Mohlene, 18 years old, was born HIV positive. She contracted the infection from her mother, and this is called “vertical transmission.” Her mom died many years ago from AIDS, and today Mohlene held my hand and smiled as we talked about her home and her family. Tomorrow she will lose both of her legs, but she doesn’t know this yet.


We don’t know why, at 18, Mohlene has developed a problem with the blood flow to her legs, but suffice it to say the lack of blood to her legs has left her with black, necrotic feet. Her toes are like pieces of chalk and have no feeling. Left alone they will become so infected they will take her life. Tonight we tried to save them, but they cannot be saved.


Tomorrow, I will take her legs and hopefully save her life. She will be wheelchair-bound but hopefully will be alive to share the rest of her life with her family who tonight will sleep on the pavement in the hospital grounds with the hope that a miracle will save her. Her father stands in disbelief as I describe what we found in surgery. Her legs are dead, and emails and consults to the US reveal no other options.


Her sister asks me, “Are you treating her like this because we are in Haiti?” I assure her that I am treating her as I would a member of my own family in the U.S. There is nothing else that can be done.


Our entire team of 15 are in the operating room at 11 p.m. and we complete our first surgery. She will return several times this week as we strive to preserve as much of her legs as possible.


Most people here do not have access to medical care. They seek care only when there is no other option. We provide assistance where and when we can. Sometimes it is too late to save a limb, but just soon enough to save a life. We will know more in the coming days.


In the last 4 days we have performed surgeries on 14 patients and touched the lives of many. We have reconnected with staff and friends and have been welcomed by patients who seem surprised that we have “come back.” The team has been resilient, efficient, caring and amazingly competent in their work and have provided empathy and love to these people who continue to suffer in the most austere of circumstances.


Although Mohlene will leave the hospital without her legs, I hope she will leave with our love and support and the knowledge that we have done the best we could to help her.

Two days after this was written, we took Mohlene back to surgery where we amputated both legs through her knee joints. She is still in the ICU, and we are hopeful that she will survive. She gave me a big kiss the day I left. She is a survivor.

Love, Bull


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