PORT-AU-PRINCE, Haiti -- In the stifling confines of Tent No. 6, where a half-dozen patients fan themselves with cardboard while flies circle overhead, Evaline Methelus is stretched out on a cot, her face etched with pain from a leg crushed during the massive earthquake of Jan. 12.

"She was selling clothes in front of a high building, and the building fell on her," her husband, Norginale Urite, says in Creole through an interpreter.

It's taken more than three weeks for the 31-year-old Methelus to make it to Sacred Heart Hospital for proper medical care. But now, she and her family are about to get bad news from a Memphis surgeon: The leg is dangerously infected and must come off.

"The problem is, the infection could spread and make her very sick. I don't want to do any amputations," Dr. Derek Kelly, of Le Bonheur Children's Medical Center, says as Methelus' mother, Pierre DeLasiene, 50, closes her eyes and holds out her hands as if to wish it all away.

The reason for the family's distress is all too apparent. Life here in the Western Hemisphere's poorest nation is hard enough for even the most able-bodied person. To become an amputee in Haiti, Kelly says later, "is right next to dying."

Kelly, a Campbell Clinic pediatric orthopedic surgeon at Le Bonheur, is part of a surgical team from the Memphis hospital that has spent nearly two weeks providing care for victims of the magnitude-7.0 quake, which killed an estimated 200,000 Haitians and left hundreds of thousands of others injured or homeless.

Composed of two surgeons, a critical care specialist, a pediatric anesthesiologist, a nurse anesthesiologist and other support personnel, the team works at a facility known locally as Centre Hospitalier du Sacre-Coeur. While the nearby 82-year-old Sacred Heart Cathedral was destroyed in the quake, the hospital still functions even though the wing with patients' rooms was rendered unsafe and ominous cracks climb the walls leading to the operating rooms.

The Le Bonheur crew is part of a significant Memphis presence in quake-relief efforts in Haiti. Its arrival was possible because FedEx flew the members and supplies free of charge and because St. Jude Children's Research Hospital donated more than $1 million worth of medication. Another local firm, ExtraOrtho Inc., contributed $160,000 worth of equipment, and the Memphis Grizzlies NBA team chipped in $50,000 to help pay for security.

The group is among several from around the world that have descended on Sacred Heart. Teams from Knoxville and Nashville also are on hand.

The base of the Le Bonheur effort is a compound outside of Port-Au-Prince run by Haiti Medical Missions of Memphis, which was established more than 12 years ago by Dr. Gordon Kraus, a Memphis internist. Large and well-equipped by Haitian standards, it features a clinic, operating room, kitchen and dormitory and other facilities.

After traveling from the compound to the hospital each morning, the team does six to 10 surgeries, handling everything from orthopedic surgeries to gastroenteritis cases to gall bladder removals. Often they use makeshift methods required by power outages and equipment shortcomings.

Many of the patients have had severe crush injuries from the quake.

"These injuries are beyond anything I've ever seen," said Dr. K.J.S. "Sunny" Anand, chief of critical care at Le Bonheur.

The amputation of Methelus' right leg below the knee begins shortly after Kelly's visit to the tent, one of several set up outside Sacred Heart because of the damage to the patient wing.

To allay local fears that foreign doctors are too quick to order amputations for Haitians, the hospital's owner has set a policy requiring that the operation not begin until a Haitian doctor has been included.

Prosthetics are provided, but because Haitians must walk so far, and on poor surfaces, to meet their daily needs, the artificial limbs often wear out quickly. Health care being what it is, there's usually no chance for replacement.

The operation reveals that the infection is even worse than earlier feared, as both Kelly and the Haitian surgeon, Dr. Bernard Nau, agree. Eventually, it would be life-threatening.

"It was moving up (the leg)," Kelly says. "It was time to do it."

But there's a Haitian saying that, roughly translated, ends with the line, "We need our hands and our feet to survive."

That explains why, back in Tent No. 6, the anguish hasn't fully dissipated. With her husband out of work, Methelus was the family bread-winner.

"It's going to be hard for the family," her mother, DeLasiene, says.

— Tom Charlier: 529-2572