The hostilities have started.
We are at the ready in Boguila because
another rebel group – we call them the ‘Groupe d’Auto-Défense’ (AD) – is
attacking the Seleka from Boguila. We have already received gunshot wounded;
some gravely injured, others, less so.
It is interesting to see the reactions
from the hospital staff – it is easy to say that MSF is neutral and independent
but practically, when emotions ride high, it is another story altogether. Here
is what happened…
This past
Monday, we were planning to transfer one of our patients to the hospital of
MSF-France in Paoua (approximately 60-70 km from Boguila). All was well and we
were just about to depart when we got the news that there was an armed
confrontation between the AD and the Seleka on the road to Paoua. Needless to
say that our transfer was cancelled for security reasons and that we stayed
put.
A few hours
later, a truck from the Seleka arrived at the hospital and the soldiers brought
us two injured, both with gunshot wounds – one in worst shape than the other.
The team from IPD was ready: our ‘Salle de pansements’ had been filled at
capacity with dressings and IVs and the personnel had seen worst.
The first
injured only had a few superficial wounds that just needed a good cleaning and disinfection
as well as dressings and a good follow-up.
However,
the second one sustained gunshot wounds to the abdomen, and on both the legs
and arms. He was losing a lot of
blood and was showing signs of shock. We quickly started to intravenous lines
and covered the wounds before bringing him to the operating theatre. The OR
team ran to get dressed with the OR clothes and get the room ready. In the
meantime, we had to control the flow of soldiers wanting news from their
colleagues. They only speak Arabic so we asked one of our nurse supervisors to
translate for us. He calmly explained to them that we are doing all we can and
that they have to respect our instructions – one of the soldiers had made his
way into the OR while we were preparing the injured for the surgery!!! In order
to help with this problem, we stationed an expat nurse outside the door of the
OR – they seem to be a bit more respectful of the rules if a ‘white’ person is
there versus a coloured one. Thankfully, they quickly understand that not
everybody can circulate in the hospital.
The surgery
starts and we find out that the injured had gunshot wounds – pellets – in the
abdomen, the right leg and the right arm. We succeeded in removing the
superficial fragments from the leg and the arm. The others that are slightly
deeper will have to migrate by themselves to be removed later. We now open the
abdomen – what are we going to find? Usually, this type of injury can cause
lots of damage as the abdomen protects many vital organs – liver, spleen,
intestines, kidneys, etc. We could also find a hemorrhage or a septic infection
if the bowel has been touched. We can’t believe it! No organs have been
injured! The bullets only penetrated muscle deep. This man is so lucky! In the
end, we still remove two or three 9mm bullets…
We finish
the surgery and bring the patient back to the Soins Intensifs/Urgence pavilion
where he will stay for a few days.
It is only
after the surgery that we find out our patient is in fact the commander of the
Seleka group stationed in Boguila. There are already many visitors –
militaries, family, etc. – and they all want any news about him. We have to be
careful of who enters the hospital and who does not. What are we going to do if
civilian wounded start arriving? How many wounded can we expect?
We discuss
with the national staff (secourists and nurses): it is important to remain
neutral and to watch what we are saying when we work at the hospital. They have
to remember and respect the MSF principles. We are not only treating the
injured here, we have their families in the hospital and they can hear
everything that is said. Our staff responds to these reminders in an exemplary
fashion…When new patients arrive, the civilians will be placed on the pediatric
side so that they are at opposite sides with the military, thus minimizing any
altercations between them. And everyone completely understands the consequences
a bad comment in the presence of any of the groups would bring. They can all
wear their MSF ID badge with pride.
In the
following days, as expected, injured civilian patients, from the older man to
the fifteen-year-old girl: all were working in their fields and they were the
unfortunate recipients of the retaliation of the rebels on the civilians. These
little people work in their fields in order to gather some money that will help
them eat and a lot of them become the unknown victims of the rebellion and its
repercussions.
When will
the international community intervene in order to stop such violent events on
the inhabitants of this country that only ask to survive: survive the war, the
malaria, the hard life.
Janique
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