Fieldset
An emergency in Burundi: "We were his best and only hope"

When a seriously injured man is brought to MSF's trauma centre in Bujumbura, Burundi, anaesthetist Kariantti and the medical team do everything they can to try to save his life. But, with limited resources, their options are running out... 

A road accident victim is brought to MSF's trauma centre in Bujumbura, Burundi

The following days gave us little rest. 

The next day we received a man who had been run over by a car. He was in a state of shock upon arrival, with tachycardia (an elevated heart rate) and cold extremities.

He had deep lacerations in the pelvic region and was bleeding heavily. The surgeons suspected a vascular injury and he needed immediate surgery.

Things looked bad. But, here in Bujumbura, we were his best and only hope...

Before transferring him to the operating theatre, we did a chest and pelvic X-ray, which revealed a collapsed right lung and a totally fractured pelvis, scattered to pieces.

Things looked bad. But, here in Bujumbura, we were his best and only hope. 

Theatre

We had already started fluid replacement and a blood transfusion in the emergency room, but the man was still in the same condition when he arrived in the operating theatre.

The surgeon placed what's called a pleural drain to remove the fluids from his chest after which we were ready to start the anaesthesia and operation.

The surgeons repaired the ruptured veins in his pelvis, while we gave him every drug and blood product we could find.

But there was no way to stabilise his scattered pelvis and nothing we did seemed to help.

He was still severely tachycardic with low blood pressure and cold all over. He was still bleeding from pretty much everywhere.  

Accepting defeat

There was no way to save him. Not here, not with the resources we had.

We would have had a fighting chance

The surgeons packed the wound and finished the operation.  Very soon after that, we witnessed his last breaths and his heartbeat descending into asystole – the most serious form of cardiac arrest.

We knew there was no use trying to resuscitate him. He was gone and the only thing left for us to do was to let him go.

Dealing with loss 

Trying to describe your feelings afterwards is impossible.

What is it like when someone dies in your hands? The anger, the self-blame, the sorrow, the helplessness.

Especially knowing that perhaps somewhere else, like my home country Finland, with more specialised equipment and almost limitless resources, we would have had a fighting chance.

But here in Burundi? No.  

"We bleed the same"

But are we not people here as well? Do we not deserve to live here, as well as there? Do we not deserve to survive?

We bleed the same but we don’t die the same when some of us are surrounded by more resources.

But our loved ones left behind, they do mourn the same, mourn for the life lost. A husband, a wife, a mother, a father, a child – lost. 

Now, let it sink in. And that’s where you’ll find me.  

--

Read more: Stories from Kariantti's time in the field

In the operating room: Yemen, day 3

Operating under fire: Keeping calm in Bangui