Four months after the earthquake that devastated Haiti, there remains an overwhelming need for emergency aid to the impoverished Caribbean nation.

Haiti is still struggling to provide homes, sanitation and basic health care to hundreds of thousands affected by the Jan. 12 quake, according to an Associated Press report earlier this week.

The nation's medical clinics, hastily set up after the disaster to treat critical injuries, now see long lineups of Haitians who suffer scabies, parasites, worms and massive infections.

North Vancouver's Mandy Hengeveld has witnessed the devastation first hand. The Lions Gate Hospital emergency room nurse and her co-worker Darren Chan were in Haiti last month as part of an international team of 15 nurses, doctors and surgeons. The team saw 2,000 patients in mobile clinics over nine days in the country that is still reeling from the quake that killed up to 300,000 people and left many more wounded and homeless.

"Scabies and worms are prevalent in the tent camps, and it seems like such a crime that people are being forced to live like this," said Hengeveld, who returned from Haiti on April 10.

The medical team was sent by U.S.-based non-profit New Reality International. The team performed 43 surgeries during its nine-day stint based at a small medical clinic 30 kilometres east of Port-au-Prince. The doctors and nurses also offered mobile clinics throughout the region and in Port-au-Prince.

"At each clinic word spread quickly of our presence and without fail hundreds of people would line up patiently and for hours on end for their turn to see one of our medical team members," said Hengeveld, 33. "A glimmer of hope was what many people wanted."

In one mobile clinic at a nearby tent city, the doctors examined a boy whose mother had brought him in out of concern that he could not keep up with the other children. The doctor heard a loud heart murmur and suspected congenital heart disease or rheumatic fever, a disease that is rare in Canada but not uncommon in the developing world. The team's pediatrician agreed the child would benefit from a surgical consult, which in Haiti would be impossible, Hengeveld said. In Canada the situation would have never reached this point. It was heartbreaking, Hengeveld said.

One other day at the clinic, a concerned mom brought in her seven-year-old. The boy shyly complained to Hengeveld of nausea and vomiting. Through his worn shirt, the nurse could see his protruding belly. After convincing the boy to lift up his shirt for an examination the team diagnosed a hernia. "He was fortunate that we saw him at the start of our week, as the surgical team's slate was filling up quickly," said Hengeveld, adding that as the week progressed only emergency cases could be squeezed into the OR team's surgery-packed day. Hengeveld figures the surgical team's flexibility saved one young boy's life. Doctors removed the boy's appendix, which they estimated had ruptured five days prior to his arrival at the clinic. They were able to treat the infection.

Others weren't so lucky. Hengeveld remembered one mother who brought in her toddler who had a mass in her neck, that had gradually grown since the girl's birth. "She begged the surgical team to remove it, but it was too complicated a surgery being so close to her airway."

Hengeveld said living conditions were better than expected at Haiti Christian Mission in Fonds Parisiens, where a temporary residence has been set up on the second floor of the medical clinic on the grounds of the orphanage. The nurse slept on a patio under a mosquito net after working 16- to 18-hour days but was fed two meals a day and had the luxury of running water.

Scattered around the mission were countless tents that were home to displaced Haitians. Among them were medical students whose dreams were put on hold when their school crumbled to the ground. "In the earthquake, they lost their medical school. They lost their nursing school. They lost a lot of their doctors and nurses in the process, so their health-care system is even more strapped," said Hengeveld.

New Reality International's founder and executive director Laila Mickelwait said the need for medical help in Haiti is staggering. The organization sent out its first health-care team into Haiti even before the quake because of the nation's crippled health-care system. "Now the need is so much greater. The general hospital and many of the health-care facilities that used to provide some care to a lucky few are merely tents with over-crowded cots for the most grievous emergencies," said Mickelwait.

Right now, the organization is raising money to purchase an X-ray machine for the clinic in Fonds Parisiens. The machine is needed for doctors to properly diagnose and treat the many tuberculosis cases the clinic sees. Haiti has the highest per capita TB burden in the Latin America and Caribbean region, according to the World Health Organization. After HIV/AIDS, TB is the country's greatest infectious cause of mortality in youth and adults.

The organization is also recruiting medical and dental professionals for upcoming relief trips. "We need nurses, primary care, internal medicine and ER doctors, general surgeons, anesthesiologists and dentists," said Mickelwait.

Another team of emergency room nurses from Lions Gate Hospital will leave for Haiti in June.

Mickelwait praises the volunteers from Lions Gate Hospital, who she says have been simply amazing. "One thing I noticed is that their hearts were in their work. They worked tirelessly and with a deep compassion for those they were serving," Mickelwait said. "After our June trip we will have had seven team members from Lions Gate. That does say something about the quality of health-care providers at Lions Gate Hospital as well as the heart of the Canadians in general."

Christina Mavinic has worked as an emergency room nurse at Lions Gate for five years. The 30-year-old was the first of the hospital's nurses to volunteer in Haiti, when she travelled there in late February, eight weeks after the quake. Mavinic kept a journal of her seven-day stint at the medical clinic. She wrote about her arrival in a tent city where the team set up a mobile clinic, noting the smells, sounds and sights of the poor living conditions of the refugees. "Big eyes on little faces, situated above hugely swollen bellies and bare feet greet us as we set up our modest pharmacy, tables to examine people at and a tent for shelter from the blazing sun," she wrote. "What struck me was how the community came together to round up the sickest infants and children (mostly orphans being looked after by the community as a whole) and put them at the front of the line." The team made its way through the lineup of people, its pharmacy supply dwindling as they rationed everything from Pedialyte to Tylenol. Mavinic said that six tablets of Tylenol were the equivalent of three months' wages in Haiti, making basic medications out of reach for most Haitians.

The team Mavinic will join in Haiti in June will focus their mission on preventive health-care and bringing primary health-care to the island's rural areas. The volunteer organization has been given clearance by the World Health Organization to administer vaccines, said Mavinic. The team hopes to take with it a basic immunization program for infants and newborns.

Meanwhile, Hengeveld plans to return to Haiti in November.

Hengeveld said the Haitians she met are both grateful for the support and surprisingly resilient in the face of tragedy.

The nurse recalled an incident during her April visit while en route to a mobile clinic in Port-au-Prince. At one point, children who were pleading for water and food surrounded the team's car. "You wanted to give them everything you had, but even then you knew it was not enough," said Hengeveld. "Our Haitian driver would turn in French and say to us 'These are my people -- there are not enough words in the dictionary to express how thankful I am that you have come to help us.'"

Hengeveld said the outpouring of support she received on the home front was equally heartfelt.

"It was really amazing the support I had behind me -- people giving baby clothes or a bottle of Tylenol. I want to get the word out that the support given went so far. And also that so much more work can still be done there."

New Reality International's Mickelwait said donations are needed to purchase food for distribution at mobile medical clinics. The organization is also seeking donations of new and used tents to give to Haitians without adequate shelter due to the earthquake.

To donate, contact mandyhengeveld@gmail.com or visit www.newrealityinternational.org.