball while balancing on his fake leg, a milestone for child amputees.

But the 40-year-old carpenter was disappointed to learn that an anticipated job is no longer available at the Hopital Albert Schweitzer in Deschapelles, where the U.S.-based Hanger Orthopedic Group’s new clinic has treated more than 200 amputees since February. The position didn't work out after communication mix-ups and cutbacks at the hospital's woodworking center.

That leaves Ducarmel and his wife, Darline, 37, unemployed and struggling to provide for Schneily and his brothers, Scarcely, 13, and Schmeider, 10.

The family recently left a tent city in Leogane, eager to escaped the crowded, noisy, unsanitary encampment. They were able to return to their former home in the city outside Port-au-Prince, a house owned by Darline's mother. But the house was severely damaged in the quake and the second floor quarters, where Schneily was injured when the ceiling collapsed, remain uninhabitable.

Now Schneily's family is camped in a tent in the courtyard of their shattered former home, five people to one bed, with no income and little food, trying to come up with a plan for the future.

The whole Similien family is together again in L'Escale, the housing community for patients of Hopital Albert Schweitzer in Deschapelles, Haiti. Schneily, in front, wears his new prosthetic leg, and from left to right are his mother, Darline; brothers Scarcely and Schmeider; and father, Ducarmel.

By JoNel Aleccia

DESCHAPELLES, Haiti -- Late afternoon on Friday, Ducarmel Similien arrived back at L'Escale with his two older sons, Schmeider, 10, and Scarcely, 13. The boys had been staying in a tent city in Leogane with their grandmother and were anxious to see their baby brother -- and his new prosthetic leg. It was the first time the family had been together since they learned that there was hope for a new limb for Schneily, the 4-year-old who lost his left leg in Haiti's earthquake.

"Everything is different now," said Ducarmel, 40, who discovered that while he was gone, Schneily learned how to walk on his new leg without crutches.

With new hope for his youngest son and the promise of a possible job here at Hopital Albert Schweitzer, Ducarmel and his wife, Darline, 37, say they're looking forward for the first time since Jan. 12.

"Now we have less problems than before," Ducarmel said through a translator.

Ducarmel has heard from family members who saw msnbc.com's series of stories and relayed the outpouring of support for Schneily.

He says his greatest dream is that the boy will one day be able to go to school in the United States, where Schneily would have more opportunities for education and employment. Although the earthquake caused terrible pain to his family -- and to his country, Ducarmel said he relies on faith in the future.

"God has a plan for me and God has a plan for Haiti," he said.

By JoNel Aleccia

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?"

Msnbc.com is leaving Haiti this week, but will continue to follow the progress of Schneily and his family, Jay Tew and the Hanger clinic at Hopital Albert Schweitzer in Deschapelles.

Assellia Exelant tosses a ball to a fellow amputee during physical therapy exercises aimed at improving balance.

Assellia Exelant lost her left leg in the earthquake, but even that wasn't the worst thing.

The 32-year-old Port-au-Prince woman also lost her husband, Pierre Agent, 41, who died amid falling debris. That left Assellia injured, grieving and responsible for the sole care of her two children, ages 7 and 14.

"It's like most of my life is gone," Exelant says through a translator. It's not a complaint; it's an explanation.

For Exelant, who was running a thriving soda-and-beer concession outside the prime minister's office, there is no choice but to start over. A new prosthetic leg will help, but she knows the rest is up to her.

"I have family who can help out," she says. "But in Haiti, everybody has their own problems."

We are a world apart, but we are the same. Those are the sentiments echoed in multitudes of letters from U.S. amputees who shared their stories with amputees in Haiti. Selected letters were translated for patients at Hopital Albert Schweitzer in Deschappelles, Haiti.

Elias Brown

One of those letters was from 5-year-old Elias Brown who was moved by the story of Schneily Similien, a boy who lost his lower left leg in the Jan. 12 earthquake. At age 4, Schneily is the youngest patient at the hospital.

Elias, who lives in Austin, Texas, knows what it means to be different. Born with a congenital birth defect, his left leg was amputated when he was 2. He wanted to let Schneily know he wasn't alone, said his mother, Meagan Brown.

"Dear Schneily," Elias wrote, "My leg got amputated when I was 2 years old. And then I got my first prosthetic leg a little bit after that. It's hard to have your leg amputated. Don't be scared because God is with you.

When you get your prosthetic leg we can play together and run. I really hope that I can come to Haiti sometime and we can run and play together. Love, Elias."

In Deschapelles, as an interpreter for msnbc.com read the letter to Schneily's family, the boy's father, Ducarmel, smiled widely and gave a thumbs-up sign. "Amen," he replied.

To read other recent letters sent by readers, click here.

DESCHAPELLES, Haiti -- Joubert Pognon, 46, works as a policeman at the National Palace in Port-au-Prince, but he wasn't on the job when the earthquake struck. Instead, Pognon was in the parking lot of his three-level apartment building, where falling debris trapped him.

He spent three days stuck in a sprawling, awkward position, not quite lying, not quite standing, with his crushed left arm pinned above his head. By the time rescuers reached him, it was too late to save the limb.

He's now a patient at the prosthetics clinic at Hopital Albert Schweitzer and is waiting for an advanced artificial arm to arrive from the United States so that he can go back to work. Pognon says he's grateful he didn't lose his right arm, because he's right-handed and will still be able to shoot a gun. Like many earthquake victims, Pognon says he didn't panic during the ordeal. "I believe in God," he said.

Tammy Duckworth, assistant secretary of the U.S. Department of Veterans Affairs, lost her legs in 2004 after a rocket-propelled grenade hit the Black Hawk helicopter she was piloting in Iraq. Here, she's shown arriving at the World War II Memorial for a ceremony honoring World War II veterans on March 11, 2010 in Washington D.C.

Tammy Duckworth was prepared to die for her country. But the Army Black Hawk helicopter pilot never expected to return home severely injured. Helicopter pilots who are hit by enemy fire usually perish in a fire when their aircraft crashes.

"I thought I'd come home in a box or I'd be fine," she says, of her time serving in the Iraq War. But when her helicopter was hit by a rocket-propelled grenade, severing her legs, she went from "being a hotshot stud helicopter pilot to near death in a split second."

Her story, told in her own words, concludes msnbc.com's series of essays by Iraq war veterans who, like the victims of the Haiti earthquake, are a growing number of amputees learning to rebuild their lives after limb loss.

Duckworth was nominated last year by President Barack Obama to serve as the Department of Veterans Affairs' assistant secretary for public and intergovernmental affairs. She's also completed the Chicago Marathon, fulfilling a promise she made to herself when she was recovering at Walter Reed Medical Center. She continues to serve as a major in the National Guard.

By Tammy Duckworth

The head of the therapy department realized how upset I was. He grabbed a single thin white sheet of paper and told me to try and hold it. So I did, confused as to what he was getting at. He then said to me, "See, you do have grip strength. Today, it's one piece of paper. Tomorrow, it will be two pieces. The next day it will be three pieces, and the next day four. And pretty soon, you will be able to hold a whole stack in your hand. You do have strength there; don't let this machine tell you that you don't, because you do and we will get you back to where you need to be." More often than not, it was about baby steps.

President Barack Obama and Tammy Duckworth place a wreath at The Bronze Soldiers Memorial on November 11, 2008 in Chicago, Ill.

