On the fifth day on their response to the disaster in Haiti, Médecins Sans Frontières (MSF) teams remain focused on trying to cope with the huge demand for lifesaving surgery from those who suffered terrible injuries in the quake. They are doing that by stretching their existing, limited operating theatres to the limit by working around-the-clock, while at the same time trying to create more capacity by finding new premises and transporting in mobile structures.

Photo: Julie Rémy, MSF | In Choscal hospital, where MSF relocated after its original facilities were so badly damaged, the operating theatre has been working nonstop since early on Friday. Here, a 12-year-old girl had to have her leg amputated after gangrene and infection had set in.

In the newly working hospital in the Carrefour district, the MSF surgical team carried out 90 operations within 24 hours of setting up the theatre. This only two hours after they identified the hospital. The surgical team at Choscal hospital has performed around 90 operations in that location since it began surgeries there Thursday. Another team is working from a shipping container and carried out 20. More capacity is on its way, but the twin theatre inflatable hospital has been delayed because one of the planes it was on did not get permission to land at Port-au-Prince airport and was re-routed to Dominican Republic. The other half of the hospital did arrive today but MSF is still concerned that vital supplies are being held up.

Photo: Julie Rémy, MSF | Medical care under tents continues in front of what was La Trinité trauma hospital and rehabilitation center in Pacot. More than a thousand patients have received primary medical care here. The team was able to gather supplies and set up a tented clinic using the grounds of the pharmacy.

The conditions in towns outside of the capital, some of which were even closer to the epicentre of the earthquake, are becoming clearer. An MSF team plans to go today by helicopter to the town of Jacmel, on the southern coast of the island. Others have been to assess the needs in Léogâne, about an hour outside of Port-au-Prince. In Saint ­Marc, an area less damaged by the quake where thousands of people from the city have fled, there are hundreds of injured in the hospital. Despite the transport problems, MSF has managed to get in more than 100 additional international staff to help the teams who were working in Haiti before the earthquake. The specialists include surgeons, anesthetists, nephrologists and psychologists. Many of these have had to come by road from the airport in Dominican Republic but MSF has managed to get four cargo planes into Port-au-Prince since last Wednesday with staff and tonnes of relief material. The teams on the ground say that conditions are not improving yet for the sometimes desperate people on the streets. The lack of food and clean water is causing further stress. MSF is still trying to get a full account of its Haitian staff. We know that some have not survived the quake but communications remain difficult and we have not yet been able to trace all our colleagues.