This article first appeared in From The Independent newspaper, UK: Read the original piece here.

The hacksaw my colleagues have been using for amputations in the absence of any surgical equipment is broken. One of their most urgent tasks yesterday  was to track down a replacement at the market. There were 12 people  depending on the success of this mission, 12 people who will die if we  cannot remove their gangrenous limbs.    Many of the patients Médecins Sans Frontières is treating have been pulled  from the rubble of the collapsed buildings. There is not only the risk of  septicaemia, but also "crush syndrome", which is where damaged muscles  release toxins into the blood, potentially causing kidney failure. We  desperately need dialysis machines to keep these patients alive.    It is unspeakably frustrating to think there were two of them on the cargo  plane, which has been turned back from Port-au-Prince airstrip three times  in as many days, most recently on Tuesday night. Five patients in another  MSF health centre have already died because we don't have the medical  supplies that we need.    I've never seen the kind of devastation I'm seeing in Haiti, despite having  flown in to many emergencies. We're seeing the kind of daily casualty  numbers you expect to see in a war. In some areas the city is absolutely  destroyed. And it's always the most vulnerable who suffer most. Whenever I  leave our makeshift clinic, I see so many people begging for surgery, for  even the most basic medical help.    The almost incomprehensible scale of the destruction makes it all the more  unacceptable that medical supplies are not getting through. MSF teams were  treating patients within half an hour of the quake last Tuesday. We have  managed to get some electricity working, and water, and we have treated  more than 3,000 people in the Haitian capital and performed more than 400  surgeries. But we need more supplies if we are to continue saving lives  here, and bringing them in has been incredibly difficult.    Since last Thursday, MSF has had five planes diverted from Port-au-Prince  to the Dominican Republic. The planes carried a total of 85 tonnes of  indispensable medical and relief supplies. Now those supplies are being  moved by truck. Some trucks have arrived, others are still making their way  along the only viable route. It's causing huge delays and we're in a race  against time.    MSF has successfully landed another five planes with a total of 135 tonnes  of supplies at Port-au-Prince. But that is only a drop in the ocean. To  give you some idea, we estimate we need at least another 195 tonnes if we  want to continue to scale up our medical relief here. Deprived of these  urgent medical supplies, doctors are having to be ever more resourceful in  saving Haitian lives. We ran out of histamine drugs for anaesthetics at the  weekend, twice we have run out of plaster of Paris to fix fractures. And at  the moment, we don't even have a simple thing like crêpe bandages. Our  logistics team are working very, very hard, but it's just a nightmare.    

The writer is a British surgeon working for Médecins Sans Frontières in  Port-au-Prince.