It's been a while since my last post and a lot has happened... a few weeks ago now some of our clients encounted a nasty experience with shifters. For us as staff it sure wasn't an easy day ensuring everyone made it to camp safely.
So the day of the attack I was riding morning sweep - this means I'm last to ride, I have one of the three satellite phones in my backpack aswell as a first aid kit. There's another satellite phone at the lunch truck, and another in the runabout vehicle which is often ahead at camp.
I'm riding along, frustrated because I have dodgy back wheel (hubs wearing out, spokes are having issues, and I have somehow managed to bend the rim aswell) - i killed one of my slick tyres so now I am riding with a knobbly tyre on the pavement.
Up ahead of me I see James riding back towards me. Something must be wrong.
"Claire do you have the sat phone on you? You need to call Sharita" His words are rushed, he's out of breath. I calm him down and get more details. He tells me there's been a robbery up ahead, people have heard gunshots over the other side of the hill and people are scared for their own safety about continuing over the hill.
I am confused - I don't know how people hearing gunshots over the hill equate to a robbery. I pull out the sat phone and give the boss a call. She says that there is a military base up ahead and maybe it is just training.
James tells me people are waiting on the otherside of the hill, so I keep riding onwards until I catch up with the last 10 cyclists.
Then I learn that at least 3 cyclists have been held up at gunpoint. Shots were fired. No one has many details. I give the boss another call - she's already at the police station getting some police escorts in our car and military guys and heading back towards us.
One of our dinner trucks which had broken down catches up with us. Gabe jumps out and tells me someone has been shot. We don't know who. We know they have been taken to the nearest medical centre but no idea of their condition. I make another call to the boss.
We make a plan - the riders and bicycles are bundled onto the truck. The stage is over. No one will lose their EFI because of today. We make it to the next village where more riders have stopped.
6 riders have robbed - they have had mostly food and water stolen, but also some USD and cameras aswell.
The sat phone is ringing and it's Paul - he wants to know what's going on but everyone's trying to talk to me at the same time and I'm still trying to find out what's going on. I tell Paul I will call him back and he's very unimpressed.
Patrick tells me I must go and see Kendra. I give the sat phone to Gabe and tell him he must firstly call Sharita (who was requesting 5 minutely updates) and then call Paul at the lunch truck and let him know what's going on.
"Kendra has been shot?" I ask him.
"no it's just a rock they think" he tells me. "but she's been coughing up blood"
So Patrick takes me to see Kendra (Kendra has given me permission to share this story).
I am very relieved to see her sitting up and smiling and looking perfectly well. She has a small puncture wound on her chest. She tells me someone threw a rock at her straight in the chest, another person threw a spear which thankfully flew over her shoulder, a few moments later someone fired a rifle. The first thing I do is send Patrick back to Gabe to ask him to phone Sharita and tell her that no one has been shot and everyone is stable.
Kendra has some bruising, but mostly I'm concerned about the fact that she has coughed up a very small amount of blood shortly afterwards which would indicate some kind of lung trauma. She is thankfully in a stable condition. Another rider is also at the little medical clinic with a small amount of blood trickling from her ear - the wound from the butt of a rifle which she had pushed up against the side of her face.
Sharita eventually pulls up with the landcruiser and a few military guys. We organise for the remaining riders to be bundled into vehicles and taken to camp. Some of the riders that have already made it to lunch continue riding. Everyone has been accounted for.
We take Kendra to Isiolo hospital (really just wanting a chest x-ray) and check out the local Emergency department. It's a little cleaner looking than Moyale hospital at least. But still - some of the basic things we take for granted back home (like having oxygen and suctioning equipment on standby at the end of each bed) are still missing.
The person who sells the x-ray tickets is on their lunch break (which goes for two hours) so we hang out at the hospital for a while. Eventually we get the x-ray, and thankfully there's nothing serious on there (maybe a broken rib, but no major lung trauma).
At the end of the day I think everyone knew that we were lucky that no one was more seriously injured.
