The call comes just as I have plodded home after a long and tiring day in the operating theatre. All hands are needed in the hospital to help deal with a road accident. Two biscuits later I stuff the pockets of my white coat with equipment I may need and when I reach the outpatient department I discover that this is not 'just' an accident. This is the nightmare which we hoped would never happen.
At the local accident blackspot, at the foot of a steep valley, a speeding crowded bus has failed to take the bend over the bridge, and plunged into the Nitbi Rivey 60 feet below. Passers-by have scrambled down the slope to bring the injured to the road, and passing vehicles are now bringing them to the hospital in steady numbers.
In the reception area Dr Gordon, our surgeon, rapidly assesses each arrival and gives instructions as to where they should be taken - the seriously injured need immediate attention, the less serious can wait to be attended to later, and there are those so seriously injured that nothing can be done. All our doctors are here, and all available nurses and student nurses, whether on or off duty, work smoothly together as airways are protected, IV lines inserted, injuries determined, management decided.
As I check where there is space for me to work, I find one man among the 'too seriously injured' who is sitting up and talking. His only problem is swelling in the neck and as this may or may not be serious he is transferred to the ward for observation. Next to him is a child of ten years who is restless from a severe head injury - and the pain of a badly fractured leg which will need to be cleaned tonight. The next man is already dead. Another man is brought in with acute abdominal tenderness - he almost certainly has internal bleeding and must be operated on tonight. The man sitting outside has only a small knee laceration, and some bruising. Later he may realise how fortunate he has been. The girl has broken both arms and one leg, but her facial laceration is small.
Elsewhere, others are also working. Dr Amos battles vainly to save the life of a man with severe chest injuries whose wedding he had attended ten days previously. He then has to go and break the news to the young widow, one of our nurses. In the resuscitation room Dr Mike is assessing a large man who complains loudly of pain in his chest - he does not feel the pain from his leg fracture, and must have a spinal injury, but it is his skull fracture which proves fatal.
At last it seems that all the injured have been assessed, and the initial management mapped out. I find a man wandering among the patient trolleys, looking for his relative who was on the bus. I check on his behalf but find no-one of that name - and we both know that means he must be among those who have not survived. Our parish minister is around. He came to offer help and to be among the distressed, but found his nephew among the injured. Fortunately he is not seriously hurt.
In the ward, nursing staff are coping admirably with the many admissions. I look into theatre where Dr Gordon and his team have several more operations to do. It is now well after midnight, and there is little more I can do to help, so I head for home, knowing that others have a full night's work ahead of them. Tomorrow the less urgent injuries will be more carefully assessed, X-rayed, operated on, plastered, put in traction.
Next morning, the whole community is stunned. Fifty-six people dead, 44 injured, some seriously. Many are local people. In the hospital we are all tired, physically and emotionally. The press arrive, then senior police officers and the Provincial Commissioner. The telephone never stops ringing with enquiries. And there is still much more medical work to be done.
Over the next few days there are many messages of appreciation for the care given. And, from our own minister, Rev Julius Nyaga: 'On behalf of all Christians in this parish and region, I thank you all for the effort and good spirit that I witnessed, the love to save lives . . I could not tell the nurse from the driver because of the teamwork . . Be sure that your work is rewarded by the Father'. Alison Wilkinson is a missionary doctor at the PCEA Hospital in Chogoria, Kenya
At the local accident blackspot, at the foot of a steep valley, a speeding crowded bus has failed to take the bend over the bridge, and plunged into the Nitbi Rivey 60 feet below. Passers-by have scrambled down the slope to bring the injured to the road, and passing vehicles are now bringing them to the hospital in steady numbers.
In the reception area Dr Gordon, our surgeon, rapidly assesses each arrival and gives instructions as to where they should be taken - the seriously injured need immediate attention, the less serious can wait to be attended to later, and there are those so seriously injured that nothing can be done. All our doctors are here, and all available nurses and student nurses, whether on or off duty, work smoothly together as airways are protected, IV lines inserted, injuries determined, management decided.
As I check where there is space for me to work, I find one man among the 'too seriously injured' who is sitting up and talking. His only problem is swelling in the neck and as this may or may not be serious he is transferred to the ward for observation. Next to him is a child of ten years who is restless from a severe head injury - and the pain of a badly fractured leg which will need to be cleaned tonight. The next man is already dead. Another man is brought in with acute abdominal tenderness - he almost certainly has internal bleeding and must be operated on tonight. The man sitting outside has only a small knee laceration, and some bruising. Later he may realise how fortunate he has been. The girl has broken both arms and one leg, but her facial laceration is small.
Elsewhere, others are also working. Dr Amos battles vainly to save the life of a man with severe chest injuries whose wedding he had attended ten days previously. He then has to go and break the news to the young widow, one of our nurses. In the resuscitation room Dr Mike is assessing a large man who complains loudly of pain in his chest - he does not feel the pain from his leg fracture, and must have a spinal injury, but it is his skull fracture which proves fatal.
At last it seems that all the injured have been assessed, and the initial management mapped out. I find a man wandering among the patient trolleys, looking for his relative who was on the bus. I check on his behalf but find no-one of that name - and we both know that means he must be among those who have not survived. Our parish minister is around. He came to offer help and to be among the distressed, but found his nephew among the injured. Fortunately he is not seriously hurt.
In the ward, nursing staff are coping admirably with the many admissions. I look into theatre where Dr Gordon and his team have several more operations to do. It is now well after midnight, and there is little more I can do to help, so I head for home, knowing that others have a full night's work ahead of them. Tomorrow the less urgent injuries will be more carefully assessed, X-rayed, operated on, plastered, put in traction.
Next morning, the whole community is stunned. Fifty-six people dead, 44 injured, some seriously. Many are local people. In the hospital we are all tired, physically and emotionally. The press arrive, then senior police officers and the Provincial Commissioner. The telephone never stops ringing with enquiries. And there is still much more medical work to be done.
Over the next few days there are many messages of appreciation for the care given. And, from our own minister, Rev Julius Nyaga: 'On behalf of all Christians in this parish and region, I thank you all for the effort and good spirit that I witnessed, the love to save lives . . I could not tell the nurse from the driver because of the teamwork . . Be sure that your work is rewarded by the Father'. Alison Wilkinson is a missionary doctor at the PCEA Hospital in Chogoria, Kenya
