September 5, 2007

First “Ambulance” Call in Mthatha

It was a busy day Monday at the clinic and I was trying to keep the patients in some semblance of order, which is challenging enough in English and even more so in Xhosa. In the middle of it all, two young men walked in, picked up our stretcher, and walked out. They returned in a few minutes with a young man on the stretcher and wordlessly put him down in the middle of the floor. With the help of our after-school program director, who is Xhosa, I was able to figure out that he had just been shot, several times, in a fight.

I had never seen a gun shot wound during my time in the Nome Ambulance Department but quickly swung into EMT mode. He was fairly lucky as the bullet appeared to pass through his abdomen with minimal damage. He did have a broken elbow, however, which was spurting blood. (Ironically, of all the body parts the children have been teaching me in Xhosa, the only one that has stuck so far is the word for elbow – “nqneba.”) We got him bandaged up and put him in the back of our truck to take him to the hospital. My fellow volunteer Robert drove and I rode in the back. “Great,” I thought. “I’m finally doing something and it’s just like Nome!”

Of course, it was nothing like Nome. First, the canopy on the truck bed has about four feet of clearance so I was crouching. Second, I realized how used I was to the machines we had on the ambulances in Nome. I could just hook a patient up to one and get a set of vital signs. On Monday, I had to physically take them, which is not usually hard but becomes much harder on rutted and pothole-strewn roads. I could hardly keep my fingers on a vein long enough to get anything. Third, we had to negotiate downtown Mthatha without lights or sirens. Downtown Mthatha brings new meaning to the word chaotic – pedestrians crossing freely, cars ignoring lane marking, stop lights that barely function, and so and so forth – and I doubt lights or sirens would have helped. Fourth, I had no tools. It was just me, my knowledge, and the patient. No fluids, no needles, no stethoscope, nothing. Fortunately, he was fairly stable without any interventions.

We got the hospital (the shiny new Nelson Mandela showpiece hospital) and handed him over. I took off my gloves and went to wash my hands. And though I searched high and low and found several sinks and soap dispensers, I found no soap at all. And it wasn’t like all the soap dispensers were just temporarily empty. It looked like they had never even seen soap. So I rode back to Itipini with my hands at arms length. We’ve got plenty of soap at the clinic.


Vickie said...

All I did on Monday was have a nice day out with the family this side of the Solomon Bridge. Sorry you did get in on any gunshot wounds, we certainly have had them. But I have never had to deal with a spurting elbow either. I was taught never to trust a machine when it came to patient care. Machines can fail you, use your God given senses, except taste if at all possible. And actually Jessie, riding in the back of Medic III on NOme roads does compare somewhat to your road conditions in Mthatha. I guess you should have taken your medic bag with you, complete with liquid soap. This was a great story, I will share it with other deparment members.