Throughout my recovery, I was fortunate to meet a number of fellow amputees who help to show me the way back to a normal life. I was the fifth women amputee from the Iraq conflict. Before I even woke up all four of the previous female amputees had been to Walter Reed to see my family and to see me. They showed me their weaknesses, their vulnerability and their strength. I hung onto their strength, because I knew that if they could get through it and survive, then so could I.

As amputees, we have adapted, we are stronger and we can make the most out of our second chances.

To watch videos of Tammy Duckworth on MSNBC cable, click here.

By JoNel Aleccia

DESCHAPELLES, Haiti -- Even in a community of amputees, John Markinley has seen more than his share of trauma.

The 21-year-old student from Port-au-Prince lost most of his left hand and part of his right leg in his country's disastrous earthquake, which trapped him for three days in the rubble of his school until rescuers could find and free him.

"I just waited," he says. "I knew they would come and get me."

But Markinley refuses to dwell on his disability -- and he doesn't let others stay down, either. As the unofficial ambassador of L'Escale, a housing community set up for prosthetics patients treated at the nearby Hopital Albert Schweitzer, the tall young man with the quick smile believes it's his job to be upbeat.

"I try to give joke, to give comedy," Markinley says in his best English, a language he studied in school and practiced on his own. "The doctor told me that the best thing that's good for stress is to laugh."

And there's actually a lot of laughing going on at L'Escale, where the population has shot up just this week to some five dozen people ranging from young children to grandparents. All around the compound of eight four-room houses, residents are chatting and joking, playing the card game "Casino," listening to Haitian hip-hop on the radio and generally hanging out on this sultry spring evening.

They're all either amputees who spend their days trying out new limbs at the Hanger prosthetics clinic at the hospital or family members and friends who've come to support them.

"It's a built-in community for them," says Mandy McGlynn, a physical therapist from the Toronto Rehabilitation Institute who just finished a two-week stint at the Hanger clinic.

Strangers who arrived traumatized and depressed by the events of the past two months have become companions bonded by empathy and understanding, say patients and hospital organizers alike.

"All the people here is my friend," says Markinley. "We are the same."

That's true for Genneviege Delus, a 38-year-old mother of four who was selling trinkets on the street in Port-au-Prince when the earthquake hit.

"I was running and that's when a building collapsed on me," says Delus through a translator. She lost her right leg above the knee.

Before she arrived in Deschapelles, Delus says she was sad and depressed. She'd never been around another amputee before and hated the stigma of being one.

"When I come down here, I see many people who have no legs and no arms and I feel happier," she says. "There are other people like me here. I thought I was the only one."

From a practical standpoint, L'Escale provides food and shelter for patients who may stay two weeks or more. A local community organization provides meals twice a day, says Ian Rawson, the hospital's managing director.

For Haitians who've lost their homes and possessions, the cinder block houses outfitted with simple twin beds are palatial and the free medical care is an unimagined luxury. It's so nice, in fact, that the complex is nearly full, with little prospect of any rooms emptying soon.

That's a problem, Rawson says. On one hand, some of the patients are almost medically recovered enough to leave. On the other, they have no other access to living arrangements and care.

"What do you do with all these people who have nowhere to go?" he says, acknowledging that organizers are working to come up with a plan.

While hospital leaders grapple with that question, newly arrived amputees Emmanuelle Lundy and Wilfrid Macena, both 26 and from Port-au-Prince, adjust to their temporary home.

The two met each other after the earthquake, which claimed Lundy's left leg and Macena's right. Seeing so many other amputees coping with the same condition has made them stronger, says Macena, who stops strangers who approach him with pity.

"It's OK," he says, gesturing around the grounds of L'Escale. "To be living with one leg is living. A lot of people didn't get a chance to."

Mannuela Sainterne practices walking on her new prosthetic leg with the help of physical therapist Mary Anne Kramer-Urner. Sainterne's right leg was amputated 22 years ago because of disease, but she's never been able to afford a prosthetic.

By JoNel Aleccia

DESCHAPELLES, Haiti -- For Mannuela Sainterne, the aftermath of Haiti's devastating earthquake may actually make her daily life better than before.

She's part of a small group of amputees injured before Jan. 12 who suddenly find themselves eligible for free limbs from aid workers who say they'll take all comers, regardless of the cause of their injury.

"How could you possibly say, 'You're not from the earthquake, so we won't help?'" said Jay Tew, the prosthetics expert running the new rehabilitation program at the Hopital Albert Schweitzer.

So far, they've treated patients who've also lost limbs to disease, violence and congenital abnormalities, all common causes of amputation.

Sainterne, a regal woman in a pink headscarf and purple dress, doesn't know her age, but guesses she might be 40. She lives in the mountains outside Deschapelles. She's been without a right leg for 22 years, ever since doctors at HAS had to amputate it above the knee to stave off a disease whose name she doesn't remember.

Since then, she's gotten by on rough wooden crutches now worn and scarred by years of use. This week, she was learning to walk on brand-new artificial leg supplemented by a pair of high-tech metal crutches.

"Before, you had to have money to get a leg," Sainterne said through a translator.

Soule Vertus lost his leg several years ago after being hit by a stray bullet in a drive-by shooting in Port-au-Price. He never thought he'd get a prosthetic until a friend told him about the clinic at Hopital Albert Schweitzer providing free limbs and care for amputees.

Soule Vertus, 33, of Port-au-Prince lost his right leg above the knee in 2006, at the height of an outbreak of political violence.

He was fixing cell phones at a small stand in downtown Port-au-Prince when a bullet from a drive-by shooting shattered his leg, forcing doctors to amputate.

He never imagined he'd be able to get an artificial limb, but after the earthquake, a friend heard about the program at HAS and urged him to come. On Monday, he was measured and fitted for the new leg.

That won't solve every problem for Vertus, who is living in a tent city near Port-au-Prince.

But if there's an upside to the disaster, it's that new services will be available to people who were suffering even before Jan. 12, said Lucy Rawson, president of the fund-raising Friends of Hopital Albert Schweitzer. Her husband is Ian Rawson, the hospital's managing director.

"Things are bad, but there can be good around the edges," she said.

Staff Sgt. John Olson was on patrol in Iraq with his Army unit on Oct. 27, 2003 when he was hit by a rocket-propelled grenade that tore off his right leg.

Josh Olson became one of the first soldiers to lose his leg at the hip level in the Iraq war when he was hit by a rocket-propelled grenade while on patrol in 2003. He was a 23-year-old Army staff sergeant when he had to grapple with the situation so many Haitians are suddenly facing.

His story, told in his own words, continues msnbc.com's special series of essays from amputee veterans recounting what it means to rebuild your life after losing a limb.

By Josh Olson, with Linda Dahlstrom

I always thought being a soldier was a best job in the world – I still do.

Ever since I was a young kid I wanted to enlist. It's kind of what the men in my family do. My grandpa, father and uncle were all in the military. When I turned 17 I enlisted in the Army; I was 18 when I shipped out.

A few years later my unit was one of the earliest to get to Iraq. We arrived in February 2003, a few months before the U.S. invasion. When we first go there it was pretty chaotic. All the Iraqi military and police were gone and there was a lot of looting in the streets. I wouldn't really say it was anarchy but pretty close to it. Our job was to reclaim government buildings and vehicles.

The night of Oct. 27, 2003, we were patrolling town when a rocket hit the back of the vehicle. A second rocket, the one that hit me, came about 90 seconds later. At first I thought I'd just gotten shot and I tried to walk it off. I did a quick physical inventory like they teach us: I checked my arms and hands and they were OK, but when I reached down to my right leg, I realized I had a problem.

