Recently I was asked by the wife of one of our pilots, if I could visit a patient in the hospital. According to the story we heard, two people had been killed in an accident while chopping wood. Bianus, our patient, had tried to come to their aid and was seriously injured in the process.
Bianus had an open wound, a broken fibula and tibia in his right leg, and two less complex fractures in his left leg. After almost a week, the doctor conducted a surgical debridement, where the dead tissue was surgically removed. I looked at the x-rays with the Dutch doctor, and we agreed that based on the complexity of the fracture and the infection of the open wound, it would be best to transfer him to a hospital on the coast.
Our pilot asked Aviation Organisation (MAF) if they could fly him there. The doctor inquired with a colleague about the best hospital for treating trauma patients. We thought we were all clear for transferring the patient to the coast. Far from it! Bianus is still a minor and his family decided against having him transported, because he has relatives here in Wamena who could look after him – even though one of them could have accompanied him to the new hospital. The family turned a deaf ear to all of our logical arguments and western ideas about what better medical care looks like. It reminded me of just how communal the Papua people are and how often they let things happen, discussing matters for a long time and allowing the level of suffering to become disproportionately great before a decision can be made and change can take place.
After three more weeks, a doctor in Wamena performed an operation on Bianus’ fractures. The x-rays looked good, but we were still concerned because the wound still appeared infected. In western countries, one would first treat the infection and then the fracture, because the intramedullary nailing procedure (using a long metal pin to secure the broken bones) can transfer the infection to the bones, which is highly dangerous … (… to be continued)