Friday, March 18, 2011
Sunday, March 6, 2011
Moyale Hospital
The other day I had the privilege of escorting a sick Mzungu (Swahili for white man) to the nearest hospital as we felt he required pathological testing that we weren't able to diagnose from the mobile TDA nurse and paramedic run clinic/lunch truck. I'm not going to share anymore details about his illness here as I have an ethical obligation to patient confidentiality but I will state that he is back to his normal self and there is absolutely no need for anyone to be concerned.
The sick Mzungu scored a 4 hour hospital admission to Moyale Hospital and the African health care system really hit me hard. I had an awareness that the health system was poor, but it's not until I saw it up close with my own eyes that it really made an impact.
There are two other men sharing the same room as the Mzungu. One speaks pretty good English and I learn the he has Malaria. He looks to be roughly the same age as me. The other is much younger - 14 maybe. He is very sick. I try and find out what's wrong with him and the man with Malaria tells me he has a sore throat and hasn't been able to eat for 3 weeks - but I know there must be more to it than that. He has IV fluids running. No one seems to care about taking a set of vital signs. His lungs sound terrible - he has a death rattle. His body is emaciated. Around him are his family who sit him up so he can breathe better. He vomits into a bucket, passes urine into the same bucket. There aren't many nurses. His family take the bucket away and wash it out.
The hospital is not very clean, everything is old, the assessment equipment is very basic. I'd be surprised to find a cardiac monitor, a defibrillator, a blood gas machine or any of these basic essentials that you would expect to find in a hospital at home. There's people sick with Malaria, yet no mosquito nets.
As I ride my bike through the countryside I notice that the people aren't old. 40 is considered old for the people that live in these parts of the world.
I clamp the Mzungus IV fluids myself when the bag empties because there is no one else around. He's doing ok and I think we can do a better job looking after him on the lunch truck after all. Time to push for a discharge.
The sick Mzungu scored a 4 hour hospital admission to Moyale Hospital and the African health care system really hit me hard. I had an awareness that the health system was poor, but it's not until I saw it up close with my own eyes that it really made an impact.
There are two other men sharing the same room as the Mzungu. One speaks pretty good English and I learn the he has Malaria. He looks to be roughly the same age as me. The other is much younger - 14 maybe. He is very sick. I try and find out what's wrong with him and the man with Malaria tells me he has a sore throat and hasn't been able to eat for 3 weeks - but I know there must be more to it than that. He has IV fluids running. No one seems to care about taking a set of vital signs. His lungs sound terrible - he has a death rattle. His body is emaciated. Around him are his family who sit him up so he can breathe better. He vomits into a bucket, passes urine into the same bucket. There aren't many nurses. His family take the bucket away and wash it out.
The hospital is not very clean, everything is old, the assessment equipment is very basic. I'd be surprised to find a cardiac monitor, a defibrillator, a blood gas machine or any of these basic essentials that you would expect to find in a hospital at home. There's people sick with Malaria, yet no mosquito nets.
As I ride my bike through the countryside I notice that the people aren't old. 40 is considered old for the people that live in these parts of the world.
I clamp the Mzungus IV fluids myself when the bag empties because there is no one else around. He's doing ok and I think we can do a better job looking after him on the lunch truck after all. Time to push for a discharge.
Sunday, February 27, 2011
Arba Minch
Hi there from Arba Minch!!!
Well more interesting times arise as the wound infections start. We've done a few intravenous infusions out of the back of the lunch truck to try and get them better. Fingers crossed they keep getting better.
I have been for a morning walk around every single pharmacy that is open in Arba Minch trying to restock the antibiotics. The ciprofloxacin and the cloxacillin is easy enough to find... trying to get some oral clindamycin for those people that are allergic to penicillin is a different story however! I think I've been to every pharmacy and haven't been able to find anything. I ask for an antibiotic for someone with a wound infection who is allergic to penicillin - the man digs out the cloxacillin. "No - Penicillin allergy" I reinforce - so he finds some Augmentin (which also contains penicillin). I point out that amoxycillin is a penicillin too.
"Yes but this antibiotic is very good for wound infection" he says/
Not getting anywhere today.
