“The highest reward for a person's toil is not what they get for it, but what they become by it.”

— John Ruskin

David de Vos / Special to the Californian

Bakersfield neurosurgeon Dr. Ian Armstrong examines a baby at a Haitian camp on the outskirts of Port-au-Prince last week. Many of the patients he saw had received no medical care since the earthquake.

Scott Mortenson / Special to the Californian

"We were leaving the orphanage where we had camped out for the week and had set up a 'hospital' for severely injured children," said Dr. Ian Armstrong. "I was leaving behind precious children I had fallen in love with during our time there. They had serious injuries: shattered pelvis, burns, skull fractures to name a few. Our truck was loaded and everyone else was leaving. I took a moment to pray for the children before we left."

I believe the future of Haiti is also the future of humanity

Bakersfield neurosurgeon Dr. Ian Armstrong thought he had seen it all in a career that included a decade working in one of the busiest trauma centers in the country.

Then he went to Haiti.

"I'm a hardened trauma surgeon," he said. "I was in Yugoslavia in '94. I've seen a lot -- but I had not seen anything like this.

"The smell of bodies still under the rubble fills the air. Children with no parents, kids with crush injuries, kids with burn injuries ... It's a war zone."

Armstrong, 51, grew up in Bakersfield and maintains a practice both here and in Southern California. On Jan. 30 he and about 40 other volunteers returned from Port-au-Prince after spending nearly a week there treating scores of victims of the Jan. 12 earthquake.

He worked with a team of medical professionals and disaster relief experts through the nonprofit Transformational Development Agency. Armstrong expects to return to Haiti in a few weeks and hopes to continue working with the team over what they expect will be a long-term effort.

"I think there's a moral obligation for the world to step up," he said.

Rikki Alakija, who co-founded Transformational Development Agency with his wife, Dr. Ayoade Olatunbosun-Alakija, said the devastation and suffering in Port-au-Prince is certainly widespread, but the team also witnessed scenes of hope and laughter and heard stories of love and reconciliation.

And as he led the team through days of gruelling, exhaustive yet joyful work, he was moved by Armstrong's skills and compassion.

"I can't tell you how impressive a man Ian is," Alakija said. "He was a great addition to the group."

The group members distributed medicine and shared compassion everywhere they went. They treated hundreds of Haitians for such issues as broken bones, head and neck injuries, internal bleeding, water-related stomach illnesses and stress-related problems.

So many Haitians had been without hope for so long, there were concerns among the group about being mobbed by desperate crowds. But it didn't happen.

"We'd come into a makeshift camp and people were so glad to see us," Armstrong remembered. "Everywhere we went we were treated like heroes -- which we weren't.

"The kindness, generosity and resilience of the Haitian people is amazing," he said.

But the plight of children reduced many in the group to tears -- men as well as women.

"There were many crush injuries," Armstrong said. "But now it's infected because it's a week or more later. It was either die or amputate a limb."

Like cities across Europe and America following the carnage of World War I, it will be common to see amputees in Port-au-Prince for years to come, Armstrong said.

"We have a whole society of amputees," he said. "And within six months, there's going to be a tremendous need for prosthetics."

One goal the group achieved during this first trip was to set up the beginnings of a skilled nursing facility in a warehouse. A shortage of beds is one of the most pressing problems in the region, so those lucky enough to be treated for acute injuries and illnesses are often left to their own devices in non-sterile environments that are far from ideal.

Scott Mortensen, a member of the team from Thousand Oaks, has paramedic training and is certified as an EMT. He also has experience as an adventure filmmaker, so his camera was in his hand when he wasn't caring for patients.

"What Haiti really needs is some indigenous leaders to help pave the way for solid reconstruction -- physically, politically and culturally," he said in an e-mail. "I would be honored to go back and assist that process."

But everyone in the Haiti team is worried that Americans' attention to Haiti will wane.

"This is the question that keeps me up at night because I believe the future of Haiti is also the future of humanity, Mortensen said. "Will we as a global community take time to rebuild properly? Can we employ a socially conscious infrastructure that restores hope and dignity to a shattered nation?"

Back at his Bakersfield office, Armstrong said the focus must be on bringing sustainable change, not just temporary relief, to Haiti.

And people from Bakersfield, with their culture of hard work and their experience with extreme summer heat, would be ideal volunteers to help Haiti find a new future, he said.

As he was preparing to leave Haiti, Armstrong said, he agonized. So many more needed his help. The faces of his patients called to him.

"I asked myself, 'Should I leave? Can I leave?'"

Then he knelt down on one knee and prayed.