In just two days the rain has turned the dusty street into a mudslide. This short walk to the hospital usually only takes me five minutes but after the rain it takes at least twice as long, as I slip and get stuck in the mud on my way into the clinic. The poor conditions prevent people travelling on foot, which means there will be less malnourished patients in the feeding centre today. Not only does the rain make it difficult to move around, it also cools the temperature down again, which is where today’s incident begins.
Early this morning I received word that there had been a fire in a tent and we had several burns victims in the hospital. They had been treated by our doctors and their condition was under control. But I wasn’t prepared for what I would see when I arrived. The first thing I saw was a boy of about 12 years, the skin on one side of his face completely burned off. One eye was swollen shut and his head was tilted right back so that he could see through the small slit which was once his second eye. His hands and feet were bandaged and he hobbled from one end of his bed to the other, felt for his pillow and laid down to rest without even a grimace. He wore only the tattered remains of his pants.
His older sister’s face was black and blistered, her hair burnt. She bent forward slightly and looked 40 years old. She was 14. Six children in total came to the paediatric ward; their mother was in the female ward and I was told her burns were the worst. The youngest child was only one year old. Her little body was burnt on her chest, back and feet with small blisters on her face.
I called in extra staff and we spent all day tending to these patients, cleaning their wounds, giving them painkillers and monitoring their condition. We had to send the mother and one child to Quetta (six hours by car) for further treatment. The lady’s husband accompanied them to the hospital in the back of the ambulance. I gave him a blanket to keep his son warm on the trip. He was very thankful. As he walked to the vehicle I saw he was holding on to the blanket like it was the only possession he had left. Unfortunately it was.
Of all the children we cleaned and dressed, the one that caused the most heartache was the baby; she was so helpless and completely dependent on what we did. She couldn’t say if one area hurt more than another and couldn’t be comforted by her mother. No matter which way we moved her, she was in pain. After cleaning the 14-year-old girl and dressing her burns, she started to look like a child her own age again. All the children were remarkably tough and hardly let out a single tear, despite all the cleaning and dressing. These children are not out of danger and they will be closely monitored over the next few days.
I tried to compare what it would have been like if we received these seven burns victims in a busy emergency ward back home. Here in Pakistan, we were managing these seven new admissions with only one-quarter of the number of staff, one-tenth of the resources and materials, not enough space and very limited referral options. Back home, it would have been chaos. But, as I have seen on many occasions, the MSF staff worked through these difficulties together and committed themselves to the patients to help achieve the best outcomes.
The family had been living in a tent for several years, since one of the recent floods in Pakistan. There were six children and at least three adults sharing a tent. They had never had enough money to rebuild their home. From what I could gather, their tent had been covered and had provided shelter from the worst of the rain. Unfortunately, it did not keep out the cold. The family had gone to sleep with some candles burning for light and warmth as they had no electricity. During the night the tent had caught fire and they woke engulfed in flames. The ones who made it to the hospital were lucky to escape. Another female relative wasn’t so lucky.
The scene was like something out of a war zone; something you would expect to see if an area had been fire-bombed. But this was no war. This was just poor people who had been pushed into a bad environment because of circumstances and suffered terribly when they were just trying to keep warm.