PORT AU PRINCE, Haiti (The New York Times News Service) -- The wide ramp sloping down from the third floor at the Sacred Heart (Sacre Couer) Hospital echoes the brisk swish of Dr. Alberto Sosa's surgical scrubs as he again races to the emergency room.

Sosa, an orthopedic surgeon from Boca Raton, Fla., barley turns the corner on the hospital's ground floor before he's surrounded by several people, each is clutching an X-ray belonging to a loved one among the circle of patients lying on the hallway floor.

He pauses briefly. He can't understand them, but he knows what they want: Help.

Some of the patients, meanwhile, are crying out in pain. Others are simply calling on God.

Sosa nods at the X-rays. He says "OK, OK" several times. He keeps running.

There's no time to stop, Sosa says. Move too slow and someone else will die.

"This is a lot worse than I thought it was going to be," says Sosa, who arrived in Port au Prince Monday. "I didn't expect to see people here walking around with open wounds now, after seven days."

Sosa has been working in Haiti for several years, partnering with D. Bernard Nau, the hospital's chief of orthopedic surgery.

They had scheduled a number of hip replacement surgeries for next week. There's no time for that now.

Last week's 7.0 magnitude earthquake disaster has turned the hospital into a center for war-time medicine.

Doctors have to make tough decisions quickly. Amputate an arm.

Cut off a leg. Operate before it's too late. Again.

Where the medical efforts in the first days after the earthquake were clearer-cut cases of life and death, doctors like Sosa working nearly a week after the deadly tremor are doing so against complications from open wounds and broken limbs -- injuries that would appear minor.

The people who are dying now, including two patients in their 20s in the emergency room Monday, are people who could have lived had they been treated earlier.

"Everyone here is critical," Sosa says. "Time is working against us."

It's not that the hospital lacks doctors. Several surgeons -- including Dr. Jim Smith, who runs the blog heath4haiti -- helped the Sacred Heart staff as best they could with amputations, casts and joint relocations.

What they need most is medical equipment -- particularly surgical equipment like drills, drill bits, and fracture and trauma equipment.

On Monday, Sosa and Dr. Lyall Ashberg of Melbourne, Fla., made an open appeal to hospitals in Florida's Treasure Coast, asking them to donate medical supplies.

"We don't need them a week or a month from now. We need them now -- tonight -- or else people are going to die," Sosa said.

The team has the manpower to be able to perform three or four surgeries an hour. By late afternoon Monday, they had only performed five surgeries the entire day.

The patients Sosa passed by on the way to the emergency room are the fortunate ones. Getting a spot inside the hospital means they are closer to the operating room.

Others still are waiting outside on the hospital's front lawn -- some under makeshift tents, some in the open air.

The Sacred Heart hospital, a common name for what is actually the Centre de Diagnostic et de Traitment Integre, was considered a hospital for the nation's elite.

Now there was no rich or poor, just the injured.

Sosa said among those outside Monday were about a dozen children who desperately needed surgery within the next two days to save their limbs and, in most cases, their lives.

As doctors treated 12-year-old Rudolph Fecu, whose right arm was sliced open on both sides, each of his cries of pain brought an equally sharp cry from his mother Roselyne.

"My God, my God, my son is suffering!" she cried out. "Look at how he is suffering."

Rudolph and his brother, Sebastien, were at home with an aunt and her daughter when the earthquake hit.

The aunt and cousin were killed. Sebastien made it out, but not before a piece of debris crushed his left ankle.

"His foot was like this," Dr. Maxime Arnoux explained, motioning as if he were breaking a pencil midair with his hands.

"The foot was hanging limp. We had to hold it together and wrap it as best we could so it could fuse back together."

Arnoux treated both boys and hundreds of other patients at the International Medical Clinic of Haiti on Rue Jeremie, ignoring his own fractured rib until he finally began to turn his more critical patients to the hospital on Sunday.

That was the day Eugenia Millender, a trauma nurse at St. Mary's Medical Center in West Palm Beach, Fla., arrived at the hospital with Smith's team.

After a 20-minute tour Sunday afternoon, Millender, an Army vet, emerged from the hospital and took a deep breath.

"There's going to be a lot of death," she said. "A lot of loss of life."

Smith's team also included Dr. Julia Manly and Marie Delisma, a Haitian-American ER nurse at Miami-Dade's Jackson Memorial Hospital.

Delisma found out shortly after she landed that her father, Jean Jacques, a popular schoolteacher at the College Canada secondary school in Port-au-Prince, was crushed under the school building when he returned inside to save another student after he had already saved several.

Instead of joining the rest of her family in Haiti to grieve, Delisma went to work.

"I love Haiti," she said between tears. "This is my country."

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