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AusHeal Blog

April 2016 Update – Did today really happen ?

The fortnight after Easter at HEAL Africa Hospital (HAH) in Goma D.R.Congo was extremely busy and somewhat difficult for different reasons. Though the week commenced positively with the unloading of the CT scanner sent from Australia and moving it in to the new radiology building, a variety of difficult issues then arose.

CT scan being unloaded

CT scanner from Australia being unloaded

CT in place in radiology building

CT in place in radiology building – ready for installation

(1) DIFFICULT CASES:

Two white male patients with severe medical conditions presented separately to the hospital. Efforts to save their lives were unsuccessful. This is an unusual situation. On the one hand it indicates the standing of the HEAL Africa Hospital in the community is such that ex-pat patients choose to come here. On the other hand the loss of the two patients was quite distressing to all staff involved.

 GWEN WETZIG writes below regarding one of the difficult incidents and other distressing cases in what she titled: Did today really happen????? …..

“Yesterday morning I was sitting in our AusHEAL office located on the top floor of the Cinquantenaire Building at HEAL Africa Hospital.  My husband (Dr Neil) was with one of the Hospital Residents conducting a surgical outpatient clinic.

About mid-morning I heard a siren. It was getting closer …. and louder… As I predicted it entered the HEAL Africa gate closest to the Emergency Department.  From my office I have a ‘birds-eye’ view of this particular section of the hospital grounds. I was unable to see anyone actually being transferred from the ambulance to the Emergency room.  However, I texted Neil to suggest he might ‘just call by’ Emergency after he had finished in Outpatients.  This he did……Two young boys had been rushed in to the hospital with severe electrical burns – penetrating skin, fat and through even to muscle and bone!!  Neil commented that he had not previously seen such severe full thickness burns…. to arms, hands, legs, back and front of the chest and abdomen. He was surprised that both young boys even survived.  A bigger picture was revealed later.  Two brothers (aged 4 and 6) were standing on a balcony and the younger one saw a wire hanging down.  He reached out and grabbed it……. The current went straight through him – into his hands and up his arm.  His older brother ran and grabbed him around his body – at which time the current transferred to the brother and went through him and out his back.”   

Despite intervention on the day, surgery on the younger brother the following day revealed no blood supply through the arm which took the initial electric shock.  His arm was completely dead and had to be amputated through the shoulder. The electric current had also penetrated his abdominal wall and his liver. Furthermore, there was some ‘mishap’ outside resulting in shorting the theatre building such that the boys remaining burns were cleaned and debrided in the dark. Neil’s battery powered headlight was well used. The power outage meant that the older brother’s surgery had to be postponed, adding ‘insult to injury’ in the truest sense.

One of the burns cases

One of the burns cases

Gwen continues…….. “As if that was not enough trauma for today……. another siren was heard in the afternoon, to be followed by an ambulance racing into HEAL Africa Hospital Emergency Department.  Again watching from the third floor, but not being able to see clearly what was actually happening, I alerted Neil (who was in a meeting) to the fact that there could well be another need for assistance in Emergency.  Correct again!!”   

Neil reports …….”This time it was a South African man aged 62 from a mining company in a village some way from Goma. He was brought to the hospital first by helicopter and then by road in an ambulance. An anaesthetist from the UN Hospital was sent for as the HAH nurse anaesthetists were having difficulties. Neil assisted with the resuscitation while the UN doctor was awaited. The man had probably suffered a severe heart attack and after all was done in the Emergency Department that could reasonably be done, he passed away.” 

Resuscitation in the Emergency Department

Resuscitation in the Emergency Department

And there’s more from Gwen ……….

As Neil was recalling to me the events of the day; he received word that there was a 26-week pregnant woman in the maternity department with a bowel obstruction. She could not be taken to the main operating theatre as the power had not yet been restored so she was taken to the maternity ward emergency theatre. The findings were 2 separate examples of a very uncommon surgical condition called “intussusception” where one part of bowel slips inside another and can, as it did in this case, lead to strangulation of the bowel.”

The highlight of the week was the discharge from hospital of Kitso, the little girl who underwent successful oesophageal by-pass surgery exactly 3 weeks earlier. Her recovery has been remarkable.

Kitso able to eat normal food 3 weeks after surgery

Kitso able to eat normal food 3 weeks after surgery

(2) DIFFICULT NATURE:

On Thursday night the 31st of March and into the early hours of Friday, a large thunder storm occurred – not uncommon for this time of the year. However the rain was heavier and more sustained than usual. Staff arriving at the hospital the following morning were shocked to find the hospital flooded. Almost a metre of water had run through the operating theatre, wards and radiology building leaving a field of thick mud throughout.  Electrical equipment including radiology equipment and ultrasound had been partly submerged. All, a devastating blow to the staff.

Mud in the operating theatre

Mud in the operating theatre

04 Flood level at front gate

Flood level at hospital front gate

Although officials from the local authorities came to the hospital, little assistance from the government was available for a clean-up and return to work. Neil wondered if the UN would help and spoke to Dr Jo Lusi (Founder and Legal Representative of HEAL Africa) who liked the idea. After some difficulties getting through the security cordon the hospital executive eventually met with the UN Director of Civil Affairs who arranged for engineers to visit the hospital and assess the damage. They declared the hospital a ‘disaster’ and sent fresh water, firemen to hose paths, cleaners and an electrician to check the power. Meanwhile the HEAL Africa Hospital technical team set about pulling electrical equipment to pieces, drying and reassembling it in the hope it would work again. Damage was estimated to be close to US $700,000 damage. Insurance does not exist in D.R.Congo!  In what is a sign of Congolese resilience and effort, the surgical block was able to re-opened, wards and radiology areas were cleaned and some of the flooded electrical equipment was thought to be functional. All within 48 hours!

012 UN officals inspecting the Radiology Department

UN officals inspecting the Radiology Department

Recovery ward after cleaning 48 hours after flood

Recovery ward after cleaning 48 hours after flood

At the end of the week PAUL BAKES, AusHEAL team member from Brisbane, arrived. A timely visit. With his IT and electrical expertise he will be able to assist with the recovery and oversee repair of equipment and software problems that have occurred. He was accompanied by cinematographer Nick Paton and Jason Elsmore. Nick is doing some filming in preparation for the 2016 AusHEAL Fundraising Dinner to be held on Friday 27 May in Brisbane. Jason is the Senior Pastor at Gateway Baptist Church in Brisbane coming to assess the work and meet and encourage the people AusHEAL has been involved with over the last 10 years at HEAL Africa Hospital.

Whereas Paul will remain at the hospital for a further 3 weeks the remaining team members left Goma Wednesday to wind their way back home. 

Nick Paton filming a story

Nick Paton filming a story