Instead I find a heap of nice young local men who are waiting for me to finish my internet time because they really want to take me out tonight because they have a big celebration. It's the night before they start their fasting time - this means they aren't allowed to eat any proteins, they're not allowed to drink, and they're not allowed to have sex during this time. I tell them no - but it's never that easy.
Well more interesting times arise as the wound infections start. We've done a few intravenous infusions out of the back of the lunch truck to try and get them better. Fingers crossed they keep getting better.
I have been for a morning walk around every single pharmacy that is open in Arba Minch trying to restock the antibiotics. The ciprofloxacin and the cloxacillin is easy enough to find... trying to get some oral clindamycin for those people that are allergic to penicillin is a different story however! I think I've been to every pharmacy and haven't been able to find anything. I ask for an antibiotic for someone with a wound infection who is allergic to penicillin - the man digs out the cloxacillin. "No - Penicillin allergy" I reinforce - so he finds some Augmentin (which also contains penicillin). I point out that amoxycillin is a penicillin too.
"Yes but this antibiotic is very good for wound infection" he says/
Not getting anywhere today.
Instead I find a heap of nice young local men who are waiting for me to finish my internet time because they really want to take me out tonight because they have a big celebration. It's the night before they start their fasting time - this means they aren't allowed to eat any proteins, they're not allowed to drink, and they're not allowed to have sex during this time. I tell them no - but it's never that easy.
Tuesday, February 22, 2011
Sweeping in Ethiopia
I love Ethiopia. I especially like riding sweep in this country. Many riders don't like to be "swept" - I like to try and respect this. This means I try and hang back as soon as I catch up to the last rider if they look like they're doing okay. It means there's lots of time for awesome photographs. Lots of time for Pepsi and coffee, and it means lots of time for me to practice my Amharic with the local kids. I'm a bit limited to "what's your name" and "how are you" but I'm sure I'll learn a bit more as time goes on.
I was sweeping up a hill the other day and I met a group of 4 kids, one of which was holding out a baby goat. Of course I have to stop, and take a photo. Then they let me hold the goat too. It would have only been a few days old. A rider had already bought a goat and wanted to take it along with us on the lunch truck - but for infection control reasons the rules are "no goats on the lunch truck" - so I gave my little one back to the boy and continued on my way.
Surprisingly I don't get many rocks while I'm riding sweep - i think it's because I have the energy and time to talk to lots of the kids, try to greet them in Amharic, and remain pretty cheerful.
Medically we're still keeping busy... a bit of minor surgery in the back of the lunch truck, the wound infections start coming in, the gastro for the time being has been keeping at bay.
I was sweeping up a hill the other day and I met a group of 4 kids, one of which was holding out a baby goat. Of course I have to stop, and take a photo. Then they let me hold the goat too. It would have only been a few days old. A rider had already bought a goat and wanted to take it along with us on the lunch truck - but for infection control reasons the rules are "no goats on the lunch truck" - so I gave my little one back to the boy and continued on my way.
Surprisingly I don't get many rocks while I'm riding sweep - i think it's because I have the energy and time to talk to lots of the kids, try to greet them in Amharic, and remain pretty cheerful.
Medically we're still keeping busy... a bit of minor surgery in the back of the lunch truck, the wound infections start coming in, the gastro for the time being has been keeping at bay.
Saturday, February 12, 2011
Rest Day :)
I am currently sitting at a little internet place in Gondar, Ethiopia. We have 2 rest days here and I feel like I have earnt them.
It has been a busy week medically. Tired bodies, increased heat, gravel roads make a recipe for more work! There's been lots of riders with heat stroke as they cycle through temperatures up to 49 degrees out in the sun. It doesn't matter how many times I remind people to keep drinking, adequate hydration is always going to be a hard battle. The explosive diarrhea has started, and there's been plenty of gravel rash to patch up.
Blessing the lunch truck driver has been having issues with his visa coming into Ethiopia so he's still stuck in Khartoum - which means Mathias is driving the lunch truck at the moment.