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I knew I was injured but didn't realize my leg was gone, blown off at the hip. I tried to crawl back to the vehicle and then my driver saw me.

Later when they started cutting my equipment off at the aid station, that's when the pain kicked in: the sharpest, worst pain all the way down to my core. It took the wind right out of me, but they couldn't give me any pain medication because I'd lost so much blood they were afraid I'd pass away.

What I remember most about the helicopter that airlifted me to a hospital in Mosul was that there was a female on board and she smelled good, like she'd just showered. She was the first female I'd seen in about nine months. I don't remember anything else until I woke up eight days later in Germany. I still thought I was in Iraq and so when I saw my parents there I asked them I worried about why they were in a war zone and reminded them of how dangerous it was.

When they first told me I didn't have a leg, I was like "OK, but I'm still alive." It didn't honestly set in until about three months later when I was at Walter Reed and I put my prosthetic on for the first time and looked in the mirror. That was a blow, like getting hit in the chest. I thought, "Now I have to depend on this for the rest of my life." It wasn't something that was going to go away.

I went from being a 23-year-old who owned a house, owned my car, did everything on my own and was an infantry leader to a patient at Walter Reed who couldn't even go to the bathroom by myself -- my mom had to wipe me.

One of the things that drove me the most was that I wanted my independence back. I've always been taught to never quit, no matter what, and if there was still air in your lungs, you go fight. I knew there was something out there for me to do. I realized life wasn't over; it was just a new chapter. I was the same person inside, but on the outside I was different.

When Josh Olson was recovering at Walter Reed Medical Center, he went on a patient outing to a shooting clinic and hit an astonishing 48 out of 50 targets in a row. He was later hired as an Army marksmanship instructor at Fort Benning, Ga.

Some days I still deal with depression and am mad that I don't have a leg, but it's getting easier to snap out of it. I've had to learn patience. Before I was a real Type A personality and "go go go go." I'm still kind of that way but having a prosthetic has made me slow down.

Someone asked me after I got hurt if I could do anything what would it be. I said I wanted to go back to Iraq with my prosthetic and look the insurgency in the eye and say, "You tried to knock me down but you didn't."

There's a program called Operation Proper Exit where they take wounded soldiers back to Iraq. It's given me a lot of closure. I used to wonder if it had been worth it, all the pain and death. I lost quite a few friends over there and have other friends who got blown up like me. But then I saw the playgrounds in Iraq and the schools and the traffic moving freely. Nothing will ever replace my leg and the friends I lost but, yeah, it was worth it.

Back when I was at Walter Reed, I was afraid I'd have to leave the Army but then I had an opportunity to come down to the marksman unit and try out as an instructor. Now I teach Army marksmanship in Fort Benning, Ga., and I'm training for the 2012 Paralympics. Shooting competitively for the Army and the Paralympics is my job.

When I first heard about the Haiti earthquake I remembered what I was going through at an American hospital and I can only imagine what it's like in a country like Haiti. I'm a soldier; I was in a war zone. I knew I could get hurt. But they didn't see it coming.

I know it won't be easy for them for the first year or two, like it wasn't for me. They'll have to make the decision if they want to live or if they want to give up.

For me, when I'm down, it helps to remember there are people who have it worse than me. When my unit went back to Iraq the second time, the guy who had my job was actually killed, along with one of my friends, so getting hurt may have actually saved my life.

A lot of my friends went on and joined the Special Forces. I'd have like to have done something like that, but I try not to think about it too much -- because that's just not what it is.

By JoNel Aleccia

DESCHAPELLES, Haiti -- Schneily Similien doesn't want to wait a minute longer.

The 4-year-old Haitian boy who lost his left leg in the earthquake has just arrived for another visit at the clinic where he knows that today he's supposed to get an artificial limb.

He sees more than a dozen grown-up amputees wearing their legs, and, like any preschooler, he wants one, too.

"Papa! Papa! Go get my leg for me," he calls out in Haitian Creole. "Papa, get my foot so I can walk."

Schneily's father, Ducarmel Similien, also spelled Cimilien, is as anxious as anyone to see this new contraption, the device that's supposed to make his son whole again.

Still, he urges the rambunctious boy to be patient -- and brave.

"We're waiting, we're waiting," he says to his son. "Remember, don't cry when they put it on."

There seems to be little chance of that when prosthetics expert Jay Tew shows up a few minutes later with the leg. Tew is the manager of the newly launched Hanger Orthopedic Group clinic at Hopital Albert Schweitzer and Schneily is, so far, the youngest of some 85 patients.

The boy opens his eyes wide and giggles at the sight of the leg before hopping quickly on his crutches into the fitting room. He smiles as Tew powders his residual limb, a smooth stump of dark skin.

Tew slides a sock on the boy's limb, then a liner, then the leg. Over that he smoothes a sleeve that will hold the limb on Schneily's body.

Finally, it's time to walk.

Schneily slides off the bench where he's sitting and steps gingerly onto the floor. The leg is a little short, Tew says, and they'll need to adjust it later.

Schneily will need new shoes, too, two of them, for proper fitting, and he gives someone, anyone, money to rush to the nearby market to find a pair of size 6 children's sneakers.

Meanwhile, Schneily takes one step, then two, and then looks anxiously toward his dad. The smile is gone. His left knee buckles a bit.

"Stand up tall, up tall," Tew urges in English, frustrated once again that he doesn't speak Creole.

As Tew holds him, Schneily takes a few more hard, wobbly steps away from the bench, then back before Tew sits him down.

"Yay!" Tew cheers, slapping Schneily's hand. "High five!"

A few feet away, Ducarmel watches the process intently until Schneily is done. Then, the 40-year-old carpenter, a man who has trekked across hundreds of miles in post-quake Haiti to get help for this child, walks over to the corner of the room, bows his head against the cinder block wall -- and cries.

The leg is fine, he tells a translator, but it's also a jarring reminder that even with the device, an already hard life in Haiti will be even harder for his youngest son.

"I wish I could reverse the universe," Ducarmel tells the translator as he wipes his eyes. "I wish it never happened at all."

Tew walks over to comfort Ducarmel, to tell him that the first fitting is often much harder on the parent than the child.

"He is going to do great," Tew says through an interpreter.

Within minutes, someone calls out that they have the shoes, a pair of used Buzz Lightyear sneakers that light up with every step. It's not clear whether Schneily recognizes the popular character from the children's movie "Toy Story," but he eagerly dons the new shoes.

With Tew's help, Schneily steps out into the courtyard to practice with his crutches and his leg, moving cautiously on the rocky ground. He seems perplexed by the leg and by Tew's instructions to walk heel-to-toe, the best way to mimic a natural step.

After a few tries, he starts to get the hang of it. The limb doesn't hurt him, he says. That's a good sign, although as he puts more weight on his residual limb, it could become very tender. All amputees have to be careful to avoid pressure points that cause skin breakdown and sores, which can lead to infection.

It'll take practice and time for his body to adjust, but Tew predicts that Schneily will be running within the week.

As the child grows, Tew promises that the clinic will be in place to lengthen the shank of his prosthetic limb or even to replace it every year or so. The goal of the project is to train Haitian physical therapists and technicians to help the region's amputees now and in the future.

"Infinity and beyond," Tew says, quoting Buzz Lightyear's famous catchphrase. "That's our slogan now."

Prosthetist Gil Mejia from Richmond, Va., makes a cast of the residual limb of earthquake victim Emmanuele Lundy, from Port-au-Prince. The cast is the first step in the process of creating a custom fit prosthetic leg. Here Mejia presses his thumbs into the fiberglass to make indentations around the big tendon just below the kneecap to create extra snugness in a spot where the amputee's limb can carry more weight.

