Emergency in Mogadishu
Canadian Dr. Dan Deckelbaum recently worked with AMREF’s Flying Doctor Service. Read his diary about evacuating patients after a bomb exploded in one of the most dangerous places in the world.
By Dr. Dan Deckelbaum
March 25, 2010
Just after intubating a patient shot in the head in Turkwel, western Kenya, I received this text message on my mobile phone. It’s the Flying Doctor Service’s medical director, Dr. Vadera: “2 suicide bombings Mogadishu, multiple victims, 2 jets airborne, 3rd waiting 4 u.”
The time is 14:30. We still have to return to the Flying Doctor Service headquarters at Wilson Airport in Nairobi, and take off for Somalia by 16:00. Mogadishu’s airport (I use the term loosely), has an unlit runway so we have to leave before sunset. We can’t risk an overnight stay in one of the most dangerous places in the world.
We land at Wilson airport at 16:02. I leave my patient under the care of Dr. Vadera. Will, our pilot, is waiting at the plane’s door. I run in and off we go.
Mogadishu’s airport is protected by the African Union forces. The goal of the evacuation is to rapidly transfer the most severely injured victims by plane, spending as little time as possible on the ground.
En route, we prepare everything we need to treat two critically ill patients. But from preflight communications we learn that there were many victims amid utter chaos at the airport.
Scoop and Run
Landing in Mogadishu is exciting to say the least.
For safety reasons, the approach is from the ocean. The aircraft flies at sea level, skimming the peaks of the swells, for the last five minutes of the flight. Then we bank a sharp right and within seconds touch down on the runway. Soldiers, heavily armed, await our arrival. We open the door to be deafened by jet engines ready for rapid departure or potential escape.
I barely hear the soldiers and the AU doctor despite us yelling into each other’s ears. They quickly take me to the armored personnel vehicle where the critical patients await. We identify two patients to transfer. We take the first in the stretcher and run to the jet. We avoid resuscitation on the ground to minimize our time: this is the epitome of “scoop and run.”
We have room for one “walking wounded” patient, an AU soldier from Burundi.
The plane door closes and we are airborne again. The time from touch down to take off: 11 minutes. Not bad.
Two of the patients have second and third degree burns to 35 per cent of their bodies. Six hours after the explosion – we are far behind the recommended resuscitation parameters. We quickly gain IV access and rapidly resuscitate.
One patient has lost two fingers. As the Burundian soldier complains of decreased hearing, blood drips out of his right ear.
I ask the captain to warm up the cabin as burn victims are very susceptible to hypothermia. I am sweating. There isn’t much space to work around on this two hour flight.
In total, nine patients, four of whom are in critical condition, are evacuated from Mogadishu on three flights. The evacuations are free from complications and the patients will undergo treatment in Nairobi.
The blank stare of shock on the soldier’s face is difficult for me to describe. I am not sure what he is thinking but he must be questioning… what am I doing in Mogadishu?
What have I done to deserve this?
The critical victims’ faces are almost completely covered with dressing because of their burns, but I am sure as we speed towards Nairobi at 41,000 feet above sea level, that their only thoughts are of their uncertain survival.
