The risks of travel

Every time you get into a vehicle around here, you’re taking a risk.  How big of a risk depends on a number of factors – night driving, weather, fog, condition of the road itself,  intoxicated drivers, etc.  Four days ago, we had a reminder of just how treacherous travel can be on the mountain roads leading to and from our hospital.  A couple districts away a bus accident took place, with 28 people injured and 8 dead.  24 of the injured were treated at our hospital.   We received word of the accident at around 9:30am, but because of the remoteness of the accident location the patients didn’t start arriving until six hours later.

It was quite a scene as vehicle after vehicle pulled in carrying the wounded.  Our staff did a great job of pulling together and caring for these patients.  We have a disaster management protocol that allows us to more efficiently care for patients in this sort of mass casualty scenario, but things are always chaotic when so many patients are arriving at one time.  The initial priority is triaging patients – deciding who is critical (red), who is sick but can wait (yellow), and who has just minor injuries and can be seen once the dust settles (green).  There also is a designation for patients who are beyond saving who we try to keep as comfortable as possible (black).

Patients were triaged as they arrived.  Dozens of people from the surrounding area were standing around to see what was happening.  The medical issues faced by these patients are our first concern – for some patients, giving immediate treatment makes the difference between life and death.  There was a 27 year old man who was having a very hard time breathing, and it was immediately apparent he had a pneumothorax (punctured lung) from one of the 5 broken ribs and broken clavicle he had suffered.  A chest tube was inserted, and he almost immediately felt more comfortable.  We then moved quickly on to the next patient.  Pain medicine, tetanus shots, suturing, and wound care were needed for almost everyone.  Broken bones are commonplace too in these types of accidents -  one man broke both his wrists as well as his leg.

After a couple of hours things started to settle down.  Critically injured patients were stabilized and a few were transferred to higher centers down the mountain.  17 patients were admitted to our ward, in addition to our normal patient load – making a very busy next few nights for our nurses.  We also think of the incredible emotional trauma these folks have just been through.  Many had lost a friend or loved one.  We pray for peace and healing for these patients.

Life is difficult for people living in remote areas surrounding our hospital, and the hazards of travel certainly play a part in this.  We hope that unfortunate events like the one that happened a few days ago serve as a catalyst for folks to take safety precautions like wearing seat belts, not drinking and driving, and limiting night time travel.

An article about this accident from one of Nepal’s national papers can be found here.