Fieldset
In the operating room: Yemen, Day 9

Anesthesiologist Kariantti and the team feel the pressure as the MSF hospital in Khameer faces a lack of beds and an impending cholera outbreak...

 
Things have been starting to speed up in the last couple of days, with the flow of patients into the hospital steadily increasing.
 
Yesterday, as we were performing a c-section on a mother with severe pre-eclampsia, the surgeon informed us about a 40-year-old woman with a gun-shot wound to the abdomen, who needed an immediate operation.
 
We took her quickly to the other operating theatre.
 
Thankfully, the bullet had missed her more vital organs and she was hemodynamicly stable. 
 

Two-year-old gunshot patient

 
Suddenly, we seemed to be drowning in trauma patients.
 
In the evening we received two more patients with gunshot wounds. One was superficial, a five-year-old girl. The other was critical - her two-year-old little sister who had been shot in the abdomen.
 
There were multiple perforations in her bowel, so the surgeon Dr. Ali could only perform damage control surgery.
 
She needed observation and treament in the ICU, which was once again full.
 
Luckily the new mother with pre-eclampsia and her baby were both doing well, so we could move her to the maternity ward to get a much-needed bed.
 
Two days after stabilising her, the surgeons made her a stoma.
 

Cholera outbreak

 
We were not the only ones with logistical problems. 
 
It seemed that we had an emerging cholera-outbreak in our hands.
 
Two days ago there was one patient with cholera admitted to the isolation ward. The next day there were six, and the day after 16.  
 
The outbreak was quickly turning into an epidemic, and the isolation ward was already full.
 
The hospital administrator together with our expat project coordinator Claire, medical activity manager Dr Yanu, and head nurse Dorothy were already planning on different strategies.
 
The next day they had already set up a cholera treatment centre in the hospital yard!
However, this still only gave us 15 more beds for cholera patients due to the small premises, so we had to refer some of the patients to other cholera treatment centres.
We would just have to wait and see how things will develop.