My final week here at AMREF Flying Doctors has not been a gentle wind-down. We evacuated a premature neonate from South Sudan as well as flights to Johannesburg, Madagascar, The Seychelles and Cape Town. In total I have flown 38 missions covering more than 40,000 miles around Africa.
We’ve treated patients from Cairo to Cape Town, the Seychelles to Cameroon. Its been a challenge at times but always rewarding and enjoyable. The team at AMREF Flying Doctors are an amazing group of professionals and I am privileged to have worked with them.
In South Sudan we evacuated a baby boy born the day before, 2 months premature. These babies often have breathing difficulties as their lungs are not fully developed. The clinic, in a very remote area had done a great job with baby Jordan, setting up a very creative positive airways pressure device. They had rigged some plastic tubing from the baby’s nose to a jug of water, creating a very literal 4cm of water pressure to help inflate his lungs. It was clearly not practical for him to continue on this set-up though, not least because we would have had water all over the floor of our jeep and later our aircraft. Looking after neonates is a little intimidating, its not my speciality and everything is just so small. When things go wrong, they go wrong very quickly. I was worried about how the little man would cope in the relatively hypoxic environment of the aircraft cabin. After some thought, I managed to recreate the airway pressure using close-fitting nasal cannulae and an increased oxygen flow rate, while keeping a close eye on oxygenation as overdoing it can also be harmful (particularly to the development of the eyes). It was a nervous flight, using our incubator for temperature control, managing the breathing as above and staying on top of his blood glucose and electrolytes, which can be difficult in very small babies. Thankfully we got him to the neonatal intensive care unit in Nairobi in good shape.
Island hoping in the Indian Ocean saw us evacuate an American tourist from Madagascar with a fractured femur and a critically ill German lady from the Seychelles. She had suffered from a serious but undiagnosed insult to the brain, she had been fitting and was unconscious. She required intubation and mechanical ventilation in order to be safely evacuated. I was so focused on this that I forgot to get an exit stamp in my passport before departure. I’m still there in the Seychelles as far as their immigration knows! I guess I’ll have to call the embassy to avoid becoming an international fugitive!
Cape Town was my final flight and the evacuation of a patient with intestinal failure. It was a straight forwards clinical mission and gave us time to have some fresh seafood at Victoria Quay in the shadow of Table Mountain – a great way to finish my trip.
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Below : with Omar – captain, pilot and friend on the flight deck of our Cessna Citation Bravo