“She had this surprised look on her face. She was the same height as the other children. She wasn’t using her hands. It was so lovely.”

Thirty-eight people work at Handicap International’s rehab center, which is on a teeming thoroughfare called Avenue John Brown. The building had been an unfinished supermarket, its concrete pad and large footprint perfect for a rehab gym.

The center today has 3,000 “beneficiaries” — the term it prefers — on the books. About 650 have lower-limb prostheses and 210 have upper-limb ones. There are 105 children. The staff custom-builds artificial limbs and assistive devices, trains the clients to walk, carry things, climb onto buses, cook, scrub clothes and care for themselves.

These days, however, there are often empty chairs in the indoor-and-outdoor waiting room.

Many earthquake amputees have been effectively discharged from care, seen only if they have problems. Those still coming in regularly are people whose rehabilitation has been delayed or complicated.

On the day of Coralie’s session, Judette Jusme, 30, was practicing between the parallel bars. Pinned beneath earthquake wreckage for a day, she lost her right leg above the knee and, months later, her right arm below the elbow. Last year, she developed tuberculosis and was hospitalized for six months.

She once supported seven members of her family with her salary as a lab technician. She doesn’t work now. She is tall and parts her hair in the middle, over a patch of scarred scalp. She has chronic headaches, and sometimes when she lies down “I can still hear the hammers they were using to dig,” she says after her session, eyes filling with tears. “Sometimes I wonder why I am alive.”

For many of Handicap International’s clients — especially the younger ones — things have gone better.

A few times a week, members of the staff, usually with a therapist-in-training, make home visits. They assess the household environment and watch the client move in it. They’re on the lookout for obstacles to autonomy and privacy that can be fixed.

The team reached Sebastien Lamothe, 10, the last client on a recent day, in mid-afternoon. The boy was home from school and taking a nap. He lives with his uncle’s family — nine people in three rooms.

Sebastien has large eyes, a broad face and Chiclet-white front teeth. His mother and grandmother died in the earthquake; his father isn’t in the picture. He is an only child, although now his household features many cousins.

The boy emerged from an inner room and came to the breezeway on the side of the house. He had lost his right leg above the knee. One of the therapists felt the stump. The bone was growing and coming closer to the skin, which might soon cause pain when Sebastien wears his artificial leg. He will probably need a surgical “revision” at some point.

Sebastien put the prosthesis on. It’s a complicated process that involves wrapping the stump of the leg and then inserting padding into the device’s molded socket and out the bottom of it. He did it faster than the three adults the team had visited earlier in the day.As the team put Sebastien through his paces — climbing over a low wall, walking to the privy, standing straight to have his hips measured — his uncle, who sells lottery tickets, described how things were going.

The boy doesn’t have to cross busy streets to get to school. He is the only child in his school who is missing a limb. No, he doesn’t feel isolated. He plays with his classmates and cousins. He likes soccer. He can kick but can’t run. He doesn’t talk about his mother much. A counselor used to visit him at home but doesn’t anymore because he has adjusted well. He wants to be a pastor when he grows up.

“He is a happy boy,” his uncle said.

Hard to be optimistic

The prospects aren’t quite so good for 51-year-old Henry Ovinel.

He escaped injury when the house he shared with his brother in Village de Dieu collapsed. Fleeing with the crowd, he stepped in a foot-size hole in the pavement and was trampled. He lay in the street for an hour before his brother, who worked at an icemaking plant, rescued him and took him to the hospital.

Ovinel had a compound fracture of his left lower leg — bone sticking through skin. Normally, such an injury wouldn’t require amputation but would need surgery, antibiotics and meticulous nursing care.

“I suffered a lot for several days. The only option was to cut. That’s how they saved the leg,” he said without irony, sitting on a concrete wall in the squatters camp in Champs de Mars. He’s lived in a shanty there since the earthquake but is about to move into a rent-subsidized apartment out of town.

A year after the earthquake, he was fitted with an artificial leg. It hurt too much for him to use and he gave it back after a few weeks. When he had a follow-up appointment two months later, the organization that provided the limb was gone. He says now he’d be open to trying a prosthesis again or even getting surgery to make his stump more compatible.

Ovinel is a “street worker”— a private-duty sweeper, a carrier of loads, a runner of errands. Or he was. He hasn’t worked since his injury. He spends his time sitting with friends at one of the shaded entrances to the downtown park. His brother supports him.

“In cleaning streets, you need to walk with a broom. The kind of work I was doing is not fit for people with one leg,” he says.

He would like to find a job in which he can sit. Perhaps in sales. He can barely read but is good at arithmetic, he says. He’s not terribly optimistic, given his age.

“I wasn’t doing that good with two legs,” he says. “And now I have one.”