Necks, burns and malaria – week 2

Last week proved to be a gentle introduction. At least least from a clinical perspective. The majority of my patients required simple interventions to be safely evacuated.They certainly didn’t require critical care. Medicine works differently out here and evacuation by air ambulance can serve other purposes from back home.

The temptation is to think that it was not worthwhile flying five hours to Cameroon; to evacuate a man with a stroke from a remote area – for the one hour flight to hospital in the country’s capital. But you realise that the 400km distance would have taken several days by road and the lack of resources would have meant a medically-accompanied escort would have been unlikely. Distances by road in Africa are measured more realistically in time, rather than by miles. Air remains the most sensible form of medical transport in many areas.

This week however, our work has increased markedly in complexity and clinical severity. Cases have included spinal injuries – one from a gunshot wound, severe, life-threatening burns and cerebral malaria. Its been a busy and challenging week.

A suspected spinal injury was sustained by a Kenyan man in a motorcycle accident in Shimba Hills National Reserve. They were a long way from a landing strip and so we had a 4 hour round-trip in a helicopter in order to safely evacuate him. Flying low over Kenyan Game Reserves, spotting zebras and gazelles on route was a great experience. We had a large audience when we touched down at the village. In stifling heat, I assessed the mans injuries, immobilised his spine, gave him pain relief and awkwardly loaded him into the cramped helicopter. He was discharged from hospital the following day.

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Another incident involved evacuating a man from Mogadishu who was injured during the suicide attack last week. Somalia is just beginning to emerge from being a failed state for over 20 years. It has had no functioning government for that length of time and has been one of the most dangerous, turbulent places in the world. However, AMISOM (African Union Mission In Somalia) has been trying to establish peace for some time now. A new president has recently been elected and it was he who was targeted in the attack last week.

Mogadishu lies on the indian ocean coast and the on-going security situation demands that we approach the airport low and fast over the sea, rather than flying over the city. Taking off, we also fly out to sea. The man we evacuated had been shot in the neck, he was paralysed and was breathing with his diaphragm only – as his other breathing muscles were also paralysed. We stabilised him on the ground and evacuated him to Nairobi. Sadly, he passed away in hospital a few days later. War is such a futile business and wrecks so many young lives.

The photographs below show AMISOM soldiers at Mogadishu airport and loading the patient into the aircraft.

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Unfortunately, the burns patient is also in a bad way. He was the sole survivor of 4 in an air crash, shortly after take off. He sustained very serious burns (around 60-70% body surface area), fractures and lacerations. We evacuated him to intensive care in Nairobi and he remains very poorly. His chances are not high, but there is always hope.

My final mission from last week was to evacuate a young Kenyan lady with very severe cerebral malaria (P. Falciparam) from South Sudan. She required some resuscitation at the airport as she was in a poor state, but we safely evacuated her to Nairobi where she is still being treated in hospital. Her chances are good.

I had time to relax at the weekend on a hike up a local mountain with some of the staff from the office and a trip to the cinema yesterday afternoon. Thanks for reading. Live updates (Twitter) on @siforrington and @AMREFflyingdocs

www. flydoc.org http://www.AMREF.org

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1 thought on “Necks, burns and malaria – week 2

  1. Rodge More O'Ferrall

    Great to see you getting really stuck in Simon. It is wonderful and essential work in a world often preoccupied with trivia and scandle rather than important issues like saving lives.

    Reply

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