Steve Williams has bound wounds in some of the worst slums of the world, but what has landed on Haiti is the very wrath of God, a hammer blow to the skull of an already dying man.
"We're talking about Armageddon here," said Dr. Williams, an internist with Allegheny General Hospital and longtime doctor with Hopital Albert Schweitzer, a charity hospital founded by a Mellon family heir and headed by Pittsburgh-based administrator Ian Rawson.
The poverty was already stunning, say Pittsburghers who volunteer at the hundreds of clinics that stretch across the island nation of 9 million.
People walk the streets in rags. Hunger gnaws. Electricity is a whim.
"A lot of people are going to starve to death or die of their injuries, trapped under the rubble," said Dr. Williams.
He could find no way to make that prediction any happier.
Today, the halls of Hospital Albert Schweitzer were flooded. It withstood the tremors that flattened so much of Port au Prince and remote villages up and down the island.
"All nurses and residents were called in to handle a large number of new patients -- traumatic injuries, mostly," said Mr. Rawson, who was able to issue a statement to the Hospital's Web site today. "Hard to get a social history, but several reports of collapses of multi-story buildings."
Estimates of casualties have been hard to come by, with so many structures gone that it could take weeks to retrieve the bodies under them. Officials on the ground offered estimates that started in the thousands and, in one startling conjecture, suggested it would run in to the hundreds of thousands.
For Nicole Carlin, a Lawrenceville woman who, with her husband and three children, works at a mission near the suspected epicenter of the quake, the question is simple: is her house in Haiti still there?
"We have no idea," she said in a telephone interview from suburban Philadelphia, where the family arrived just days after leaving Haiti for a visit here.
The Carlins work with Codep -- the Comprehensive Development Project -- which reforests the mountains on which Haitian famers plant peanuts, beans and coffee.
"The construction is just not built to withstand any kind of shaking like that," she said.
Even with the buildings standing, the quake could mean catastrophe to the rural farmers and their families. If the mountain road was wiped out, it shuts off her village, L'Acul, from the markets and, more importantly, from the supplies of food staples on which the population subsists. Haiti does not grow rice, one of the key, cheap staples.
"Essentially most of the people eat rice and beans. But the distribution system is such that they only have about two days supply in the pipeline," said John Winings, a former Ross resident, now living in Raleigh, N.C. and working with the reforestation project.
For Dr. Williams, the likely scenario, with stunned residents of Port au Prince taking to the roads in search of food in the countryside, along with the potential for thousands to die of injuries as treatable as broken legs and infections, the potential for a cascade of disasters is frighteningly real.
"On a good day in Haiti people are marginally nourished," he said. "Not everyone eats every day. Not everyone has potable water. This is on a normal day in Haiti. People literally walk around in rags.
"You are going to have problems with food and water for a massive population. Think of Brooklyn flattened by an earthquake and no way to get to it."
Dennis B. Roddy can be reached at firstname.lastname@example.org or 412-263-1965. First Published January 13, 2010 7:45 PM