After removing the cast, technicians fill it with plaster and insert a metal rod, visible in foreground. Once the plaster dries, it can be handled by the rod as the fiberglass cast is cut away, as Dubreille Elinor, left, is doing here. The resulting plaster shapes, several of which are visible at right beyond Elinor, are models of the individual amputees' stumps. Custom prosthetics are then built to fit these models.

Prosthetist Jay Tew applies a dense foam wrapper to the plaster model, shaping the first layer of the "socket," the part of the prosthetic that holds the residual limb. This foam layer acts like the inner sole of a shoe -- a firmly cushioned lining in the eventual prosthetic.

After the socket receives its foam wrapper, Alix Paul, left, uses plaster to attach a metal mounting plate where the socket will connect to its post and foot. Next comes a carbon fiber wrapper and layers of fiberglass, all of which are bonded with epoxy. Behind Paul, Randy Roberson, of Birmingham Ala., works with Mark Pierre, Joel Charles, and Herold St. Louis to apply flesh-colored epoxy resin to another prosthetic. After hardening, it will be attached to a metal post and a foot matched to size of the amputee's remaining foot.

The last step in assembly, fitting, means first steps for Christela Eliance, who tries out a new prosthetic leg with help from Jay Tew and her sister Marie Yolaine. At this final stage, the prosthetic expert will make any adjustments needed to ease pain or improve fit.

By JoNel Aleccia

As Christela Eliance takes her first shaky steps on a new prosthetic leg at a clinic in rural Haiti, she's following in the path of hundreds of thousands of Americans.

The limb crafted for the 20-year-old Port-au-Prince woman who lost her left leg in the Jan. 12 earthquake is the same kind used in the U.S.: basic, durable and, best of all, fast to make, said Kevin Carroll, vice president of prosthetics for Hanger Orthopedic Group, the company leading the Haitian Amputee Coalition, with a clinic in Deschapelles.

Since late February, the clinic has provided more than 85 plastic and laminate limbs -- including arms, lower legs and full legs with knee joints to patients like Eliance, who says the possibility of walking again has helped her cope with the trauma of amputation.

"Sometimes you think about what happened and it's hard," she said through a translator. "I'm glad I have people and my family to help me."
But the outreach effort also has renewed an ongoing debate in the international prosthetics community: What's the right kind of limb to use in developing countries?

If you ask Colleen O'Connell, a board member with Healing Hands for Haiti, the primary prosthetic group in Haiti before the quake, the answer is a rugged, all-plastic limb manufactured according to standards set by the International Committee of the Red Cross, which typically provides prosthetics in war zones.

A below-the-knee ICRC limb can be built for about $300, said O'Connell. Plus, it's easy to train technicians to repair and maintain. Hanger's limbs don't hew to those suggested standards, costing about $5,000 to produce in the U.S., and about $2,000 in Haiti.

That raises questions among some in the international community and even some who've worked at the new clinic site.

Mike Landry, a physical therapist who is also an assistant professor at the University of Toronto, just finished two weeks of helping amputees adjust to new limbs in Deschapelles. A veteran volunteer who has worked in Bosnia, Kosovo, Sri Lanka and Rwanda, he praises the project and says it has made more progress than any other similar effort in the developing world.

He praises the project and says it has made more progress than any other similar effort in the developing world. But he worries that it may be difficult to sustain such momentum for the long haul, perhaps doing a disservice to amputees fitted with limbs now.

"For-profit firms can come in quickly and leave just as quickly," he said. "This could be a problem."

In addition, Robert Kistenberg, president of the U.S. chapter of the International Society for Prosthetics and Orthotics, says the Seattle foot, a type of prosthetic model used by Hanger, isn't particularly durable in places like Haiti.

"They perform well until exposed to heat, humidity and moisture, hello rainy season, and then the foam rapidly disintegrates," he said. "I'd give it six to nine months."

Carroll, the Hanger executive, disagrees. He said this type of foot has been used extensively in Louisiana and other hot, humid places, with great success.

"The Seattle foot has been around a long, long time," he said of the device invented in the mid-1980s. "It's not something that came out last week."

Jay Tew, the prosthetics expert who set up the clinic, says he fully expects the project to continue for years. He said it could be possible in the future to add ICRC limbs and training, but it was important to get started.

"That's the key: sustainability," he said.

In these early days of earthquake recovery, it's important not to miss the larger goal of providing help, education and training quickly, said Al Ingersoll, a Healing Hands for Haiti board member recently hired as a prosthetics adviser for the country. Hanger is not required to use ICRC technology, which is not allowed in the U.S. because of liability concerns, he noted.

And they're not just making limbs, they're also training Haitian workers as technicians to help patients and to produce and repair prosthetics.

The new lab in Deschapelles is on track to fill a gaping hole in rehabilitation services in rural northern Haiti, says Ingersoll, a prosthetics expert from Minneapolis.

On a recent Tuesday, the crew manufactured 17 limbs in a single day.

"Hanger states that they are here for the long term and after seeing what they are setting up, I believe them," he said.

CANGE, Haiti -- Teacher Gerome Lausier was in his Port-au-Prince classroom when the earthquake hit, collapsing the school and killing many of his sixth- and seventh-grade students. His left arm and hand were crushed in the rubble.

Doctors had to amputate just below the shoulder to save the life of the left-handed father of three. Lausier, in his late 30s, traveled 40 miles to Zanmi Lasante, a small hospital in Cange, where he has been measured and fitted for a new arm that he hopes will allow him to return to work.

Friends before the earthquake, Carmene Geurrier, 16, left, and Mike Shelove Julmiste, 25, visit with each other after having their prosthetics adjusted in Cange, Haiti.

By JoNel Aleccia

CANGE, Haiti -- Carmene Geurrier and Mike Shelove Julmiste were childhood friends before the earthquake, girls from Port-au-Prince who grew up knowing the same games and songs.

Now young women, they've forged an even tighter bond under nearly unimaginable circumstances: both are earthquake amputees, learning to walk on new limbs at a remote medical clinic in Haiti.

"When I'm alone, I'm stressing, but when I have a friend like her, I am happy," says Carmene, 16, through a translator. She lost both legs below the knee on Jan. 12, when her house collapsed.

"I feel the same," says her friend, who goes by Shelove, a 25-year-old who lost most of her left leg when her home crumbled around her.

The pair found each other again at Zanmi Lasante, a small hospital in the rugged mountains of Cange, nearly 40 miles from Port-au-Prince. Like hundreds of other earthquake victims, they were brought here by worried family members because of the reputation of its founder, Dr. Paul Farmer, a Boston infection control specialist whose organization Partners in Health champions health care in Haiti and much of the developing world.

Indeed, Shelove says it was "Dr. Paul" who told them to be patient and wait because a medical crew was going to bring them new limbs.

Last week it happened, when a crew from the Hanger Orthopedics Group stationed at the Hopital Albert Schweitzer in Deschapelles came to fit the girls with prosthetic legs.

"I feel OK now because I got my legs," says Carmene, who now sports clear plastic shoes with bows slipped over her two artificial feet. "But if I didn't get the legs, I would not feel good at all."

Before the quake, Carmene was a high school student and Shelove was studying at a local university. The disaster changed everything. Now Carmene lives with extended family in Mirabalais, a city near Port-au-Prince. Shelove's family went to live with extended family, too, but she doesn't know if there's room for her in the home. Like many Haitians, the young women don't speculate about the future, prefering to concentrate only on today. Right now, that means their new limbs.