Yesterday, even though it was a "rest day" we were working for most of the day. We took the lunch truck to get fuel and to get properly cleaned. The trucks take a beating over here so we have to look after them. We visited the local hospital trying to get my suturing forceps sterilised which I had to use the other day... The theatre nurse exchanged mine for a sterile pair but then she was asking if we had a box to put them in... which would defeats the purpose of them being sterile in the first place. We came to the conclusion that perhaps the clinic/lunch truck is perhaps cleaner than Gondar University Hospital. We tried to pick up some supplies from the pharmacy here, and managed to find most of what we needed. There's no decent dressings here, but we've still got quite a bit of stock anyway. I was also trying to find a spacer chamber for any more acute asthma attacks that might arise on the way as I gave the existing one to a client already. We have one in the Emergency bag still anyway but it would be useful to have a second one on the lunch truck aswell. They don't know what a spacer is here though even when I drew a picture. Maybe in Addis.
The rest of the day we spent cleaning the inside of the lunch truck which was pretty dusty and disgusting after the unpaved section in Sudan. Then it was time for clinic... and finally time to party!
Miles goes back home to Istanbul today which is good for him, but sad for us because he is an awesome person to have around.
It has been a busy week medically. Tired bodies, increased heat, gravel roads make a recipe for more work! There's been lots of riders with heat stroke as they cycle through temperatures up to 49 degrees out in the sun. It doesn't matter how many times I remind people to keep drinking, adequate hydration is always going to be a hard battle. The explosive diarrhea has started, and there's been plenty of gravel rash to patch up.
Blessing the lunch truck driver has been having issues with his visa coming into Ethiopia so he's still stuck in Khartoum - which means Mathias is driving the lunch truck at the moment.
Yesterday, even though it was a "rest day" we were working for most of the day. We took the lunch truck to get fuel and to get properly cleaned. The trucks take a beating over here so we have to look after them. We visited the local hospital trying to get my suturing forceps sterilised which I had to use the other day... The theatre nurse exchanged mine for a sterile pair but then she was asking if we had a box to put them in... which would defeats the purpose of them being sterile in the first place. We came to the conclusion that perhaps the clinic/lunch truck is perhaps cleaner than Gondar University Hospital. We tried to pick up some supplies from the pharmacy here, and managed to find most of what we needed. There's no decent dressings here, but we've still got quite a bit of stock anyway. I was also trying to find a spacer chamber for any more acute asthma attacks that might arise on the way as I gave the existing one to a client already. We have one in the Emergency bag still anyway but it would be useful to have a second one on the lunch truck aswell. They don't know what a spacer is here though even when I drew a picture. Maybe in Addis.
The rest of the day we spent cleaning the inside of the lunch truck which was pretty dusty and disgusting after the unpaved section in Sudan. Then it was time for clinic... and finally time to party!
Miles goes back home to Istanbul today which is good for him, but sad for us because he is an awesome person to have around.
Wednesday, February 2, 2011
Story of the Lost Children
The other day I was riding afternoon sweep when I come across Kristian and Ram stopped by
the side of the road. With them are two very small Sudanese children - the boy aged maybe 5, the girl only 3.
These kids are in the middle of the desert, it's hot outside, and there is no signs of any civilisation or signs of life in sight.
Kristian and Ram are both very concerned about the wellbeing of the two children. I suggest we continue on our way. We can't take these two children with us to Cape Town! A vehicle passes about every 15 minutes. The kids do not look too unwell, dehydrated or sick, and I believe that once we are gone, the Sudanese people will look after these children.
Ram and Kristian don't like my plan so I discuss with Sharita (the boss) what we should do. She suggests we keep moving and says she will go back and check on them, but Ram and Kristian still don't want to leave them.
I eventually flag down a vehicle and a man gets out of it. I explain using a lot of gestures (because I don't speak much arabic, and he doesn't speak English) that the children are lost and we are concerned about them. He thanks us and starts walking with them away from the road and into the desert.
I am sure these people must have places, homes, hidden from our eyes where they live. Often we will see a person in the middle of nowhere just walking, or sitting next to the road - just usually not quite this small!!!
the side of the road. With them are two very small Sudanese children - the boy aged maybe 5, the girl only 3.
