Just a minute…

Lorry crash victimThat was all it took to change Evas’ life… one minute she was speaking with the other fifty or so people travelling on the back of a lorry to attend a funeral, the next she was lying dazed on the ground with pain in her chest and leg and great trouble breathing. The lorry had been driving down a narrow winding dirt road from her village up near Mafuga forest when the inexperienced driver lost control and the vehicle left the road and tumbled down into a valley rolling over in the process.

All around her others were calling in distress, some crying, some moaning whilst others had died in the accident. Spectators who had seen the incident were shocked and distressed. They were able to phone down to a village further along the road who dispatched help to move the injured to Kisiizi Hospital. Thus Evas found herself lifted onto another vehicle and about 40 minutes after the accident she arrived in Kisiizi in a lot of pain.

That day was in fact a bank holiday in Uganda, Martyrs’ Day, remembering the early Christian believers burned at the stake in Namugongo. The casualties arrived at Kisiizi at around noon which was excellent timing as we had just completed the routine ward rounds and the next shift of nurses were due to arrive shortly.

We did not have any advanced warning so just found a crowd of distressed attendants arriving with the injured. I think 24 came in the first batch and then a further 18.

The Staff responded magnificently, exhibiting professionalism and compassion. In a remarkably short time mattresses were brought to the Out-Patient / Accident and Emergency department and patients were triaged as they were brought in, most lying on the mattresses on the floor as we had insufficient examination couches. Some patients were taken to adjoining rooms in our Community Health Insurance office and immunisation area because of space. Everyone available came to help and staff called in colleagues from home to assist. The flexibility shown was excellent with the chapel cleared of benches and transformed into an overflow ward area. Student nurses worked well in support of Staff and non-clinical Staff gave valuable support to the clinical teams. Those staff on the wards cared for the existing patients to ensure they did not get forgotten in the hive of activity that took place.

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Evas smiling at the end of the day.

Evas turned out to have a fractured femur on the left side but also, more critically, a collapsed left lung with rib fractures and blood in her chest. She was stabilised with iv fluids and given pain relief and moved directly to the operating theatre where Dr. Henry inserted a chest drain to help the lung expand. She needed a blood transfusion and a splint / traction for her fracture. She recovered well from the emergency procedures. The photo was taken at 11pm and you will see that in spite of all she had been through she could still manage a smile!

Thankfully Evas and all the other casualties we received have made good progress and many were able to go home after a couple of days. One man had arrived with a serious injury so his foot was partly detached from his leg but Dr. Robert and his team were able to repair it and hopefully he will be able to walk on it again.

We were really pleased with how the hospital staff responded to this unexpected major incident and how the logistics worked out well. For example, we had enough intra-venous drip fluids and drip stands and cannulas to resuscitate and stabilise all the patients.

At the end of a very busy day we gave thanks to God for helping us provide this care to such a number of shocked patients and attendants. Sometimes we focus on the things that don’t go so well and criticise shortcomings but on this day we saw the training and organisation result in what was truly an impressive day. The prayers and financial support of Kisiizi Partners are part of the background to the successful outcome. For example, the oxygen concentrator needed to support Evas when she was so breathless due to her chest injury had been purchased with funds from Kisiizi Partners. The fact we have Anaesthetic Clinical Officers on site 24 hours a day in such a remote location as Kisiizi is partly due to the salary support offered by Kisiizi Partners. In contrast, some of the government hospitals in the region may have very limited staffing cover and one speculates that had Evas and the other casualties ended up in one of these other institutions the outcome may have been different.

So thank you Kisiizi Partners and Friends for your invaluable support and encouragement.

Pictures for this story can be found at the Kisiizi Hospital website Major Disaster.