Meltdown

Perhaps it was waiting to happen. Triggered by a relatively innocuous incident on C ward: A father, quite slight of build, entered carrying his eight- or ten-year old daughter in his arms, the male nurse right behind carrying the IV bottle which was hooked up to the girl. She was placed on an unmade bed, as nobody (read: the nurses) had prepared one for her; the nurses continued to sit around a table even after the girl was laid on the bed. I stood for a few minutes watching the scene unfold, wondering when the staff would spring into action. A few minutes later, a nurse sauntered in nonchalantly, carrying a sheet, then leaving the father and others to the task.

My sense of disbelief and frustration was mounting. How do you teach people to care? I left the ward as soon as I felt the tears welling up, standing off to a side to allow my incredulity to subside. Instead, the floodgates opened, and I sought the confines of the international staff office to give my mounting grief and sadness some breathing space.

I don’t know how anyone becomes accustomed to seeing trauma on a daily basis. Over the past 5 weeks, I’ve seen blood and I’ve seen raw skin post-graft. I’ve seen bloodied and bandaged eye-sockets. I’ve seen more amputated limbs than I care to recall – including freshly-stitched and healing stumps. I’ve learned more about broken bones and sign nail surgery than I thought possible. I’ve seen muffled cries of pain, shame, horror and even some smiles and laughter; thank goodness for visitors’ day and the overpowering resilience of children.

I’ve sat by the beds of patients whose tales are shocking and heartbreaking; a drunken motorbike driver plowing into a young girl, breaking both of her legs and hips. A tractor that fell onto a kid, smashing up his face. A mother who dropped a pot of boiling water on her infant, causing severe burns over nearly half her body. A tractor-full of thirteen related farm-workers who died in the most horrific landmine explosion of recent times, while the driver alone (also related) was spared. An elderly woman whose entire arm was amputated following a motorbike accident; a fourteen-year old girl who lost her leg to a landmine explosion on the field where she worked; a young father lucky to escape a mine explosion with all limbs intact, and now afraid to return to work on his uncle’s farm.

Too many tales of children climbing coconut trees or poles and falling to the ground, breaking one or more limbs. Far too many children terribly banged up from motorbike accidents, their injuries worsened by riding sans helmet. (I am still undecided: Does this qualify as egregious neglect by parents or is it simply a question of a lack of funds to improve safety?) Children losing fingers to snake bites. And, my most surprising discovery to date: serious eye and foot injuries arising from what a common but dubious practice among youth in the countryside: catching rats with arrows.

I’m suddenly reminded of the young woman that arrived shortly after me, wheeled to the bed next to mine: Her husband put an axe into her head. That image and memory resurfaces. I see the bed where she would have lain beside me and I wonder whether she is still alive…

Incidents and accidents are waiting to happen every day. The proportion of disabled people in this country apparently ranks among the highest in the world. Even at Emergency, the phrase civilian victims of ‘war’ now encompasses more than landmines and military conflict.

Because traumatic amputations are nearly an everyday occurrence and amputees such a common sight on the wards, there was an almost poetic (and hilarious) quality to a young nurse’s reply when Ombretta asked her about the wedding-style hairpiece she was wearing; (in translation) No, she said without skipping a beat, it’s not my own hair, it’s a prosthesis.