Traumatic Amputation – All in A Day’s Work

Warning – Semi-graphic pictures below

Some days are weird here. Like when you find yourself roaming up and down the streets of a township, looking for a five-year-old boy whose fingers you’ve been told have gone missing. And then you find him and it’s true…

Thursdays are the days we hand out soup at a clinic in Clermont, and then set up the Mobile BEC outside the meeting hall a few miles away. We were all set up at the hall, and I had just gotten back from walking down to get drinks and snacks, when a lady casually walked by. Bro. Siphwe asked her in Zulu if she was interested in our Bible course, they chatted for a minute, and then she carried on. A few minutes later she walked back by – still casually – and they chatted some more. When she walked off, Siphwe told us she said a little boy was home alone and had gotten shocked – his fingers were gone; they had called an ambulance this morning (it was now about 1:30), but it hadn’t shown up.

Helen, the nurse from the UK, wasn’t with us today, so I – being a former EMT – was the most-qualified. Kinda scary since that was a really long time ago (and since EMT’s basically just drive the ambulance and do what the paramedics tell them). Tim and I walked in the direction the lady had gone, but didn’t find her. I tried to ask a few people where they were but no one spoke English. Finally we saw Matt waving at us from up the hill.

When we got back up, they had brought the little boy out and he was sitting by himself with a towel wrapped around one arm. Drops of blood were spattered all over him and he had a bleeding spot on his forehead. He was sniffling softly, but not crying. He was very calm and didn’t try to keep me from removing the towel, as you would expect. I wasn’t sure what I would find, but was hoping that the “fingers gone” thing wasn’t actually true.

This is what was beneath the towel:

He was missing part of two fingers, with the bones fully exposed. His pulse and breathing were strong and he had a pulse in the wrist of the hand that was injured. He appeared to be in what people generally call “shock,” but not in actual medical shock from loss of blood.

They wanted us to take him to the clinic we had just come from. (Siphwe pointed out later that there were plenty of people with cars…it’s one of those things you don’t quite understand). We weren’t sure the clinic had an emergency department, but then I remembered having seen a sign that said, “Casualty,” this morning as we parked on a different side of the building (notable only because of a conversation Helen and I had had about the various names for emergency departments).

I tried to wrap his hand a little more securely, and then held him on my lap (so as to avoid getting the car bloody) as Tim drove us and the neighbour who found him. She said he was doing something with the DVD player and she heard a bang. That’s all the information we got, although the other lady had said he got shocked. There were no burn marks, which seems odd; but I don’t know enough about electrocution to know if it’s a valid story or not.

The boy sat motionless until we were about halfway, when his arm began shaking badly. I was afraid for a moment that he really was going into shock, and wanted to tell Tim to hurry; but since he was driving as fast as he could there was no point in mentioning it and potentially freaking everyone out. I just held him tighter and he finally stopped shaking.

When we got to the clinic Tim dropped us off while he went to park. Nobody came to look at the boy, but the neighbour spoke to the lady at the window as we sat down. There was no waiting room, just a couple of chairs.

The cut on his eyebrow started bleeding again so I kept dabbing it with the towel. At this point my adrenaline started to wear off or something, because as I sat there, whispering songs about God to him in Zulu, I started to cry. Luckily Tim walked in then and it snapped me out of it. There’s really no crying allowed.

We didn’t have to wait long before they pointed to a room. We walked into a large room with several beds. There were two nurses and a very young doctor or intern or schoolboy or something. They just stared at us – the nurses didn’t even get up. I took the towel off and showed them his hand, and the neighbour explained in Zulu.

The nurses gasped, and one kept repeating, “Amputated! Amputated!” She was clearly not expecting that and had no idea what to do – so she did nothing. I finally picked a bed and sat the boy on it and just continued to keep my arms around him. He began shaking again and finally crying a little. I squeezed him really tight and he stopped and kind of leaned back against me. It was infuriating that Tim and I were in a room full of Zulu speakers – half of them with at least some medical knowledge – and not one person said anything comforting to the kid in a language he could actually understand. I know culture is different. But caring is generally universal. That was a disillusioning moment.

After at least two minutes of just looking at us, one lady came over and stuck a thermometer under his arm. No vitals, no examination of the hand, which had started bleeding again. She did put several drops of something – hopefully for pain relief – in his mouth, and then walked away.

The young guy came back over and very carefully put his gloves on (understandable, but please hurry!) and then spread a paper covering over the bed the boy was sitting on.

Then he wanted to take the kid’s shirt off. He started to just pull it off like it was any normal day, but I was able to at least hold the hand up and gather the arm of the sleeve slightly, so the two of us could guide it somewhat gently over the mangled mess. I wanted to ask if they could just cut it off, but I didn’t know how many shirts the kid had. He never flinched as we removed it. After he was undressed we had him lie down and the guy covered him with a paper thing. He took the bloody towel away (throwing it into a heap at the end of the bed – no biohazard container here) and left me holding his hand like this:

for several minutes. Finally he brought a pad like you’d put under a person who might wet the bed, and folded it around the hand. There was no pressure on it and still no one had touched him other than to take his temperature.

At this point Tim and I realized there wasn’t much more for us to do. I asked the neighbour if she had a phone and she didn’t, but she said the mother would be told where they were and they would find them.

I was conflicted about leaving him but there wasn’t any more to do. I’m sure he’ll have to be transferred somewhere for surgery, but who knows when that will happen. So I said bye, and the boy looked around at Tim and me, confused I’m sure. I pointed to the neighbour to show him she was staying. I really hope she got up out of her chair and put her hand on his head or something. I said, “Take care of him,” and we left.

There’s so much wrong with what happened. No supervision + no ambulance + uneducated medical staff = a really bad day to be this kid.

On the way back I remarked to Tim, “If you can’t get an ambulance for a kid who might bleed to death, what does it take?” But it’s not just in the townships. Apparently ambulances are hit-or-miss here period.

I was a little shaken up after all this. Not badly, but just feeling slightly nauseous and dizzy from the smell and sight of the blood, and trembly from the adrenaline; so when we got back to Matt and Siphwe I asked if we could wrap up a few minutes early. We got back to Westville and I went to my room to scour and relax for a few minutes. Soon there was a knock on the window and a Dr. Pepper suddenly appeared through the bars. I take back all the bad stuff I’ve blogged about Matt.

I’m hoping something good will come of this. Maybe his mother will come check out the meeting, or send him to Sunday school. I can’t remember his name (it starts with an L) but I’ve now got a soft spot for him and want to see him again.

I’m gonna go drink that Dr. Pepper now.