When Donna Harris received a message on her answering machine from a medical mission outreach office Feb. 8, she thought it was a solicitation for donations. “I just deleted the message,” she said.
Her husband and son have participated in numerous mission trips across the globe, so calls like this aren’t uncommon in her Tifton, Ga., home.
What the caller didn’t say was that her son, Jeff, was in serious condition after a jeep accident in Bangladesh. She’d find out later, in a phone call from his fiancée, that Jeff was being airlifted to a hospital on a nearby medical base.
“She said they didn’t know much, but if there was further need for surgical or medical treatment, he would be flown to Japan or Australia,” recalled Mrs. Harris. “We started thinking about how we’d get to Japan. Then we made phone calls to friends and church family. News went all over the Internet with our friends, and strangers even, praying for him.”
Jeff,
a fourth-year medical student at the Medical College of Georgia, anticipated
plenty of adventure when he embarked on a three-week medical mission trip to
Bangladesh in February with 18 other MCG students, faculty, residents and staff.
But he didn’t expect to be on the receiving end of the treatment. The best-laid
plans….
The trip was organized by Dr. Walter F. (Ted) Kuhn, professor of emergency medicine, and his wife, Dr. Sharon Kuhn, assistant professor in the Department of Family Medicine. MCG’s Emergency Medicine Program allows medical students and emergency medicine residents to travel to Third World countries and treat underserved populations through an international medicine elective. Other members of the health care community often participate as well.
“The experience is mutually beneficial, with the physicians educated and enlightened by the experience,” said Dr. Kuhn. The trips generally last one to three weeks and take place in primitive environments such as villages in the Peruvian Amazon, remote towns in Myanmar and the Masai region of Kenya. Accommodations often consist of sleeping bags under mosquito nets. Most of the trips, including the Bangladesh trip in February, are co-sponsored by Mission to the World, the missions-sending arm of the
Presbyterian Church in America based in Atlanta, but no religious affiliations or participation are required of MCG team members.
There
are risks involved with travel to the developing world. Among the precautions
the Kuhns take is ensuring that each team has at least one leader knowledgeable
about the region’s diseases, evacuation procedures and other safety factors.
Four trained leaders accompanied the Bangladesh group.
“We rate areas we visit by risk factors, everything from political instability to climate to distance from a quality health care institution,” said Dr. Sharon Kuhn. “On high-risk teams, we also send a fully equipped bag for emergencies that includes rescue and resuscitation equipment, cervical collars and splints, a stretcher, emergency medications, IV fluids, a laceration repair kit – everything you need until you can reach more definitive care.”
The Kuhns also extensively train with students before departing, emphasizing areas such as culture differences, wilderness medicine preparation and water sterilization. “We encourage them to get appropriate immunizations and malaria prophylaxis to keep them safe,” said Dr. Sharon Kuhn. “But we don’t understate the risks. We want to make sure they feel the goals are worth the risk and we do that up front before we leave. It’s important to be sure they know as much as possible before committing to the trip.”
The training proved invaluable during the February trip to Bangladesh.
The first few days of the trip proceeded as planned. The group arrived in the village of Ruma and set up a free medical clinic in a church. Jeff wrote in his journal Feb. 5:
We arrived to flags waving “Free Medical Team,” and a crowd gathered outside the church. Our names were announced and we were welcomed with flowers. A family had given up their home across from the church for our medical team to stay in and many families gave up their blankets to ensure that we had enough to stay warm in the cool mountain nights. Our days started around 5:30 a.m. to a chorus of roosters outside our thatch-walled house, and I usually crawled under my mosquito net by 8:30 p.m., exhausted.
That same day, MCG medical student Christy Lawson wrote,
Today, a beautiful young woman came into clinic bringing her adorable baby to meet one of the doctors who had been on the trip last year. The young woman was healthy, the baby growing beautifully. A year ago, this woman had been near death. She had chicken pox and developed encephalitis as a complication. She was brought to the clinic with active seizures, low blood pressure and a high fever. The only thing they had to give her were three antiviral pills and IV fluids. The doctor prayed, asking that Jesus would spare the woman and her child. Amazingly, both lived. The woman asked this doctor to name her baby. Today, she brought Hannah Grace to meet the doctor who prayed for her and named her.
Only
two days later, it was Jeff who was in the grips of a medical crisis. The MCG
group was traveling in jeeps to their base camp when the second jeep in the
caravan stalled on top of a hill. The engine died and the local driver lost
control of the vehicle. The driver, two Bangladeshi pastors, Jeff and two of his
classmates, Meredith Welch and Jenny Hill, plummeted down a 30-foot ravine.
Christy witnessed the accident from another jeep in the caravan. “I couldn’t tell if it was flipping or not; there was a huge cloud of dust,” she said. “It all took a second or two; the jeep fell over the edge of a ditch and I couldn’t see it anymore. We sort of sat there in stunned silence. Then I was out and running.”
Looking down into the ditch, she was stunned to see the jeep had not flipped, but fell into the ravine basically intact.
“It looked as though someone had picked up the jeep and placed it at the bottom of the ditch,” she said. “It looked physically impossible.”