Carmene is worried about her residual limbs, which are excruciatingly sensitive to the sockets of her prostheses. The slightest pressure makes her wince in pain. Shelove's limb is tender, too, but not so bad. And both girls are determined to wear them.

"They says they want to go dancing," says Will Millien, the handsome Haitian translator speaking to the girls. "I told them, 'I will take you dancing.'"

Helping amputees feel whole again is the reason these hospitals have partnered in rural Haiti, says Dr. Koji Nakashima, a physician in Cange.

Because Zanmi Lasante, which means Partners in Health in Haitian Creole, didn't already have a prosthetics center set up, they invited Hanger teams from the newly formed prosthetics lab at the Hospital Albert Schweitzer to make and fit limbs for amputees and to provide rehabilitation care afterward.

In Haiti, amputees without limbs are likely to be isolated; some never leave their homes.

"When someone gets a prosthetic, they go from wheelchair-bound to walking and from not working to working," Nakashima says.

Every weekend for a month, Hanger teams have made the arduous 100-mile round-trip drive to Cange through the lush Artibonite Valley and up into the rocky hills. Jay Tew, the prosthetics expert leading the project, sets up shop in a church sanctuary, where dozens of patients on mattresses and blankets have filled the tile floor and spilled out into the courtyard.

On this day, a couple dozen people arrive with the swaddled stumps that signal missing limbs. When Carmene and Shelove walk into the room under their own power, Tews stops and gives them hugs and a round of applause. It's a dramatic improvement from when he first met them to take measurements in early March.

"To have someone coming in walking on their own in a matter of two weeks, it made me cry," said Tew, wiping a few hasty tears. Not many amputees are so mobile so quickly.

The girls laugh and tease, strutting across the floor so Tew can see how well they walk. Amputation changed their lives forever, but getting a new limb will help them move forward with confidence -- and even humor.

Carmene, for instance, says she now has a whole new way to test potential boyfriends.

"If any guy is going to try to talk to me," she says. "I'm going to show him my leg first."

When msnbc.com asked our readers who've suffered from limb loss to share their stories with amputees in Haiti, many responded with words of encouragement and hope hard earned by their own journeys.

"My heart goes out to each and every one of you who suffer limb loss," said Debbie Bean, who lost her hands and feet due to meningococcal virus. "But I would like to offer some words of encouragement to you. Every day that goes by you will find yourself a little stronger, a little more eager to do the things that make you happy."

One reader, who lost his arm in an accident, said that while his body was injured, his spirit was still whole. "We may have lost our limbs but we are still the same people."

A father of four whose arm was amputated following a car accident wrote to say he had to push past the limitations others tried to place on him. "I do not feel I have anything to prove. I just want to live my life to the fullest," he wrote. "I continue to enjoy playing softball, golfing and riding motorcycle. There have been times of depression and self pity but over those times I have learned to focus on what I have rather than what I do not have."

Some say they've found new meaning in helping others, such as through the Amputee Coalition of America's peer-to-peer outreach program. "When you begin to become strong again, reach out to other amputees," wrote Robert Bailey of Baton Rouge, La., who lost both his legs in a tractor accident. "All those feelings and questions you thought no one understood, they do. Many, many amputees find strength in themselves that they never knew they had."

Click here to read recent letters.

If you'd like to write a letter to be published, please enter it in the comments field below. Selected letters are being translated this week and shared with some of those who lost limbs in Haiti's earthquake, including 4-year-old Schneily Similien.

Many of msnbc.com's readers have been so moved by Schneily's story that they've asked how to help. The best way is by donating to Hopital Albert Schweitzer, where he is receiving treatment this week, and the Haitian Amputee Coalition which is helping to provide prosthetic fittings and rehabilitation there. Donations will be used to fund his ongoing treatment and that of hundreds of other patients.

By JoNel Aleccia

DESCHAPELLES, Haiti -- Darline Similien climbs off the back of a motorcycle in the blazing morning sun and sweeps her youngest son, Schneily, into her arms, mindful of the 4-year-old's missing leg.

She sees visitors with cameras and pauses, shy about her appearance after a 5 1/2-hour road trip by bus and by bike. But Schneily just hugs her tighter.

"You're not ugly mama," the brown-eyed boy with a headful of braids says in lyrical Creole."You look nice, Mama."

It's been only four days since Darline has seen Schneily and his father, Ducarmel, but for the family on a desperate quest for a prosthetic limb to replace the boy's left leg, crushed in the earthquake, everything has changed.

Finally, they've made it to the Hopital Albert Schweitzer, where a group called the Haitian Amputee Coalition has begun providing free prosthetics for victims of the Jan. 12 temblor. It's Schneily's best hope for a better life, but getting the child to Deschapelles was anything but easy.

Msnbc.com first introduced readers to Schneily Similien, also spelled Cimilien, soon after the quake, as Ducarmel vowed to do anything to get his boy a limb.

Less than a week ago, the family got word that Schneily could get help, but only if he made it to the hospital, more than 80 miles from the tent city in Leogane, where the family has been living since the quake destroyed their home.

Transportation there for a single adult usually costs about 250 in gourdes, the Haitian currency. That's about $6 U.S., but far too pricey for a family with no work since the disaster and little money left to survive on.

"If I had to get here on my own, it would have been almost impossible," Ducarmel, a 40-year-old carpenter, said through an interpreter.

Instead, he found help from the Catholic Medical Mission Board, an aid group whose Haiti director lost her leg in an air crash several years ago while delivering medical supplies outside Port-au-Prince. Since the earthquake, Dr. Dianne Jean-Francois has made special effort to find help and comfort for amputees because she said she understands their needs.

"They are children, they are adults, they are men, they are women," she said. "So many. There was no difference. The earthquake hurt them all."

Through CMMB, Ducarmel got a ride for Schneily and himself, but there was a catch. Because the need is so great, aid groups limit transportation to the patient and a single guardian. Darline and their two other boys, Schmeider, 10, and Scarcely, 13, had to stay behind in Leogane, with little water or food.

Still, just after dawn last Thursday, the father and son boarded an SUV with five other amputees and five of their family members for the long trek through the rural countryside.

By Haitian standards, the road to Deschapelles, National No. 1, is a good one, winding past villages of tin-roofed shacks, fruit stands and ubiquitous lottery shacks where locals take a chance with 5 gourdes. But it's also both dusty and muddy, with deep ruts and potholes and cars racing dangerously fast in both directions, appearing to barely miss passersby -- or each other.

For HAS patients, the trip ends with a hard right turn on Dr. Mellon Road, a rocky, narrow street named for the hospital's founder, William Larimer Mellon, and into the hospital's courtyard.

For Ducarmel, every bump and jolt was worth it for the lively boy who's become a pro on crutches since his amputation less than a week after the quake. Schneily hops easily down concrete steps, across the uneven ground, sometimes roaming so far that his dad has to call him back. He's eager to make friends, rushing out to greet John Spinoza, a 10-year-old who's also missing a leg.

"He's ready to walk," Ducarmel says. "He wants to do it."

Within hours of his arrival at HAS, Schneily's leg was examined, measured and cast by Jay Tew, the prosthetics expert for Hanger Orthopedic Group, the American firm that's spearheading the effort.

Now, a tiny plastic-and-foam limb, just over 9 inches tall, is waiting for Schneily, who's the youngest amputee the crew has seen yet. Next he'll be fitted with the new leg. If all goes well, Schneily will be able to walk for the rest of his life.

