Fieldset
Treating trauma on the shores of Tanganyika

From the picturesque shores of the great Lake Tanganyika, anaesthetist Kariantti shares his first impressions of Burundi's biggest city, Bujumbura, where MSF runs a trauma hospital. It's not long before he is called into emergency surgery... 

MSF's L’Arche de Kigobe trauma centre in Bujumbura, Burundi

There is a true gem in Africa that not too many people know about – Burundi.

Hidden between the greenest misty hills and the great Lake Tanganyika, it’s a sight to see it all from an approaching plane and already reason enough to visit.

The air is fresh and there’s often a nice breeze coming from the lake.

It’s full of kind people, interesting culture and very cool drum music.

Also, this year, Burundi's national football team qualified for the Africa Cup of Nations for the first time in nearly 50 years. 

As he started to stabilise before my very eyes, I was once again reminded of how fast the surgeons here really are

But the gem isn’t without problems, also something that not many people are aware of.

In 2015, Burundi witnessed an increase in tensions and violence, especially in the country’s biggest city, Bujumbura. And, although things have calmed down a lot since then, the political tensions still seem far from over.  

Treating victims of trauma

In the summer of 2015, MSF opened a trauma hospital, L’Arche de Kigobe, in Bujumbura, in response to the rising violence.

Despite the decrease in victims of violence, there is still a great need for a trauma centre in the city, providing free emergency care for the population.

We still have a great influx of patients in the form of victims of traffic and domestic accidents, as well as burns, gunshot and other violent wounds luckily being the minority these days.

This would be my next mission. 

Arriving in Burundi

Burundi is, in many ways, a much calmer environment than my two previous assignments with MSF in Yemen and the Central African Republic

To be honest, I wasn’t really sure what to expect. 

After my arrival at the airport, I was once again amazed to find my bag on the baggage claim waiting for me after immigration (I’ve never had my bags lost on an assignment so far).

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Anaesthetist Kariantti Kallio arrives at MSF's trauma centre in Bujumbura
Anaesthetist Kariantti Kallio arrives at MSF's trauma centre in Bujumbura

I was taken to the project coordination office only to find a good Congolese friend of mine, Jacques, from my previous mission in CAR, sitting behind the desk of the HR Coordinator.

What a lucky coincidence! We were off to good start already.  

First impressions

After a few briefings on arrival, I was off to the hospital the next day.

I found a well-functioning trauma hospital (although squeezed into somewhat small surroundings) run by a very competent and nice group of national and international staff, including nurses, surgeons, doctors, orthopaedics, anesthesiologists, psychologists and physiotherapists. 

The week during my handover was rather slow, which was good since the other international anaesthetist Jerome was participating in a training course in Brussels. However, at the very moment of the departure of my predecessor, Morten, things started to speed up.  

Emergency surgery

On Saturday morning, we received a nine-year-old boy hit by a car.

He had bleeding in his abdomen and I was brought to the hospital for emergency surgery.

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The surgical team in action at L'Arche de Kigobe
The surgical team in action at L'Arche de Kigobe

Before anaesthesia, he was already in a state of shock, with tachycardia (a very high heart rate) and low blood pressure.

We found over half a litre of blood inside his abdomen and he had a ruptured spleen, which the surgeon removed.  

Efficiency in action

We luckily had blood for the boy in our blood bank, which we transfused to him during the operation.

And, as he started to stabilise before my very eyes, I was once again reminded of how much I like whole blood (compared to different "components" that we use back home) and how fast the surgeons here really are.

All in all, I was amazed by the level of competence displayed by everyone in the team.

After the surgery, we transferred the boy to the intensive care unit for further surveillance.  

Parlez-vous français? 

Now, I just had to manage myself and the patients until tomorrow when my colleague would arrive.

Then there would be two international anaesthetists again.  

Did I mention this project is in French too? And no, I still don’t really speak it well. Great!

Luckily, everybody’s really nice. 

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