But she was jolted from the surrealism of the scene when she saw Jeff being pulled from the wreckage. “I made it to him just as they sat him down on the ground. His face was covered in blood. He had a gash on his scalp. And what frightened me the most was that his pupils were dilated so dramatically, I couldn’t seen any of his iris.”
Jeff was briefly knocked unconscious, then awoke “wet with blood, not being able to feel my arm and looking around and seeing that everyone else was still asleep, or passed out in the vehicle,” he said.
Adrenalin, instinct and years of training kicked in for the other members of the team. “It was amazing how well-oiled the team was,” Jeff said. “We had three emergency medicine-trained physicians with us. They had an emergency bag that we always kept on hand. They started putting pressure on my head laceration, washing it out and stapling it up, immobilizing my neck.”
Later in her journal, Christy lauded the efforts both of the MCG team and local villagers who responded to the crash.
I will forever be amazed and grateful at how quickly and efficiently [the local people] responded to the accident, mobilized their limited resources and got my friends to a hospital for medical treatment. I will forever be amazed and grateful at how collected, calm and together Dr. Kuhn was through the entire ordeal and how well he marshaled us all to respond well and efficiently. He is an incredible leader and physician.
The team worked quickly to triage the crash victims. The nearest hospital was hours away by vehicle, so Bangladesh police, who were escorting the American team through the jungle, radioed to a nearby military base.
“It seemed to take forever to get Jenny out of the jeep,” said Christy. “Meanwhile, two of the ER doctors had gotten to Jeff, and I went to Meredith. We prayed that Jenny would be OK. [By the time she was pulled out of the jeep], she was awake and confused. She had no idea where she was or what we were doing, but she was awake.”
The driver “was pulled from the jeep and immediately put onto a boat headed down river,” Christy said. “Apparently, his friends were worried that we would place blame on him and that he would be in trouble with the military.”
Meredith insisted that she didn’t need further medical attention, so the team loaded Jeff and Jenny onto a military helicopter heading to the Bangladesh port city of Chittagong. Drs. Ted Kuhn and Dave Hunter, a neuroradiologist from St. Louis, traveled with them to translate and help coordinate their care.
“It was about a 45-minute flight,” said Jeff. “I was staring at the ceiling, wondering if my neck was broken but confident that I was in good hands.”
Jeff was greeted by military trauma doctors who “treated me very well. They were anxious to do anything they could to help.”
Jenny was diagnosed with bruised ribs which, though painful, would heal on their own. Jeff’s X-rays indicated a possible neck fracture that necessitated a 75-minute flight to a larger hospital in Dhaka for a magnetic resonance imaging test. But until the flight could be scheduled, he lay motionless in the hospital bed in Chittagong.
“It was such a unique night,” said Jeff. “I spent 14 hours staring at the ceiling in Chittagong. It was my first experience being a patient.” He wrote in his journal,
“One nurse, Daneul, was very friendly and knew a smattering of English. We became friends overnight. He actually stayed after his shift was over to see me off to the transport. He taught me several words in Bangla and told me, ‘You are very nice.’ He asked me who I liked better, Bush or Kerry. I laughed and replied, ‘Both.’”
Once
he was transferred to Dhaka, the news took a dramatic turn for the better. A CT
scan and an MRI confirmed his neck wasn’t fractured after all. The next step in
his treatment? Warm showers and phone calls to reassure friends and family.
Three days after the accident, Jeff and Jenny were back at work in the clinic.
“It was a great reunion,” Jeff recalled. “This really pulled our team together in a wonderful way.”
Tired and sore, but ready to serve, Jeff resumed duties analyzing blood, urine and stool samples. With his shaved head, stitched head wound, black eyes and swollen face and neck, he was quite a spectacle for the villagers.
“One lady asked, ‘Does he paint his face for decoration?” Jeff laughed. “I was also called ‘raccoon’ a lot.”
As unforgettable as the accident was, Jeff insists his most lasting memories are of the people he met. “They are a very warm people, very hospitable and self-effacing,” he said. “They would come in the clinic and place their hand over their heart, then shake your hand as a gesture of appreciation. They routinely thanked us profusely. They hosted a farewell party where they danced for us and brought us flowers.”
His own health crisis notwithstanding, he encourages his classmates to consider incorporating international medicine trips into their MCG educations. “It’s hard to overestimate the impact of going to another culture and giving of your time and resources to people who are appreciative,” he said. “Christ’s love and health care are two universal languages that communicate caring in a powerful way. I think these trips bring out the best in us all and really solidify the relationships formed with classmates. It’s also really neat to see faculty members in a different setting.”
The Kuhns concur. “To practice medicine with people who don’t have access to care is very gratifying,” said Dr. Sharon Kuhn. “It’s rewarding to see the effect that you can have on people’s lives.”
Jeff will never forget the lessons learned being on the receiving end of intensive medical care. “I think I will be much more compassionate to people who are hurting – remarkably more compassionate,” he said, “because I realize what it’s like to lie in a hospital bed, stare at the ceiling, be in pain and really helpless to do anything about it.”
Visit their web site for more information about the MCG Emergency Medicine Program.
--Ellen Gladden