Thursday, December 26, 2013

The Mangled leg...

Me having a "conversation" with a bystander as I support this man's fractured femur 
Madison came running downstairs as I was talking on the phone to a friend in the States.  She tried to interrupt me, and I gestured to the phone inaudibly saying, "I'm talking on the phone!"  She said, " need to listen!  There has been a motorcycle accident right outside and someone is groaning."  I threw the phone to Mike, and ran out to take a look.  Mike took over, stopped me, so he could assess the situation for danger.  Once he gave me the "okay" I grabbed my emergency kit and ran out the gate in my flip flops, shorts, and putting on my gloves as I ran.

The scene I came upon was a man on the ground, and people starting to gather.  No one was rushing to his aid, cautiously standing back and not doing anything.  I approached the man who was groaning to do a quick once-over - and ABC assessment.  Only a small puddle of blood near his foot, he was breathing, and moving.  Then I looked at his leg.  His upper leg bone was bending at a sickening 45 degree angle. His lower leg was flopping around.  I could only partially assess him as the motorcycle he had been riding was partially laying on top of him.  I looked to the bystanders asking if anyone had called an ambulance, and their response was, "we did...but no one answered."  "Okay," I said, "have you called the police or anyone else?"  There were minor grumbles, and no obvious responses.  I didn't hear any sirens in the distance.  I then requested people to help me move the motorcycle and was given the reply, "NO!  We are waiting for the transit cops, we can't move the motorcycle."  Now, knowing this is the law here, that the transit police must assess the situation for fault and to figure out what happened, but I just shook my head in amazement.  No one had come to his aid.  No one had comforted him, no one was even touching him except me.

I looked at the taxi driver who was standing next to me, and I said, "what is more important?  Waiting for the transit cops, or helping this severely injured man?"  To which he replied, "We have to wait for the transit cops!"  The anger and frustration spewed over onto my face, that no one was going to mess with me.  So...I moved the motorcycle...because no one else would...and no one stopped me.  I then could get a better assessment of the situation.  He had sustained a large laceration to his foot - thinking about 30 stitches or more would be needed, and I could get a good view of his leg.  Since no one else would help me, I had to try and do the best I could.  I asked him his name, "Francisco," was his response.  "Where do you live?"  "Nearby he said."  He seemed appropriate to location and name.  His eyes were completely dilated.  I supported his leg with one hand, while I assessed for damage to the rest of him.  He finally stopped, looked at me and said, "Is my leg still there?  I can't move my leg or feel my foot."  I assured him that his limb was still intact, he simply couldn't feel it because he had severely broken his leg.  Why it wasn't a compound fracture (bone protruding) was an amazing thing to me.  I have never seen a leg so twisted without more damage being done.  He still had good pulses in his lower foot, so I felt a little better knowing that his fractured femur was not occluding any blood from going to his lower limb, or he that he had severed the femoral artery.

Mike had arrived at this point, and I told him that we needed to get him to the Emergency Room ASAP, and that the ambulance wasn't coming.  He started to go get the truck, when someone who had stopped said they could take him.  However, right after getting ready to transfer him to the truck, the fire department arrived.  Now...we have an INCREDIBLE fire department crew in the U.S.  Everyone is specially trained and has some sort of emergency medical training.  The paramedics in the US would have taken care of this immediately.  Not so here in Honduras.  There is very little emergency medical equipment on board a fire truck.  The two firemen jumped out of the truck with a stretcher (thank goodness), but not even a glove on their hand, no assessment of the individual, no c-collar, no splint for his leg.  But - don't blame the firemen - this is just not in their scope of practice.  I was just grateful for the stretcher.  I told the fireman to support his fractured leg.  We log rolled him onto the stretcher, and the two firemen, and four other by-standers lifted him to the fire truck, and away he went.

I went to bed that night thinking and praying for Francisco.  It made my heart sad that people were more interested in the police then helping this man.  It reminded me of the time in New York when I was carrying 150 pounds of luggage in three duffel bags when I fell down the entire length of stairs in the subway, and no one helped me.  People literally stepped over me, but no one offered to help.  My heart sank, because it felt the same.  At least I was there, lending a hand, offering a silent prayer for help and guidance.  I pray that Francisco will not lose his leg.  The probabilities are very high here.  The cost of orthopedic surgery is steep - having to pay for the surgery itself, and all the equipment that goes with it (x-rays, plates, screws, etc.) it is much cheaper to have an amputation.  It once again reminded me of the state of health care here.  It is desperate.  Few resources. Very little medicine.

Please join me in prayer for Francisco.

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1 comment:

Andrew Lloyd said...

Tsk. No one should have to be bedraggled like that, especially in such an unwarranted sort of manner. Kudos for being such a good samaritan, and an exemplar of a true, responsible citizen. Meanwhile, the victim should really be alleviated and lifted up in any capacity. Best of luck to the both of you, and hope you get to the bottom of all this real soon.

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