Yemen: "A few more hours and she would have died"

16 March 2017

Hella Hultin is a surgeon from Sweden. She wrote this post on assignment with Médecins Sans Frontières/Doctors Without Borders (MSF) in Khameer, Yemen. Here she blogs about operating on a young girl in critical condition.

We have had an awful Friday. 

It's our day off here in Yemen. Normally we just do rounds in the afternoon and are generally available, unless there is something really urgent. And sometimes there is.

I was in the hospital around 2pm, when a call came from the emergency room: a man arrived who had just been shot. He was in critical condition. 

Then it never stopped – we received one patient after the other who required emergency care, and we had to forget about our day off.

But the fact is, by the end of the day I felt pretty good! I went home at 10pm with a hopeful feeling inside. 

Our last patient for the day was a three-year-old girl in critical condition: dehydrated, feverish and with a grotesquely swollen belly. She was almost unconscious and had barely measurable blood pressure.

 

The little girl in the operating theatre. Photo: Hella Hultin/MSF

The cause of her fatal condition was volvulus: her small intestine had twisted in the umbilical region, and 50 centimetres of it was pitch black and dead. 

A few more hours and she would have died of the toxic substances from the dead tissue. 

As quickly as we could, we cut away the damaged part of her small intestine and sewed the healthy part together. During the surgery she started getting better: her blood pressure normalised, and her kidneys started to produce urine. 

We could not sew the abdominal wall properly because the intestines were so bloated, but we sewed the skin and bandaged her properly. 

After we finished the surgery, we stayed with her for a long time in the operating room to warm her with our great inflatable thermal blanket, and give her more fluids to replace everything she lost. 

Eventually, even her little feet became warm again.

In a few days, when hopefully the swelling in her intestines have subsided, we will sedate her again and repair the abdominal wall completely. 

For now I keep my fingers crossed!

 

 

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