Visiting Om in the Hospital – Lao families provide patient care in the hospitals.

February 10, 2010
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Vientiane - Lao Peoples’ Democratic Republic

On the day I arrived in Laos my friend Om was nearly killed in a road accident.  About the same time that I was collecting my baggage at the airport, Om and three of his friends were driving from Khammouan Province to Vientiane in a low-slung flatbed truck, returning to the capitol following weeks of work in the countryside.  They’d been on the road for nearly three hours and were just an hour from town when trouble struck.

The accident occurred along a stretch of road that I know well.  You come out of a long, boring stretch of flat, straight road and begin to roller coaster up and down a series of camel-back hills.  If you try to keep your speed up to make time, you’ll start cresting hills blind to what’s on the other side.  If the road’s clear your gamble pays off.  If there’s a cow sleeping in your lane or a villager pushing a handcart you better have quick reflexes and excellent brakes or you’ll pay a price for being in a hurry.  Many of the aid agencies working in Laos require their drivers to be off that road before dark.

Om and his crew were traveling in broad daylight on a dry day so they couldn’t have had better visibility.  I’d wager that Vonn, the driver, was eager to get home and a tad over-confident; he probably had the hammer down, trusting his luck as he crested each hilltop.  It must have been a shock when he found himself about to run up the tailpipe of a feeble old motorbike putt putting along, the bike moving at just dogtrot speed.

Witnesses said Vonn over-steered as he swerved to avoid the bike.  The road in that stretch is unforgiving; there are no shoulders to provide even a slim margin of error.  Within seconds Vonn’s truck was doing three-sixty rolls and the passengers inside were tumbling around like clothes in a dryer.

Cargo on the bed of the truck (a chest freezer, a tool box, foot lockers, and a motorcycle they were carrying home) went flying but, remarkably, everyone inside the cab stayed with the truck.  Remarkable because, this being Laos, it’s unlikely that anyone was wearing a seat belt.

The luckiest of the passengers broke just an arm and escaped more severe injury.  It might be hard to convince Noi, a young father of two in his mid-twenties, that he deserves second-place standing for good fortune, since he was carried from the truck in great pain from a broken leg, a fractured pelvis and two cracked ribs.  The two most severely injured in the group were Vonn and Om, both of whom suffered severe head injuries and were found unconscious.

I haven’t learned how the four were transported to Vientiane.  For certain, there was no ambulance service.  Most likely, the first people on the scene flagged down passing vehicles and persuaded drivers to carry the fellows to the city.  Probably piled on the backseat of a sedan or in the bed of a truck.  Here, you’ve got to make do with what’s available.

In any case, the guys ended up at what’s known here as the One Hundred and Five Bed Hospital.  It’s a block-solid, grim-looking building unmistakably designed by Russians back in the day when the Soviet Union yet existed and Russians had greater interest and influence in this part of the world.  After the Soviet Union dissolved and Soviet aid dried up, the Russians gifted the hospital to the Lao government.  Today, the One Hundred and Five boasts the only CAT scan in the country and the only staff capable of doing brain surgery.

The night of the accident, Russian-trained Lao doctors drilled holes in Vonn’s skull in the hope of relieving growing pressure on his brain.  He woke up the next morning able to squeeze visitors’ hands in response to their questions.

Om was unconscious for two days and now, four days after the accident, is still in a groggy, semi-conscious state. His family is encouraged by his growing responsiveness (I’m confident that he recognized either my face or my voice when I visited him yesterday) but everyone is frightened by his periodic seizures.

As soon as Vonn and Om were somewhat conscious, they were moved out of what passes here for an ICU and moved into a general ward full of critically sick and injured patients– a disaster area filled with human wreckage.  Beds line all four walls of the ward, perhaps fifty in all, with just enough space between patients to permit family members to camp out beside their loved one.

The ward is ventilated with unscreened doors and windows and visitors wander at will around the place.  Children, being children, romp and play; adults not tending to the immediate needs of the sick and injured chat quietly, play cards, cook food and while away the hours talking on cell phones or listening to music. The ward smells of food, spices, lotions, liniments, sweat, urine and feces.

Since the hospital has no nursing staff to speak of, patient care is the responsibility of attending family members.  Caregivers spoon tiny measures of food and water into slack mouths, sponge bathe naked bodies, massage damaged limbs, change soiled bedding, and constantly hope for the best.

When I entered the ward, Om’s wife was at his side slowly fanning the air above him, both to cool him and to keep the flies from lighting.  To keep Om from thrashing about she had tied each arm and leg to a corner bedpost.  She had a small bucket at her side for bathing Om and, like every other attending relative in the place, she had dropped a thin woven plastic mat on the floor, staking her claim to a sleeping place.

Om’s mother had spread a similar mat on an open patch of concrete floor a few feet distant and was trying with limited success to keep her two-year-old granddaughter playfully distracted.  When I arrived, the family was in day three of their vigil.  No one in the family had any idea of how long Om would remain at the hospital.  None would venture a guess as to where they were headed or what might happen next.

Seeing Om in that fragile state and observing his wife and his mother trying to contend with a situation they could barely comprehend much less alter, my memory carried me back a few years to the night in Nakai when Yai and I found an injured motorcyclist along the road and carried him to a hospital.

Like Om, that fellow suffered a severe head injury and lay unconscious for days.  Eventually, when they young man failed to much respond to the limited care that the provincial hospital could provide, doctors gave the family a choice: take him to Vientiane for more specialized treatment  (They were told he needed an operation that might cost as much as a thousand dollars) or, take him home to live or die.  The family couldn’t afford an operation so they took him home.  He died.

One Response to “ Visiting Om in the Hospital – Lao families provide patient care in the hospitals. ”

  1. Randy Frush on May 26, 2010 at 9:29 am

    Wow, I never new that, much appreciated.

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