DESCHAPELLES, Haiti -- The earth did not quake much, this far north. Instead, the land to the south shook loose its population and the people of Haiti's capital rolled uphill.

By the tens of thousands they fled to the mountains. They changed the face of its bone-poor countryside and tested the mettle of one small hospital.

First came the wounded. Legs crushed, arms broken, bellies punctured, they were loaded into cars and pickup trucks, the famously overloaded "tap-tap" cabs of Port-au-Prince, and driven 70 miles. Some, still bleeding, legs or arms broken, arrived on the backs of motorcycles.

Their destination after the Jan. 12 earthquake was the Hopital Albert Schweitzer, an 80-bed country hospital founded by Pittsburgh's Larimer and Gwen Mellon, heirs to a banking and oil fortune who brought American medicine to the impoverished countryside of the Western Hemisphere's poorest nation.

"They started coming around midnight," said Ian Rawson, Mrs. Mellon's son, who now runs the hospital. "I thought, OK, we'll get about 20 or 30. But they just kept coming."

By morning, 300 beds, cots and whatever could hold a wounded body packed the rooms, filled the hallways, flooded into the open courtyards.

A school bus turned up, packed with injured already hooked to intravenous bags, some with corrugated cardboard splints on broken limbs. Someone spoke of a "clinic" near Port-au-Prince where the workers knew of HAS and figured the wounded had a better chance in its operating rooms.

"We were 420 percent over capacity," said Edward Rawson, an East Liberty mural artist who flew here last week to help his father. "With all these patients come the families, too."

They counted the doors. When the houses of Port-au-Prince tumbled, the front doors came loose. People loaded their injured mothers and children onto them and stuck them into the backs of pickup trucks, whose drivers tripled the rate for an 80-mile drive. After a bouncing, wrenching journey on roads barely worthy of the name, people carted loved ones into the hospital on those doors.

Most of them stayed by bedsides until the injured were free to leave. They packed up their families, reclaimed their doors and left.

"It'll be a long time before they have a house to put the door on," Mr. Rawson said. "But you can bet it's going to be where it was before."

In the space of two weeks, HAS has become a metaphor for the extraordinary transformation now faced by the Artibonite Valley, a onetime center of sugar cane and banana farming. By some estimates, 200,000 people have fled Port-au-Prince for this region. In Deschapelles, a market town with dirt roads and no water system or electrical grid, families are doubling up and some of the patients released from HAS, or family that brought them here, have set up homes.

Precise numbers are hard to find. The hospital serves as a de facto census. Each child born here gets an identity dossier and is entered into the computer system at HAS. As Mr. Rawson tells it, a child is born and, "18 years later, they fall off a motorcycle, you don't have to register. You're already in our system."

The hospital is a one-story campus with courtyards, large, screened windows that catch the mountain breezes and a staff of 16 Haitian doctors. The Mellons insisted on training local men and women for the job of caring for their countrymen.

That staff was worked to the bone after the earthquake. By the end of one week, said Dr. Erlantz Hyppolite, a staff physician, HAS had treated at least 800 people. Probably more, said Mr. Rawson. About 200 people were given outpatient care.

Volunteers began to arrive. Leslie Rodnan, a pediatrician from Squirrel Hill who now lives in Washington, and Lise Van Susteren, a psychiatrist from Washington, D.C., came down on a mercy flight from Pittsburgh last Sunday, bringing supplies, expertise, and wide eyes.

Two days earlier, Paul Hendershot turned up at the door, a small backpack and an Army medic's kit strapped to him.

Fresh off an eight-year stint in the Army, where he gave front-line first aid to troops in Iraq, Mr. Hendershot was at his parents' house in Fox Chapel when newscasts broke in with reports of the devastation. He learned of HAS from newspaper stories describing the flood of refugees.

"A friend called me and said he would sponsor me," he said. Mr. Hendershot flew from Pittsburgh to Philadelphia and, because the Port-au-Prince airport was closed to commercial traffic, from Philadelphia to Santo Domingo in the neighboring Dominican Republic.

From there, with a little Spanish and no French, he hopped trucks, hitchhiked remote roads and picked up a motorcycle ride to the border town of Bella Dere.

Haitians were trying to beg their way into the Dominican Republic. Mr. Hendershot's driver abandoned him there -- he wasn't about to enter Haiti.

