Fieldset
In the hours before dawn

After a busy night of emergency surgeries, MSF anaesthetist Kariantti takes a moment to reflect on the day's events and to enjoy the peace and tranquillity before dawn in Burundi. 

A man passes by the MSF car, while on the road in Burundi.

It’s quiet, just the crickets and the frogs finishing their concert. 

There’s no traffic in the unlit streets of Bujumbura. Just the driver and I in our LandCruiser.

The only other random figures wandering in the darkness are the ones already commuting to their early morning shift. And a few stray dogs.

The rest of the city is still asleep.  

A double emergency 

I’m not.

Last night we did two emergency laparotomies (abdomen surgeries) at the same time. Both patients were in a state of shock when they arrived at the hospital. 

One was a motorcycle accident and had a ruptured spleen. The other had been beaten with a machete in the stomach and on the head.

The Sun will be up in an hour and soon everything will be filled with life and noise. But for now, everything is calm.

The surgeon removed the spleen from the other patient, while another surgeon repaired a hole in the ventricle (part of the heart) for the other.

Everybody worked amazingly hard and fast.

After the operation and some units of blood, both patients were much better and ready to be transferred to the intensive care unit (ICU) for further surveillance.

The ICU was starting to fill with patients but we’d worry about that in the morning. 

Post-surgery

The gates open. Everybody looks tired, even the guards.

My body is still fighting between a small adrenaline rush and extreme tiredness. It doesn’t yet know what to do with itself.

The day was very busy as well, filled with other severely ill and injured patients, but by now that all seems like a distant memory from years gone by.  

The driver and I bid each other goodnight. I can’t go to bed yet.

I sit down at the terrace of the guesthouse for a moment and smoke a cigarette.

The hour before dawn

The animals of the night are starting to give way to the animals (and the people) of the day, who have not yet awoken.

The Sun will be up in an hour and soon everything will be filled with life and noise. But for now, everything is calm.

Everything is beautiful, sitting here in the arms of sleep with just the moon giving light between the clouds.

Everything is beautiful, sitting here in the arms of sleep with just the moon giving light between the clouds.

Here, somewhere so far from home, which now feels strangely more familiar to me than my home back in Finland.

I feel like I’ve always been here. 

Reality check

The euphoria and surreal optimism of the sleep deprivation starts to set in.

I tell myself, “I can just continue with the day straight after. I’ll manage. Just sit here and watch the sunrise.”

Luckily, I’ve been here before and my experience knows better than my body.

I’ll try to sleep for an hour. After that, it’s back to the hospital.

By then, there’s going to be worlds of hurt and problems to solve again… 

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