Project Phongsali: An injured man arrives in need of help. We have to turn him away because we lack supplies.

April 8, 2010
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Dr. Tan is not a "degree doctor". He has skills similar to those of an EMT but he lacks the formal education that a medical school would provide. Still, he's calm in an emergency and when his clinic has supplies he can provide immunizations, prescription drugs and first aid for wounds.

Day 66

Once again, our dinner was interrupted.  Tonight, just as the cook set the sticky rice and fish soup on the table, two motorcycles rolled onto the hospital grounds.  The fellow driving the lead bike called for help and we all bolted from the table to see what adventure had arrived.  It was not an appetizing sight.

The passenger on the lead bike, a gray-faced man in his mid twenties, had been injured in a logging accident.  His shirt was pasted to his chest with sweat; his pant to his leg with blood.   He was in pain from two ordeals: first the accident that slashed his leg and then, the long transport from his distant village.  The young man was alert but too fatigued to speak.  His wife dismounted the accompanying bike and offered details.

She explained that her husband had severely cut his leg shortly after breakfast that morning, and had bled profusely until friends applied a compress and wrapped the leg with strips of torn cloth.  As the wound bled through that bandage they wisely left the compress in place and simply wrapped additional layers of torn cloth on top the first.

When the man’s wife and friends determined that his wound needed more care than they could provide in their village, they lifted him onto the back of a motorbike and started down a series of steep mountain trails that eventually brought them to the main road.  At that intersection they weighed their choices.  Go east to Vietnam or west to Sop Houn.  Better care likely over the border but closer, cheaper care in Laos.  They headed west.  Eight hours after the accident, they arrived in our village.

The deminers lifted the guy from the bike and laid him on a narrow wooden bench.  Yai grabbed a nearby five-gallon water bottle and slid it under the fellow’s knee to elevate the leg.  I checked the man’s foot for proper circulation.  The bandage was snuggly wrapped but not tourniquet-tight; his foot was warm and, beneath the caked blood and mud, showed decent color.  His friends had provided good first aid.

Dr. Tan arrived from his house next to the hospital and started to remove the blood-soaked bandage.  Then, he was struck by a realization that gave him pause.  He explained that while, ordinarily, he could provide treatment, the clinic was currently out of sutures. Since he couldn’t close whatever wound was under the bandage he was hesitant to remove the compress.  He recommended that the villagers proceed on to Muang May, thirty minutes away, where the district hospital was, perhaps, better supplied.

Without complaint, the victim and his wife accepted Tan’s advice.  Peng and Khampoun lifted the fellow onto the motorcycle he’d arrived on.  He wrapped his arms around the driver’s chest and wearily dropped his head between the man’s shoulder blades.  A minute later, both bikes were gone, the road dust had settled, and we were back at the dinner table.

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