Meanwhile, Darline couldn't stay away. The 37-year-old kindergarten teacher left the older boys with her mother in Leogane, and then pooled money from family and friends to pay for transportation to Deschapelles. She rode part of the way on the bus, and part on a motorcycle, ending her journey Sunday with a hug from her husband and son -- and new hope for the family's future.

"Every time I spoke to Schneily on the phone, he said, 'Come, mama, come," she said.

Schneily's parents are apprehensive about how he'll adjust to the new leg. Darline is worried he'll have an allergic reaction to the limb. Ducarmel isn't sure he'll actually be able to walk like a regular boy. But both know that this is a necessary step.

"It's very important that he get a foot," Ducarmel said. "We have to restore all of our lives."

Jay Tew, a prosthetics expert with Hanger Orthopedics Group holds the prosthetic lower leg being made for 4-year-old Haiti amputee Schneily Similien. Tew and his crew at the Hopital Albert Schweitzer are working around the clock to create limbs for victims of the January earthquake.

By JoNel Aleccia

DESCHAPELLES, HAITI -- Seventy-three legs, 12 arms.

If anyone's counting, that's how many prosthetic limbs Jay Tew of Baton Rogue, La., has turned out for earthquake amputees in Haiti in the past three weeks.

The 38-year-old clinician and his crew have been working dawn to dark at the Hopital Albert Schweitzer, an 80-bed medical center more than 60 miles from the country's capital city, Port-au-Prince.

In a clinic housed in a converted classroom, Tew has been fitting, forming, sanding, painting and testing limb after limb for the steady stream of amputees who've made it to the rural outpost.

"I don't think we're going to stop seeing new patients for some time," said Tew, a regional manager for Hanger Orthopedic Group. "They say there may be hundreds of people here once the flood gates open up."

With the help of U.S. prosthetic maker Hanger, the rural hospital founded by American philanthropist William Larimer Mellon, Jr. is rapidly becoming a center for rehabilitation -- and hope -- for Haiti's amputees.

"If I can say there's an oasis in Haiti, we're in it," says Tew, glancing around the spare clinic with its cinder block walls and cement floors that wouldn't normally constitute luxury.

So far, the hospital has been able to manufacture and deliver vital prosthetic limbs for men, women and children, patients who test their new arms and legs by dancing to music and kicking soccer balls each evening

On a hot, humid evening, more than 30 patients and their family members lounged on the porches of eight small block houses in L'Escale, an area set aside to shelter amputees who have nowhere else to go.

They laughed and chatted in animated Haitian Creole, teasing, telling stories and calling greetings to passersby. One 10-year-old boy raced to see how fast he could get across the stony ground on the crutches he'll use until his new leg is ready.

"One doesn't have right leg, one doesn't have a left leg, one doesn't have a hand," said Ian Rawson, the HAS director. "They're all there together, playing music. They've created a lovely community."

It's a community forged out of tragedy and need. Even before the earthquake, an estimated 40,000 to 64,000 Haitians were so disabled by trauma or disease they needed prostheses, leg braces or other rehabilitation services, said Robert Kistenberg, who heads the U.S. chapter of the International Society for Prosthetics and Orthotics. The earthquake added another 4,000 to 6,000 amputees to the toll in an instant, according to estimates by the aid group Handicap International and the Haitian government.

"In Haiti, they were not able to meet the needs of the people even before the earthquake," Kistenberg said.

That's where Tew and his staff come in. They volunteered to spend three months at HAS, fabricating and fitting limbs as part of Hanger's pledge to create an ongoing rehabilitation program training Haitian technicians and treating amputees now and in the future.

Patients and family members wait outside of the Hopital Albert Schweitzer in Deschapelles, Haiti.

"The key is a sustainable center," said Tew. "It's not to come in and make a lot of legs and leave."

A father of three girls ages 8, 10 and 12, Tew said he did not hesitate when Hanger asked him to go. In fact, he'd already discussed the possibility with his wife, Shannon, as they watched early television coverage of the earthquake.

"I looked at Shannon and I said, 'I'm going to Haiti,' and she said, 'Yes, I know you are.'"

For her part, Shannon Tew, 40, said she couldn't deny the need, or her husband's desire to help. A graduate of Northwestern University's Prosthetics-Orthotics program, Tew had previously volunteered to help amputees in Mexico and is considered an expert in the treatment of military amputees.

"I think it's all he could ever think of and dream of doing," Shannon Tew said.

It's part of a larger dream for HAS, too.

Founded in 1956 by a son of one of America's wealthiest families, the hospital has logged a half-century history of ministering to the medical and social needs of the poorest residents of Haiti's Central Plateau.

Mellon, heir to the Andrew Mellon family banking and oil fortunes, started the hospital after becoming enthralled in midlife with the medical missionary work of Albert Schweitzer.

Dr. Ian Rawson, director of Hopital Albert Schweitzer in Deschapelles, Haiti.

Mellon and his second wife, Gwen Grant Mellon, worked out a deal with the Haitian government to take over an abandoned fruit plantation in the rugged Artibonite River Valley. The hospital became the hub for care for the region of about 300,000 people, where poverty and disease are rampant.

It's a legacy now assumed by Rawson, 70, one of Gwen Mellon's three children from a previous marriage. Rawson retired from a career as a hospital system administrator in Pennsylvania to take over where his mother left off.

His task has been magnified by the aftermath of the quake, which may propel rural HAS into becoming a central player in the nation's reconfigured health care system. Haiti's president, Rene Preval, has called for decentralizing the country's infrastructure for health, education and jobs. Under such a plan, HAS would become one of eight rehabilitation centers around the country.

"This is the hardest work we've ever done," Rawson said of the months since Jan. 12. "But it's the most rewarding."

Mona Patel's whole adult life stretched out ahead of her on the day a drunk driver hit her as she walked across her college campus.

The 17-year-old underwent 20 surgeries, and ultimately the amputation of her right leg.

"My main concern was of my abilities to care for babies as an amputee," said Patel, now 37.

Today, Patel, and her husband, Nishat, have two daughters, Anaya, 7, and Arianna, 5. While it hasn't always been easy, she found her way right from the moment her oldest daughter was born, she said.

"I had to learn how to do things differently and a bit slower perhaps, but nonetheless, I feel that did just fine," she said.

When Patel and her daughters heard about the Haiti earthquake, they cried together, knowing what it would mean for those who would now have to cope with life as amputee.

Patel lives in San Antonio, but if she could sit at the bedside of a woman in Haiti who lost a limb, she'd tell her that a full life can still be ahead. Read on for Patel's letter.

If you'd like to write one of your own to be published, please enter it in the comments field below. A selection of submissions will be translated and given to those who recently lost limbs in Haiti at the Hopital Albert Schweitzer.

To those in Haiti,

My name is Mona Patel. I am 37 years old, a wife for 15 years to a devoted husband, and a mother to two beautiful children. First of all, please accept my most sincere condolences as I say how deeply sorry I am for your losses as a result of the earthquake. Our worlds are very different and we are strangers now, but my hope is that soon we will become friends and know how very connected we are. My friend, we share a common bond and that is of our limb loss. I, too, am an amputee.

At the young age of 17, while walking on my university campus I was struck by a car driven by a drunk driver. I underwent many surgeries to stabilize my life and save my mangled limb. The injuries to my right leg and foot were severe. My parents were faced with a very difficult decision: for the surgeons to attempt limb salvage or amputation. I feel, as any parent would, they opted for limb salvage. Infection led to the amputation of most of my right foot.

