Healing the horror

The amputees were everywhere. A leg, an arm, often both arms chopped off at the wrists or the elbows. They barely survived by begging in the streets.

Dan Kelly, a third-year medical student from Valley Forge, knew they were the wounded from a decade-long civil war that had devastated Sierra Leone.

What he did not know was why no one was helping them.

Kelly had come to Sierra Leone - one of the poorest countries on earth - with a mission. He was not sure what form that mission would take, but he knew it was far from treating the kind of medical conditions he would see on the Main Line.

His first visit was two years ago, at age 25. He had already formed an organization in the United States with the vague goal of fighting poverty by promoting health.

The amputees gave a human shape to that cause.

Now, a one-story cinderblock building - the clinic for war amputees in the "blood diamond" region - gives it a structure.

Tamba Patrick Sumane, 50, sick with malaria, did not have the $3.75 to pay a government hospital. Two weeks ago, Sumane, whose right hand had been chopped off by the rebels in 1998, came to Kelly's new clinic and was treated for free.

What has this clinic meant to amputees like him?

Sumane answered through a translator on a cell phone:

"It was as if they were dead and now they have been woken up."

His answer would not surprise Kathy Kelly. Her only son went to "where the need was greatest."

He was a high achiever - No. 1 in his class at Malvern Prep, captain of the rowing team, an honors graduate from Princeton - and he had long cared about helping others.

Kelly's quest started a few years ago, as a Web site - "a conduit for youth interested in issues of poverty and health" - with ambitions that he soon realized would cost money he did not have. So he, along with his parents and younger sister, created the Global Action Foundation.

But it was Issa Toure, a refugee from Sierra Leone and a classmate at Albert Einstein College of Medicine in New York, who gave Kelly a direction: " 'Dan, my country needs you,' he would say."

Sierra Leone, a nation smaller than Maine on Africa's west coast, is still recovering from the conflict that ended in 2002 after killing thousands and displacing two-thirds of its six million people.

Kelly won a fellowship to help pay for a three-month placement in hospitals there. He arrived in June 2006, shortly before the release of Blood Diamond, the Leonardo DiCaprio film that publicized the rebel army's practice of chopping off civilians' limbs.

"It was difficult," recalls Kelly. "I was reading by candlelight; water had to be fetched from afar."

His friend from medical school had connected him with Mohamed Barrie, a young doctor near Freetown, the capital, and Kelly approached him about doing something for the amputees.

"Like most people in Sierra Leone, I just kind of gave them money when they begged," Barrie says now. "But Dan was shocked and moved."

Together they began spending weekends working in amputee camps near the capital. But to really help them, Barrie told him, it had to be sustainable - something that would impact the rest of their lives.

So the first practical application of Kelly's humanitarian imperative came into being when he and Barrie created an NGO, a nongovernmental organization that would implement the mission of the foundation he'd started back home.

Kelly left Freetown for Kono District in the east - the region with the diamond mines, where the war had done its worst.

Was he ever concerned for his safety or his health?

"Nobody has pulled a pistol on me yet," says Kelly, who goes solo ice-camping in Patagonia to relax.

"He has no fear," says his mother. "He has no frontal lobes."

Reminded that he has contracted both malaria and typhoid, Kelly dismisses it: "I took the medications and it went away. No big deal."

Sarah Bones watched him hold meetings and teach workshops while ill last spring. "It only slowed him down to what most people would consider normal speed," she says.

They had met at a lecture in Villanova about health care in the developing world. A year later, Kelly sent an e-mail inviting the Philadelphia-area photographer to see his work in Sierra Leone. It was not an easy decision.

"I went because I believed he could make a difference," she says. "Or he would die trying."

Through much of 2007, Kelly and Barrie treated hundreds of Kono amputees in their houses, turning them into "mobile" clinics for two or three days at a time, while they sought a permanent location. Eventually, an important donor was won over.

"Chief Komanda said, 'This crazy white man has come a million miles and done what Leoneans have not done,' " says Barrie. " 'We would be crazy if we did not give him the land.' "

Kelly designed the simple cinderblock structure with a sketch program he found on the Web. There is no electricity and no staff quarters. Water is hauled in five-gallon jugs from a half-mile away.

Last Monday, people began lining up at 6:30 a.m. for the 9 o'clock official opening of the Kono clinic for war amputees and their families: people with typhoid fever, malaria, parasites, diarrhea, vomiting, pneumonia, and asthma brought on by dust from the mines.

All treatment is free. The clinic needs a water well, a generator, solar panels, and all the equipment for a lab.

"Mostly we need enough money to make sure we have a constant drug supply - that's our biggest concern. We still don't have the facilities to help women do labor and deliver children," Kelly says. "And we want to build a therapeutic feeding center here. There are a lot of severely malnourished children."

Working with a United Nations grant, Kelly also launched a program for severely malnourished children in the Port Loko District on the coast.

Both initiatives have full-time staffs and are organized to run without Kelly there. Mohamed Barrie - having resigned his hospital position outside Freetown and now working full time for the NGO - has become a partner in his long-term plans.

"The issue is not only health, it involves other sectors," Kelly explains. "We are a health-focus organization, 'using health to eradicate extreme poverty,' but you have to realize that micro-agriculture is a natural extension of health into economic development and real sustainability for this amputee project."

He plans to fly to London today to begin setting up a British office of the Global Action Foundation and to give fund-raising talks. He will return to the United States in May to graduate from medical school.

It's been a long trip from rowing on the Schuylkill for Malvern Prep to walking the hills of the blood-diamond district. Kelly has had patients - one of them an 8-year-old girl - die in his arms.

Is he still an optimist?

"I came to Sierra Leone a naive idealist," Kelly says. "Since I've been here, I've become a practical idealist. You think you can save the whole world, but you just have to pick your part."

Global Action Foundation

Valley Forge, Pa. 19481

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A Sierra Leone slide show by photographer Sarah Bones, video interview with Dan Kelly, and how you can support his work: http://go.philly.com/healthEndText