Sunday, September 12, 2010

another kind of outcome...

A Kenyan man comes into the ER agitated, saying, "I have a sick boy outside..." I grab an old wheelchair and walk out with him to find a white truck with two people inside. We don't have any spare stretchers at the time, so three of us help wheel him into "Casualty"(ER) and kick someone healthier off a stretcher. Once on the stretcher the boy is found to be pulseless and apneic and we proceed with a trauma resuscitation...Kenya style. Someone initiates lightweight CPR. I intubate the boy. We establish two IV's quickly with fluids running in, adrenaline is found and given, there is an ancient Zoll defibrillator that actually charges with a whine and delivers a solid shock! I am encouraged by the fact that the machine works. However, it is clear that the teenage boy doesn't. It is a sad moment to realize that he is beyond our help. We can only stop and ask what happened??
Apparently the truck was going down a nearby stretch of road, that is much like driving down a dry river bed, when the boy ran out in front of the truck while collecting firewood. The two men in the truck collected the boy and drove him to the hospital. Here in Kenya it is important that we keep the truck and the driver from leaving the hospital while the driver must walk to the nearest police station and bring the police back to the ER for an investigation. The truck was locked in behind gates in the hospital parking lot. Eventually some police officers did show up, as did some family members. Things seemed surprisingly calm, quiet and low key really. I couldn't understand much of what was going on so I asked one of the residents to tell me what was happening. Apparently the truck driver had to bribe the police at the station before they would come to write a report. The resident said the report stated that the boy was in the truck when it accidentally rolled over.
Clearly police reports aren't about investigating the facts. So much revolves around bribes and manipulating situations so that you can get on with your day. Never mind the loss of life or the long term impact on the family.

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