Seven years later, as I prepared for my 20th surgery to help alleviate pain, I began to evaluate my life goals, particularly of becoming a mother. I began to wonder: How would I be able to take care of my future children with chronic pain and limited endurance? Was a higher level of amputation a better answer? If I elected to amputate my leg, will I compromise my ability to care for my future children?

In 1997, seven years after my accident, I opted to have my leg amputated. I didn't know if I was making the right decision, but what I did know was that I possessed an inner strength and a positive outlook on life. I was hopeful that those qualities would prevail as I healed physically and emotionally.

We all have our unique stories and challenges as amputees. I think one of my hardest moments was the first time I saw my amputated leg. This is when the reality set in and I was terrified. What now? I had many questions. From the practical standpoint: How will I get dressed? How will I safely take a shower? How will I drive? Will I be able to wear the same size shoes on both feet with a prosthetic? How hard will it be to learn how to walk again? When will these phantom pains go away? From the emotional standpoint: How will my husband view me now? Will he be less physically and sexually attracted to me? How will people view me? How will my self-image improve?

Thankfully, amputation turned out to be one of the best decisions I could have ever made. I did not come to this conclusion overnight … it took me years to re-build myself into a confident, active young woman. I have not only remained married, but happily married. Our love and perseverance has blessed us with two amazing daughters, Anaya (age 7) and Arianna (age 5).

As an amputee I feel I have accomplished a lot, physically, emotionally, professionally, and in my public service. By far, my proudest accomplishment was giving birth to my daughters, Anaya and Arianna. Pregnancy was another challenge, but I got through it. My main concern was of my abilities to care for babies as an amputee. I am proud to say I successfully cared for my precious Anaya day and night, on my one leg. I had to learn how to do things differently and a bit slower perhaps, but nonetheless, I feel that did just fine. The second time around with Arianna was not without challenge, as now I had to figure out how to care for two children under the age of 3. Anaya and Arianna are kind, loving and compassionate children. Together we cried when we saw the devastation in Haiti. I remind my daughters regularly of the blessings and privileges we have living in the U.S. and the subsequent importance to always give back to others in need.

My friend, I wish I could do more for you. I offer you my wisdom and experience as an amputee. I send you my love and energy to begin this new journey to heal both physically and emotionally. You have seen and are living with so much sadness around you. I pray you have the patience and inner strength to move forward with your life because you are, thankfully, still alive. I believe you are here for some great purpose, a purpose that may take time for you to know. But I do believe it. I am honored you have read my letter. Until next time … much love and strength.

Mona Patel
San Antonio, Texas

In an instant, the earthquake that rattled Haiti on Jan. 12 created as many as 6,000 amputees, people who lost limbs either from direct injury or the complications and infections that followed.

Aid experts said this ranks among the largest-ever loss of limbs in a single natural disaster, and propelled Haiti to the epicenter of an existing global amputation crisis.

"We've seen many amputees, but nowhere near the magnitude of this," said Ivan R. Sabel, chairman of Hanger Orthopedic Group, which launched the Haitian Amputee Coalition to respond to the problem.

The earthquake galvanized the international prosthetics community, prompting promises of limbs, supplies and staff to help rebuild bodies devastated by the temblor and its aftermath.

Already some two dozen prosthetics groups are setting up shop, and plans are in place to distribute rehabilitation services across the country, including Hanger's site at the Hopital Albert Schweitzer in Deschapelles, 60 miles outside Port-au-Prince, where msnbc.com is tracking the stories of amputees as they rebuild their lives.

But even as attention is riveted on those who've lost limbs in Haiti, experts warn that the tragedy there highlights a grim reality: the number of amputees worldwide is rising -- and fast.

War, violence, disaster and disease are fueling limb loss estimated at between .5 percent and .8 percent of global populations, according to the World Health Organization and the International Society for Prosthetics and Orthotics.

More precise figures are difficult to get, mostly because amputation receives little attention or resources in countries where survival is constantly in jeopardy. But the problem remains very real in every country, said Robert S. Kistenberg, who heads the U.S. chapter of the ISPO.

Still, some places have more than their share. In Angola, 1 in every 334 people has lost a limb, mostly to landmines left behind by a bloody civil war, according to the International Committee of the Red Cross. Ongoing conflict in Afghanistan means 1 in every 631 people is an amputee; in Iraq, the figure is 1 in 987.

The WHO estimates that in Africa, Asia and Latin America combined, as many as 30 million people require prosthetic limbs, braces and other such devices for daily living, up from 24 million people in 2006.

In the United States, where 185,000 people suffer amputation each year, the prevalence of limb loss keeps climbing. Today, there are more than 1.6 million U.S. amputees, according to a 2008 analysis in the Archives of Physical Medicine and Rehabilitation.

And the number is expected to more than double, rising to 3.6 million people by 2050 according to researcher Ellen J. MacKenzie of Johns Hopkins Bloomberg School of Public Health.

"We knew the incidence was high. But even we were surprised to see how large the numbers became," she said of her bleak estimate.

Even that number is probably conservative because researchers didn't allow for rising rates of disease. Amputations caused by vascular disease, usually related to diabetes, account for 54 percent of cases of limb loss in the U.S. Traumatic amputation – limb loss caused by car crashes, workplace accidents, natural disasters and war – accounts for 45 percent of loss.

"Every 30 seconds, someone loses a limb because of diabetes," said Dr. David Armstrong, a professor of surgery and director of the Southern Arizona Limb Salvage Alliance at the University of Arizona. "It's like a tsunami crashing in on us."

The disease robs people of the perception of pain in their lower extremities, allowing even minor ulcers and cuts to fester into limb-threatening infections.

Regardless of the cause, the loss of a limb is a traumatic, life-altering event, noted Dr. James Gosney, a Norfolk, Va., member of the International Society of Physical and Rehabilitation medicine and the International Rehabilitation Forum who is building a prosthetics lab in northern Honduras.

Without prostheses, amputees may only get worse, suffering further physical and psychological problems as they become increasingly isolated. At the same time, their families bear a heavy social and financial burden for their care. Although wheelchairs are often available, they're often not a good long-term option as they can be impractical given the rugged terrain and harsh climate of developing nations.

"You have a population of already marginalized people who are further marginalized," he said.

Sustaining the world's attention -- and support -- is vital for amputees not just in Haiti, but around the globe, said Armstrong, the Arizona surgeon.

"That's what's happening in Haiti. What we have done is identified a dire situation," he said. "The real story is that this is happening every single day, all the time."

Four-year-old Schneily Similien's left leg was crushed in Haiti's earthquake.

By JoNel Aleccia, msnbc.com

Schneily Similien still needs a new leg.

The 4-year-old Haitian boy's left calf and foot were crushed when the Jan. 12 earthquake rocked his country and destroyed his house, sending pieces of concrete ceiling crashing down on the child and his family.

For five days, no medical care could be found in the wrecked capital city, Port-au-Prince, and by the time Schneily's parents, Ducarmel, 40, and Darline, 37, got him to a hospital, amputation was the only option.

Msnbc.com first introduced readers to Schneily Similien (also spelled Cimilien) soon after the quake, as prosthetics groups began assessing the staggering need in Haiti and Ducarmel vowed to do anything to get a limb for his boy.

"People tend not to take into account the needs of disabled people and it changes your life," Schneily's father said through a translator. "They don't consider you a whole person."

Two months after the horrible disaster that claimed at least 230,000 lives and left a million people homeless, Schneily remains among an estimated 4,000 to 6,000 amputees left to struggle in a rugged, impoverished land where if you don't work, you don't eat and there's little regard for the disabled.