These kids are in the middle of the desert, it's hot outside, and there is no signs of any civilisation or signs of life in sight.
Kristian and Ram are both very concerned about the wellbeing of the two children. I suggest we continue on our way. We can't take these two children with us to Cape Town! A vehicle passes about every 15 minutes. The kids do not look too unwell, dehydrated or sick, and I believe that once we are gone, the Sudanese people will look after these children.
Ram and Kristian don't like my plan so I discuss with Sharita (the boss) what we should do. She suggests we keep moving and says she will go back and check on them, but Ram and Kristian still don't want to leave them.
I eventually flag down a vehicle and a man gets out of it. I explain using a lot of gestures (because I don't speak much arabic, and he doesn't speak English) that the children are lost and we are concerned about them. He thanks us and starts walking with them away from the road and into the desert.
I am sure these people must have places, homes, hidden from our eyes where they live. Often we will see a person in the middle of nowhere just walking, or sitting next to the road - just usually not quite this small!!!
Onwards to Khartoum
So I'm sitting here in a very westernised shopping centre at a little internet place typing away at my blog... seems a little strange compared to the very unwesternised world outside.
We have travelled from Dongola to Khartoum over the last 4 days. I've been lucky enough to spend most of that time on my bike.
The most important thing is that Kim the cook (who lost her passport in Cairo) has managed to get herself out of Cairo and safely to Khartoum. Even though I am not overly supersticious I plan to give her my lucky horseshoe I picked up in Luxor as soon as I see her - she seemed to just have one stroke of bad luck after another poor thing! We are all very glad that we are out of Egypt now that things are a little unstable there.
The cycling has been pleasant although this morning I was sweeping with Elvis and he got a flat tyre. Unfortunately he doesn't have his own pump and his spare inner tube has an unusual valve that wasn't compatible with my pump. This meant that we were sitting on the side of the road patching a tube so we could get going again and then had to work quite hard to catch up to the riders at the back when the wind changed direction just to make life a little more complicated!!!
Riding in convoy is often a painful procedure. I sit at the very back of the convoy so that if there is any medical problems I'll know about them and can try to help. Travelling is often slow, traffic is crazy, and we were grateful to the national sudanese cycling team for helping us out.
Today one of the riders fell off their bike riding across some railway tracks as part of the convoy. She was feeling a bit dizzy and nauseous afterwards so I jumped on the truck with her for the last 20km of the day. I was quite pleased to have an excuse to get out of the sun - the dizziness and nausous feeling soon resolved and the rider is perfectly fine.
I just had my first shower in 9 days so I'm feeling nice and clean!
Hope everyone up in northern queensland stays safe
We have travelled from Dongola to Khartoum over the last 4 days. I've been lucky enough to spend most of that time on my bike.
The most important thing is that Kim the cook (who lost her passport in Cairo) has managed to get herself out of Cairo and safely to Khartoum. Even though I am not overly supersticious I plan to give her my lucky horseshoe I picked up in Luxor as soon as I see her - she seemed to just have one stroke of bad luck after another poor thing! We are all very glad that we are out of Egypt now that things are a little unstable there.
The cycling has been pleasant although this morning I was sweeping with Elvis and he got a flat tyre. Unfortunately he doesn't have his own pump and his spare inner tube has an unusual valve that wasn't compatible with my pump. This meant that we were sitting on the side of the road patching a tube so we could get going again and then had to work quite hard to catch up to the riders at the back when the wind changed direction just to make life a little more complicated!!!
Riding in convoy is often a painful procedure. I sit at the very back of the convoy so that if there is any medical problems I'll know about them and can try to help. Travelling is often slow, traffic is crazy, and we were grateful to the national sudanese cycling team for helping us out.
Today one of the riders fell off their bike riding across some railway tracks as part of the convoy. She was feeling a bit dizzy and nauseous afterwards so I jumped on the truck with her for the last 20km of the day. I was quite pleased to have an excuse to get out of the sun - the dizziness and nausous feeling soon resolved and the rider is perfectly fine.
I just had my first shower in 9 days so I'm feeling nice and clean!
Hope everyone up in northern queensland stays safe
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