One of the patients who had a bad finger injury hadn't come back to get his dressings changed like he was supposed to the last few days. After a quick discussion, Digama went to go track him down in the village. This man means business.
After a huge lunch with chicken (an attempt to slow gorettis rapid weight loss and stay her surly temper (purportedly caused by the sudden dearth of steak)), Connor and I walked to the village to see the festival that was going on. We stayed there for a while and on our walk back noticed a larger than usual commotion outside the high school. One of the students biking by us said something about a broken arm. We sent the kid to go find Biku and then increased our pace towards the school.
Three quarters of the way down the path, a huge crowd of kids was surrounding the injured student who was being carried in an older kids arms and wincing in pain. They were half-jogging and bouncing the injured arm way more than necessary. Using mostly gestures and a commanding voice, I had them stop and lay the student down. I sent Connor to go grab the nurses and tell them what's going on and some of the older kids to go find the principal. The student had a pretty clear elbow dislocation but no way to know if there were fractures too. I sent some of the students to get gamuchas (the upper half of a common outfit for males here) and some others to get a bench for me. A couple of the students in the crowd had been in the first aid class and knew what I had in mind. When the principal came up, I had him clear the growing crowd of spectators as I completed a secondary assessment. I wasn't able to ask anything I couldn't pantomime to the student but it was alright. Using his belt as a makeshift splint gave the injury a little more support. The nurses and Digama arrived at the same time as the gamuchas and bench. Anna added a swath to immobilize his arm further. Digama wanted to take it off and set the arm right there but the foreigners insisted we take him back to the hosptial to give him analgesics and get him out of the sun and crowd. We tied him to the bench and carried him back before giving him some IV medication and helping Digama reset the elbow. The he built a splint/sling with tongue depressors and bandage wrap. It would not have been passable in a western hospital, but would have made an okay wilderness splint. He will go get an x-ray tomorrow only at the insistence of the nurses. His mom arrived midway through and then he got on a motorcycle for an uncomfortable ride home between his two parents.
The more I practice and train in wilderness medicine and Ems, the more comfortable I feel handling these situations. The first moments when you walk up to a scene are often the most crucial. In addition to being competent, it's important to be able to project confidence regardless of what you feel. The language barrier seemed like a bigger problem than it turned out to be and it helped that the injury was minor. I don't have to use wilderness Med training very often but it's great to have when its needed. Connor is now completely set on getting his EMT certification when he goes home.
We went to go play frisbee at the school for the first time in a while and on the way back, one of the villagers I haven't met yet stopped me. He said something about how amazing it was that I was able to help the student earlier and something about how even doctors here don't know how to do that. While that's definitely not accurate, it was a nice sentiment.
We're planning to teach some more first aid to other classes so that the next time something an injury happens, they'll hopefully be able to get them to the hospital without further harm.
We finally watched star wars and the power only went out once during the movie. It was way hot though and some of us fell asleep.
A quick dinner and then sleep. Goretti is feeling pretty sick. I'm a typical Indian fashion, Biku keeps trying to push more medications on her despite the fact that Anna and Christina have already given her meds from their first aid kit. He doesn't believe there could be any way other than his and doesn't seem to understand why they aren't unquestioningly obeying his sage advice.
-AB
Falling out of trees
Can dislocate your elbow
Digama can fix
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