Mikeley is an adorable child. Two years old. Toddling around the hospital in his diaper and clogs, he giggles at the American visitors and mimics the funny noises they make. It will probably be several months or years before he begins to understand that he is not like the other children. Mikeley lost both arms in the horrifying earthquake that hit Haiti in January 2010.

At first, his mother is resistant to her delightful little son learning how to feed himself with his feet. Will he not be getting a prosthetic hand? The hard reality soon sinks in surrounding the feasibility of repeated resizings as he grows and she embraces the idea of Mikeley caring for himself in an unconventional way.

Mikeley is one of scores of amputees that were fortunate enough to have survived the disaster but who will have to deal with this new handicap in a third world country that has never made disability services a top priority. The estimated thousands of amputees will learn to function with their new disabilities by maneuvering around mounds of cement, crumpled sidewalks, and unsteady stairways as their homeland struggles to clean up and rebuild its very basic infrastructure.

Mikeley and his family are from the village of Leogane. When the January 12 earthquake hit Haiti, Mikeley, his mother, and three older siblings made it out of their home alive. His four-year-old sister did not. Mikeley arrived at St. Damien's Children's Hospital in Port au Prince six days later. There was no chance to save his arms.

Susie Ransbottom-Witty is an Occupational Therapist from Dillsboro, North Carolina who specializes in hand therapy. She was part of a group of 19 medical professionals that made up Team 8 sent in by the NC Baptist Men. She spied Mikeley playing out in the courtyard one day after the hospital had been cleared due to an aftershock. "When I saw him scratch his nose with his toes I knew he would adapt quickly." She decided immediately that she could help this little guy.

Susie went to work with a piece of thermoplastic material she found in the hospital. She heated up water over the stove in the compound that hosted the teams. The hot water softened the plastic enough that she could mold a cup holder that would ergonomically fit Mikeley's foot. It was designed so he could slide either foot through a handle and it has some room for his little foot to grow. He was so proud when he drank from the cup that his eye gleamed with a smile from behind the new contraption.

They also experimented with a spoon between his toes. He could hold the utensil but when he brought the spoon to his mouth the food would slide off. When he gets older and his toe coordination improves, Susie hopes he will be able to keep an ordinary spoon level, but for now, she will send a swivel spoon from home that will help him eat by himself.

Susie and Mikeley worked on carrying objects between his toes, transferring things from one foot to the other and passing an object to someone else. Another big accomplishment was getting Mikeley to carry something under his left stump, which was amputated just below the elbow. He was very hesitant to use his stump because it was still tender but he finally gave it a try and was seen carrying a rattle under his left arm and a beanie baby in his left foot.

Susie grew tearful when she talked about Mikeley and the countless others who will need to figure out how to survive following such potentially debilitating injuries. She was struck by the sweet, selfless attitude that so many of the Haitians demonstrated through simple acts of kindness to each other. She found their desire to keep their tiny hospital spaces clean and tidy to be very endearing.

And her heart ached when she saw many former patients put on a bus and sent back to their villages, which may or may not still be standing. "Part of the difficulty for me emotionally was knowing that all these people with amputations and casts were being discharged from the hospital with absolutely no place to go. I heard the story again and again from interpreters that they didn't want to leave the hospital" because of the uncertainty they faced.

Unlike many survivors, Mikeley has his family to nurture him and guide him as he navigates his life outside the hospital. He and his mother and brother and two sisters will mourn their own losses and, like most people in the earthquake devastated areas, will begin to figure out how to live a life of some normalcy one small step at a time.