Dan Kelly, a third-year medical student from Valley Forge, knew they were the wounded from a decade-long civil war that had devastated Sierra Leone.

What he did not know was why no one was helping them.

Kelly had come to Sierra Leone - one of the poorest countries on earth - with a mission. He was not sure what form that mission would take, but he knew it was far from treating the kind of medical conditions he would see on the Main Line.

His first visit was two years ago, at age 25. He had already formed an organization in the United States with the vague goal of fighting poverty by promoting health.

The amputees gave a human shape to that cause.

Now, a one-story cinderblock building - the clinic for war amputees in the "blood diamond" region - gives it a structure.

Tamba Patrick Sumane, 50, sick with malaria, did not have the $3.75 to pay a government hospital. Two weeks ago, Sumane, whose right hand had been chopped off by the rebels in 1998, came to Kelly's new clinic and was treated for free.

What has this clinic meant to amputees like him?

Sumane answered through a translator on a cell phone:

"It was as if they were dead and now they have been woken up."

His answer would not surprise Kathy Kelly. Her only son went to "where the need was greatest."

He was a high achiever - No. 1 in his class at Malvern Prep, captain of the rowing team, an honors graduate from Princeton - and he had long cared about helping others.

Kelly's quest started a few years ago, as a Web site - "a conduit for youth interested in issues of poverty and health" - with ambitions that he soon realized would cost money he did not have. So he, along with his parents and younger sister, created the Global Action Foundation.

But it was Issa Toure, a refugee from Sierra Leone and a classmate at Albert Einstein College of Medicine in New York, who gave Kelly a direction: " 'Dan, my country needs you,' he would say."

Sierra Leone, a nation smaller than Maine on Africa's west coast, is still recovering from the conflict that ended in 2002 after killing thousands and displacing two-thirds of its six million people.

Kelly won a fellowship to help pay for a three-month placement in hospitals there. He arrived in June 2006, shortly before the release of Blood Diamond, the Leonardo DiCaprio film that publicized the rebel army's practice of chopping off civilians' limbs.

"It was difficult," recalls Kelly. "I was reading by candlelight; water had to be fetched from afar."

His friend from medical school had connected him with Mohamed Barrie, a young doctor near Freetown, the capital, and Kelly approached him about doing something for the amputees.

"Like most people in Sierra Leone, I just kind of gave them money when they begged," Barrie says now. "But Dan was shocked and moved."