At Bella Dere he hired a translator for $50, hooked up with a motorcycle taxi and, three-to-a-bike, rode to Deschapelles. It was Friday night and a guard at the hospital turned him away.

He walked down the hill to Mr. Rawson's house, introduced himself and, by Saturday, was helping at the hospital.

The Rawsons were awestruck at Mr. Hendershot's daring rush across the island of Hispanola to the hospital doors. Mr. Hendershot, in turn, speaks with awe of the doctors who work to exhaustion with the overflow. "I've never been more amazed," he said. "For some things you do in combat you get awards and ribbons to make you feel all brave and shiny, but the doctors here, they're probably the biggest heroes I've ever met."

On a Friday afternoon, Dr. Rodnan and Starry Sprenkle made the rounds of the houses, huts, and dirt yards of Deschapelles. Ms. Sprenkle works through HAS on a reforestation project, planting fruit trees with farmers who can then harvest a salable crop.

Ms. Sprenkle translated. Dr. Rodnan listened. By day's end, she'd sent for Dr. Van Susteren, the psychiatrist.

At the home of Nixon Pierre-Jules, a procession of refugees came to the screened porch, sat in a cushionless chair and told their stories. Mr. Pierre-Jules didn't offer up his own story. It came out by accident. The mother of his children, Ilena Auguste, had been in Port-au-Prince. He has not heard from her since.

Marcillien Sirene, frail, elderly, looking for all the world like dignity carved in ebony, told of how she learned of the earthquake. Her daughter, Consilta Nacillien came back from Port-au-Prince with the body of Mrs. Siren's grandson, Joseph Taless.

Keening filled the air for a day. They dug a grave and buried Joseph.

"I can't sleep, even though I'm tired. Things just keep running in my head," she said.

More refugees sought out the Pierre-Jules home, sticking out in this country village by the surprising fashion of their city clothes. "Deschapelles has never seen this kind of fashion before," said Ms. Sprenkle.

It has also never seen the like of Jacques Lusca.

He took his seat on the Pierre-Jules porch. His thin arms hung limply. He rubbed his head. He talked about walking the road to Deschapelles. He talked about his nightmares, about climbing over corpses on his way.

Nobody wanted to ask him if he had any family left. They were too frightened to hear what might come next.

Dr. Rodnan sent word to Dr. Van Susteren, the psychiatrist. By day's end there would be a few more referrals.

Martine Pierre. Her 1-year-old sister died. Her aunt's foot was broken.

"Anyone with a broken foot right now will most likely die," said Ms. Sprenkle. "And they couldn't find her sister's body to bury her."

This river of pain crossed the porch for close to an hour. Story after story of fallen homes, missing mothers, crushed brothers, dead infants, finally ended with a passing remark: Nobody in the house had any food.

Dr. Rodnan made a mental note. She planned a visit to the market for a bag of rice.

The market here is a patch of dirt covered by a warren of stands, tables, tarps. It smells of roasting goat, humans, salted fish pulled from the Artibonite River. Goats roam freely, people barter. There are clothes and piles of rice and beans. There is meat swarming with flies. Pork is sold -- the whole pig. Entrails are up for sale. No one can explain what to do with them.

This is the economy of Deschapelles. It is into this place that the refugees have come.

Rolling in from Port-au-Prince, they have more education, are a bit more worldly than the mountain folk, and what will become of them and this town now that it has them is the big mystery.

"For now, they find a lot of people from Port-au-Prince are staying close to them and they can sell more easily to those people," Stepha Dieurius said as he passed through the market. "I think Deschapelles is going to be changed more and more. For good." Jimmie Tinsley, a Regent Square resident who manages the power plant here -- HAS uses four large diesel generators -- sees a major change.

He sees no tensions arising from this change. Haiti, he said, is a country of people who give away what little they have.

"People share here," he said.

At a nearby community center, Luquece Belizaire is hosting refugees. Children run across the concrete patio, which becomes a disco on weekends.

The sign above his shop along the town's main road reads "Belizaire et Mellon." He placed it there in honor of Larry and Gwen Mellon, who he remembers from the day they came here. Like the Mellons, he figures the influx of his own people will help. "This will be good for us here," he said. People, he said, are good.

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