Rita Devilus still bears the scars from the day the four-story apartment building collapsed on her.
Metal rods punch through her skin and are screwed into her bones to hold together her shattered femur and tibia.
Physically, she is recovering. But mentally, she knows she will never be the same.
"Sometimes I suffer from the pain of my injuries," the 49-year-old said. "And sometimes I suffer in my heart because I left my daughter in a pile of bricks."
Mrs. Devilus was trapped for three hours after the 7.0- magnitude earthquake that shook Haiti on Jan. 12. Three men broke apart a brick wall to free her leg. She remembers tugging at the arm of her 13-year-old daughter, Niana, who was buried under rubble. She said she knew her child was dead and that she could do nothing for her.
For the past six months, Mrs. Devilus has been healing at the Centre de Santé Lumiere Health Center in Les Cayes, receiving care from Advantage Haiti, a program started by a UTC professor.
Since the earthquake, a rehabilitation clinic run by Advantage Haiti has been flooded with patients requiring postoperative care. Dr. June Hanks, an associate professor of physical therapy at the University of Tennessee at Chattanooga who started Advantage Haiti in 2001, took a yearlong unpaid leave of absence from her job to help with the rush of patients.
"After the earthquake, I needed to go down there to provide direct service myself and also to figure out how we're going to ramp up the services provided by the Advantage program," she said.
In Haiti, Dr. Hanks sees both hope and hopelessness.
"I mean, you almost see a resiliency and a hope, but I saw more flat faces," she said. "Not totally hopeless, but just a flatness that I had never seen before, like this is almost the straw that broke the camel's back and we're not sure we're going to make it out of this."
The organization runs the clinic along with a prosthetics/orthotics shop, a residential vocational training program for women with disabilities, and a training center for the blind or those with low vision. The organization also arranges school sponsorships for Haitians.
Several Chattanooga-area agencies have been serving Haiti, the poorest country in the Western Hemisphere, for years. Eighty percent of Haiti's population lives below the poverty line, and more than half the people are in abject poverty, according to the CIA World Factbook.
Erlanger cardiologist Mitch Mutter founded the Chattanooga-based Children's Nutrition Program of Haiti in 1998. Dr. Hanks first traveled to Haiti on a mission trip in 1998 and created Advantage Haiti three years later.
Officials with both agencies have stepped up services since the earthquake, but they remain committed to their long-term missions.
On a July day when the temperature hovers above 100 degrees, Ashley Aakesson of the Children's Nutrition Program of Haiti glances back at intern Courtney Latta as they drive a dusty white Land Cruiser through bumpy, torn-up roads piled high with rubble in the town of Léogâne. The two women are en route to a training session for Haitian public health workers.
"I hope our day today is better than it was six months ago," Mrs. Aakesson tells the intern.
For Mrs. Aakesson and Ms. Latta, who both survived the earthquake in Port-au-Prince, simply making it through the day is a very real hope.
Mrs. Aakesson is executive director of the Children's Nutrition Program, a nondenominational faith-based agency that educates Haitian health workers on children's nutritional needs, the importance of breast feeding and basic sanitation and health care.
Chronic malnutrition affects one in three children in Haiti, and severe acute malnutrition affects one in 10, according to a 2006 demographic and health survey by Macro, a Washington, D.C-based public health research firm.
The Children's Nutrition Program operates in Léogâne, one of two towns nearest the earthquake's epicenter. Eighty percent of the town's buildings were destroyed or damaged past the point of being useable, according to the United Nations.
The Children's Nutrition Program has ramped up its operations since the earthquake. Its Haitian staff has grown from 43 to about 100, and its budget is about three times bigger than it was before the quake because of donations and a partnership with Save the Children.
"And with that three-times-bigger budget, we're reaching 10 times more children and their families," Mrs. Aakesson said.
The program's main priority is preventing malnutrition in children under 5. People who are malnourished before age 2 or 3 will be less productive for the rest of their lives, Mrs. Aakesson said.
"If you have one out of three kids who are suffering from this, it ends up affecting the economy of a whole country and that country's ability to be part of the world's economic system," she said. "This is a long-term problem. We are fixing it with local resources ... but it's going to take a generation for it to really show all of the effects that it's going to have."
Children in post-quake Léogâne are "getting pushed into malnutrition" for a number of reasons, said Kara Telesmanick, the Children's Nutrition Program manager.
"Their own parents are traumatized, they might be separated, they might have been killed, and so their own health is suffering as a result of that," she said. "Services are disrupted, so if they are sick, they cannot get treated as quickly and that pushes them towards malnutrition."
Teaching proper nutrition to Haitians deals with the issue "in a preventative way rather than a reactive way, and those of us who are professors like that because you are not putting a Band-Aid on the problem," said Tom Streit, a Catholic priest and Notre Dame professor who has been working in Léogâne for 17 years.
Six months after the earthquake, some Haitians still are clinging to a Band-Aid life.
Makeshift dwellings still smother the landscape. There are so many tents in Haiti that in some places entire neighborhoods are fashioned out of blue and white tarpaulins.
Some Haitians live inside corrugated metal walls covered by tarps and fastened together with ripped sheets and shredded clothing.
Others dwell in massive igloo-style white tents donated by aid organizations. In narrow lines on empty bulldozed lots, those tent neighborhoods look clean and sterile.
Jean Marc Brissau, president of the Rotary Club chapter in Léogâne, said the tents hardly are a quick fix, especially with hurricane season here.
"When it's raining, people stay the whole night standing, because water is flowing under their feet and they have nothing to lie on," he said.
Still others eat and live out of their houses but won't sleep inside because they fear another earthquake.
And while many Haitians lost limbs in the earthquake, few amputees are seen in public.
Amputees are afraid to leave their homes because of the stigma of their injuries, and many simply have not had follow-up medical care after their surgeries, said Evans Cheridor, a nursing student in Léogâne. Some have not learned how to get around outside their homes, he said.
Dr. Hanks of Advantage Haiti hopes that will change. She believes it is possible to use the earthquake as an "opportunity to change the mindset of Haitian people" toward those with disabilities.
"Because at no other point in time would there be so many people who had an acquired disability due to a natural disaster," she said.
In Haiti, there simply is no escaping what happened on Jan. 12.
The quake's devastation is never far from anyone's thoughts.
Jerry Joseph, an information technology specialist for the Children's Nutrition Program, said every sound can be ominous.
"Each noise, I pay attention to each noise," he said. "My biggest fear for Haiti is an earthquake again."
Continue reading by following this link to the Times Free Press Haiti earthquake page.