His greatest hope for a new limb -- and a new life -- may lie at the Hopital Albert Schweitzer, an 80-bed oasis in the rural heart of Haiti, where the American prosthetic firm Hanger Orthopedic Group has set up an amputee rehabilitation center.

First though, Schneily has to get there.

The 60-mile trip from Port-au-Prince to the hospital in Deschapelles can take nearly four hours, even on relatively good roads. Schneily and his parents were left homeless by the quake and are now living in a tent in Leogane, a town 20 miles from the capital, aid workers say.

His father is a carpenter, but no one has bought furniture since the quake. His mother is a kindergarten teacher, but her school was destroyed in the disaster.  With little money and scarce aid, they've battled hunger along with their fears for Schneily's future.

Deschapelles, Haiti, is located about 60 miles north of Port-au-Prince.

Msnbc.com is heading to Haiti to track the story of Schneily and other amputees as they work to build new lives. Our crew will arrive in Port-au-Prince today and travel to Deschapelles, where we'll file daily dispatches about the urgent effort.

Along the way, we'll explore the issue of amputation, a growing problem sparked by violence, disaster and disease not just in Haiti, but around the world.

We'll talk to amputee veterans of the U.S. wars in Iraq and Afghanistan about what it means to live without a limb, and share their advice for amputees in Haiti. We'll reach out to our readers as well, publishing your thoughts on what it takes to recover from tragedy and build a new life worth living.

Kortney Clemons was weeks away from finishing his tour in the Iraq war when a roadside bomb exploded and destroyed his right leg. Two years after losing his limb, Kortney became the fastest 100-meter runner in the country for his disability category.

With the flash of a roadside bomb, everything that Kortney Clemons had ever known changed. As a U.S. Army medic in Iraq, he was a week away from returning home when the blast took his right leg above the knee.

Just as thousands of Haitians a world away are grappling with the traumatic loss of a limb and a sudden shift in identity, so are U.S. soldiers who fought in the Iraq and Afghanistan wars.

With more soldiers surviving their wounds thanks to medical advances, they're now living with the loss of limbs at a greater rate than in any U.S. conflict, except for the Persian Gulf War, according to the Department of Defense.

As of July 2009, 1,112 American soldiers sustained an amputation in the Iraq war; 112 in the Afghanistan conflict, according to the DOD's most recent count.

Over the next week, amputee veterans will be recounting their experiences in their own words, sharing what it means to live, as thousands of Haitians now do, after a sudden amputation leaves them facing a future they'd never imagined.

Kortney Clemons, a 29-year-old veteran of the Iraq war, begins our series. Clemons won first place in the 100-meter sprint in the 2008 U.S. Paralympics Track & Field National Championships. He currently trains full time at the Olympic Training Center in Chula Vista, Calif., as part of the Paralympic Track & Field Resident Team, in hopes of qualifying for the 2012 Paralympic Games in London. His right leg was amputated above the knee when he was 25.

By Kortney Clemons, with Linda Dahlstrom

I wear a bracelet with three names on it; they call it a hero bracelet. I haven't taken it off since I got it a few years ago. On it are the names of the guys I was with who lost their lives at the same time I lost my leg: 1st Lt. Jason Timmerman, Staff Sgt. David Day and Sgt. Jesse Lhotka.

It happened on Feb. 21, 2005. I'd been in Iraq for more than a year with my Army unit and was going to be heading back to the U.S. in the next week or so. We were training the soldiers who would take our place and so we were out showing them the community. On the way back home, we came to a vehicle with American soldiers that had hit gravel and flipped over. We stopped by to help out; I'm a medic and there was one guy who was injured pretty bad.

They had already called in a Medevac, but we wanted to be sure so we called another one. I'm grateful we did because that was the one that airlifted me later.

---

We got the guy on the stretcher and were in the road when an IED [improvised explosive device] exploded. We lost three guys, the three I was helping out. I lost my leg above the knee, but I didn't know it then. I did know everyone was paying a lot of attention to me and so I figured something was really wrong.

Kortney Clemons in Baghdad

I remember lying there looking up into the blue sky and wondering what would happen. I wasn't in a lot of pain; I think my body was in shock. The last thing I remember before I passed out was the Black Hawk landing and the sand hitting me in the face.

When I woke up I was at the American hospital in Landstuhl, Germany - it was maybe two days after my injury. I woke up and looked down. I realized I didn't see my right foot sticking up under the sheet like it did on the left side, so I kind of knew then but I was hoping it was a dream and if I lay back and woke up again, my leg would be there.

A nurse was there and my cousin was there. She'd been working in a hospital in Iraq and they'd let her fly with me to Germany. They told me I was in a real bad accident.

I was real sad. After the military, I'd looked forward to going back to school and playing football again like I had in high school and junior college. I'd never known anyone with an amputation. At time I felt like, "Why do I have to go through this? Why couldn't I have just passed away at side of road?"

My platoon sergeant, who was with me when I got hit and had multiple fractures to his leg, was at the hospital. He told me we lost three guys that day and I realized I was really, really fortunate to be alive. I felt like I was set aside and given a second chance. That's one of those things that give me my drive.

I never looked under the covers at my leg until it was time to go back to the United States. A friend who was stationed at Landstuhl was like, "Man, man you should look under the covers to make sure you can be strong for your family."

So, I raised the covers, looked under there, laid my head back down and began to wonder where am I going to go from here? My right leg was all bandaged from amputation and my left leg was also injured pretty badly by the IED.

I spent the next 10 months at Brooke Army Medical Center in Texas. An organization flew my parents and my 8-year-old daughter to come see me from Mississippi. I was really happy to see my family after all the stuff I'd been through. My daughter was really afraid though. She thought she was going to hurt me. I told her it was going to be OK.

I got my prosthetic in April, a few months after I got hit. Learning to use it was very difficult. I'd been walking with my own legs for 25 years. With this one, I had to worry about falling. The knee would buckle. It took me a while to master it.

When I first lost my leg, I think it changed me in a bad way. I didn't know how to deal with it and I got angry. Now it's teaching me patience and how to enjoy life.

As a dad, you want to be able to play football with your son and hang out with your daughter. Now Daytriona is 13 and the only thing she cares about it if I can walk with her in the mall, and if I can hold her clothes that she's trying on. I go hang out with her; we go to theme parks and experience everything.

As time goes on, well, it's still fresh to me because I deal with it every day. It's not like I healed up and I went on with my business. Every day I put my leg on I'm like, "OK, those guys aren't here. I need to make the most of it."

When I was at Brooke, the Paralympics did a clinic to try to get us guys interested in life and to show us that even though you're missing an arm or a leg you can still participate in recreational activities. I saw a guy like myself running on a track. At the time I could barely walk, but I kept at it.

The first time I ran was awesome. I took off running and began to feel the wind in my face and I felt free.

Since then, I've had a chance to represent my country in the Paralympics and graduated from Penn State University with a degree in therapeutic recreation. I always knew I wanted to help people - that's why I joined the Army as a medic.

The hardest part wasn't learning to walk again, the hardest part was getting past the self-pity and the "why me?" phase. Your mindset really determines what you're going to do and who you are. You have to either get busy living or get busy dying.

I want people in Haiti to know there's still life after amputation. They can still have a family, still have goals, still have ambitions. I didn't choose to be an amputee and they didn't choose to be amputees. But I can still contribute to society. Society needs people with disabilities to contribute.

We all serve a purpose. We're all part of something that is lots bigger than us.