UN PICCOLO MIRACOLO A SOLOLO, 29 settembre 2012
Sembra una favola, ma quella che vi riportiamo così come l’abbiamo ricevuta è una storia vera, successa a Sololo nel settembre scorso, mentre il dottor Francesco Mari di Chieri sostituiva il dottor Bakara, in vacanza in Italia.
Alkano, un bambino di 12 anni con il cranio sfondato a causa di una sassata, arriva all’ospedale di Sololo trasportato per 10 Km con un mezzo di fortuna. La lettera racconta del delicato intervento di neurochirurgia a cui il dottor Mari ha dovuto sottoporre d’urgenza il bambino, che nonostante un primo intervento fatto per ripulire la ferita stava peggiorando visibilmente e non muoveva più il braccio destro e la gamba. La sala operatoria di Sololo non ha che poche ed essenziali attrezzature e non è di certo adatta ad interventi così delicati…
…a novembre Sister Judith ci ha assicurato che il bambino parla di nuovo, mangia da solo e cammina!
A CLOSE SHAVE BUT A GREAT SAVE
Sololo is a little known town in Eastern province, 800kms from Nairobi and 70kms from Moyale.
It was 28th September 2012, a Friday at 5:30pm, the week had taken a toll on me with tiredness making me long for a good rest over the weekend, but that was not to be.
A call from the General ward informed me to go there ASAP as there was an emergency.
I was met by a crowd of people surrounding someone, you would have thought a famous politician had come to the hospital.
A 12 year old had apparently been hit by his brother by a stone on his head, after a childish dispute. They had travelled 10 kms on the back of a motorbike all the while gushing blood from the wound. When I examined the child he was unconscious with minimal response to pain.
We took the patient to theatre where we found twigs and sand in the wound, it was unbelievable how such a small gape could shoot a lot of blood but that is akin to scalp injuries. After a procedure called surgical debridement i closed the wound.
We thought it was over, how wrong we were; it was just the calm before the storm. The whole night the patient was writhing and groaning in pain to the chagrin of the nearby patients who did not sleep a wink.
The next morning we noticed by a score of consciousness called GCS, that his condition was worsening, moreover, he was unable to move his right hand and leg. A skull X-Ray confirmed a depressed skull fracture. This causes a dangerous condition called Etradural Hematoma which is a neurosurgical emergency. This is a condition where the broken skull bone ruptures a major blood vessel supplying the brain causing compression of the brain tissue underneath. This can cause eventual death when the pressure in the non -expanding skull vault causes downward displacement and compression of the brainstem that controls breathing.
Emergency surgery was his best option. The problem was that this type of surgery needed a neurosurgeon that is found in a level 5 Hospital, this would mean 500kms on rough road, and the child could not survive the journey. Secondly, his family was financially challenged, his father at the time was in Nairobi where he works as a watchman.
Thank God, Dr Francis Mari a visiting surgeon had some experience in such surgeries and operated in Haiti and Uganda. After the family consented he was taken to theatre the second time where despite lack of specialised equipment we did a minor craniotomy where we elevated the broken skull bone and tied the bleeders and later replaced back the bone.
The boy improved considerably within two weeks, he regained consciousness, was able to eat by himself using his left hand, sat with assistance. Of concern though was that he was still unable to move his right hand and leg but could feel a pinch, his speech was limited only to 2 words abo( father) and ayo( mother). This was concerning to us, he needed a CT scan to assess his injury and a referral to a neurosurgeon.
He got a financial boost, thanks to Dr Francis and friends. He was taken to Kijabe Hospital where he was assessed with the help of a CT scan. He needed a 3rd surgery, which he successfully underwent.
He was recently discharged from Kijabe with movement of his right side, walking with assistance but speech is not fully recovered.
Halkano is the 12 year old boy who had a close shave with death, but had a quick save thanks to the help of the Sololo Hospital staff and our partners. Dr Francis we salute you.
By Dr. Samuel Iluu Munyungu.
Medical Officer Sololo Hospital.
