There’s a lot going on in Nasir at the moment. Last week our project dispatched a small team downriver on an explo mission to find the source of an alarming amount of cases of Kala Azar – a sandfly borne parasitic disease that attacks your spleen and bone marrow with disastrous consequences. They found their source – and then at the weekend while they were planning to return and do further assessment and treatments there were reports of a large attack on people migrating with their cattle in the same area. So the team was dispatched but with a different remit this time.
The conditions and work demands of running these mobile clinics sound seriously arduous – and the expat and national staff members that are out there for a few days at a time are giving it their all and are coming back dirty, sunburned and exhausted after only a few days. I may well find out what it’s like for myself in the not-too-distant future! Other organizations are also mobilising. MedAir and World vision have done an assessment and are planning to do a distribution of non-food items (Mosquito nets, cooking pots etc) and the UN are doing an assessment too.
From what we know at the moment it sounds like a large population was on the move for their annual migration – taking their cattle to better grazing grounds – when the attack happened. We may be running mobile clinics for the people who fled – and are now displaced without the basics of shelter, food, or clean water – for the foreseable future.
It’s incredible to watch how fast MSF responds in these evolving situations – the boat went out on Monday – and on Tuesday was sent back to the hospital containing seven patients, mostly women and children with gunshot wounds. A further five arrived the next day. I don’t think I’ve ever looked after a braver patient than the trembling mite of a five-year-old girl with the bullet wound to her shoulder who sat still and tense, holding back sobs while I examined her.
Our amazing surgical team worked long days to ensure that all the patients were operated on as soon as possible – the wounds were already three days old by the time they got to us, and in the tropical heat infection can set in fast. I am happy to say that all the patients are doing really well now following their treatment – but it’s a sobering thought that we were only able to assist the ones who had survived without medical aid for over 72 hours already – anybody seriously injured never even made it as far as our team in the field, let alone our hospital.
Meanwhile Nasir has had some drama too – a landmine victim was brought in one morning earlier this week, something this area has not seen for a long time and I haven’t seen – well, ever. Somewhat unfortunately for me I had chosen the previous evening to drink a couple of beers and was feeling a trifle fragile on my pilgrimage over to the office at 8am, looking forward to an uneventful hour or so on the computer whilst waiting for the ibuprofen to kick in before heading to the OPD. But just as I approached the office a cluster of people carrying a stretcher rounded the corner of the ER and I before I knew it was examining the tattered remains of this man’s leg before urgently grabbing my radio and squawking into it for the surgeon to come NOW please.
Cannula, fluids, painkillers… less than an hour later I was able to join the team in surgery and watch as Robert, our Nigerian surgeon, skillfully cut away the useless remains of foot and craft a neat below-knee stump. Luckily this man’s other leg was entirely spared from the blast, so he’ll be up and about on crutches and then a prosthesis, if we can get one, very soon.