Personal Views

Burundi … an illustration of the problem

BMJ 1997; 314 doi: (Published 28 June 1997) Cite this as: BMJ 1997;314:1914
  1. Christina M De Wind, surgeon for World Vision
  1. Burundi

    They arrived in the night of 7 November, a lorry load of wounded from a town near the Zaire border. Twenty five people with gun shot wounds and bayonet cuts, sustained at an “incident” two weeks previously. By the time we had unloaded them (a slow process as we have only one stretcher) and put them to bed, the smell in the ward was quite unbearable. The only treatment they had received so far was dressings: clean bandages hiding filthy dressings inside and those covering a wide variety of infected, purulent, and gangrenous wounds. Patients were all dirty, malnourished, and in pain.

    To simplify things for the night staff–one qualified nurse and one auxiliary–I prescribed amoxycillin and paracetamol for all, adding sleeping tablets for some. Nobody was willing to give much of a history. They said they were not sure on which side of the border they were when it happened. You do not ask too many questions anyway.

    We had just opened our clinic one week before, a small Christian hospital in downtown Bujumbura, set up by a local non-governmental organisation (NGO) together with World Vision and sponsored with American money. Everything was still new: staff, equipment, and management. Only the building was old, and renovations had not yet been completed. The …

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