Week 3 Kruger Park 28th Nov 11

Week 3 Kruger Park 28^th Nov 11

The last leg of the trip ends in Kruger National Park. Cruising the beautiful hot bush seeing the big 5- Lion, Rhino, Buffalo, leopard and elephant…. Not to mention…. Giraffe, baboons, impala, hippos, crocodile, wild dogs, fish eagle, water hog, kudu, steenbok, zebra, genet and hare just hanging around their bush land.

The last couple days chilling with cheeky monkeys and bush buck surrounding me like a character in the Bambi movie.

Finally as I lie swinging in my hammock over looking the Kruger park planning my return as I need my Bara trauma fix!

Not to mention there are more papers to write and publish for USAR and SA/UK trauma, more conferences… furthermore professional developments to pursue and friends/colleagues to correspond with in SA and advance international clinical working.

So like a duck to water.. a 3^rd return is scheduled.

Week 2 Trauma in Johannesburg – 22nd Nov 11.

Week 2 Johannesburg – 22^nd Nov 11.

After some interesting further days in Cape Town, I head back again to Johannesburg. The flight was entertaining I do meet an array of friendly and innovate people on my travels, here people actual talk to you therefore your encounters are opportunistic.

Arriving in JHB severe storms and lightening, rain does tend to follow me. Returning to JHB a second time I felt more confident and less apprehensive compared to my first visit with trepidation- familiarity breeds contempt.

This weeks my days consisted of pre-hospital response car on the roads of JHB, how I’ve missed bombing around the roads at 180kmph while experienced paramedic J is on 2 mobile phones and the radio weaving around heavy traffic who frankly do not move.

The days consisted of Motor Vehicle Accidents (MVA) and Pedestrian Vehicle Accidents (PVA), assaults, anaphylaxis’s,  medical conditions, collapses. Last MVA P1 off one of the days- entrapment in vehicle side been taken straight off, severe head injury and deep laceration anterior to posterior scalp, humeral and ? femur #, ? pelvis.

Only in Africa the tow trucks get to the accidents quicker than the EMS as they get paid to inform the companies and tow. It’s a confusing system but sometimes all EMS respond the private companies and government then depending on the patient and care needed either with ALS paramedic or ILS crew will go to the most appropriate hospital with the patient, but other days lone ALS responder attends just depends on how busy the city is. Patient today allergic reaction was unwell enough to go to a private hospital but did not have medical aid… however she was not sick enough for the government hospital…

Hilarious vision this am on a blue call to a incident- lights on and sirens driving fast on the slip road  as rush hour when some cheeky guy was following behind just to get through the traffic… so stopped the response car asked him what he thought he was doing in return he shrugged his shoulders then proceeded to get into the normal flow of traffic… Africa!

And so the days continue with picking up guns visiting the police station and many more pre-hospital calls. More MVAs, some P4 which in South Africa’s triage system is dead rather than in the UK it means lower priority and can wait for up to 2 hours.

Shame no Bara shift but that means I have to come back even earlier now- addictive Bara trauma unit needing that resus room and wanting to help those people...

Friday night 3.30am call- shooting with suspects still actively shooting. Location rural farm other side of town. Male, gun shot chest entrance and large exit  wound probably shot through posteriorly and shots x 2 bilateral femur. Lung parenchyma seeping through gun shot wound on the right chest, transmediastinal GS wound with trajectory, on auscultation fluid, bubbling sounds throughout chest. GCS 14/15, sats 90% o/a, 15 L 02 sats 92-94%, 90/54 p122, 2L hartmans insitu. With sounds of further shooting in the back ground, call for police assistance and the heli ordered. On arrival of the heli the road was closed and the patient eventually got air lifted.

We went to Jburg Gen the next evening to find out the outcome- patient went to theatre we think but we had some information he was waiting for CT chest report? Anyway he was on a high care ward- not ITU. That’s incredible- these folks are robust and do not die easily!

SA trauma return....

Arrived 13^th Nov 2011-11-22 – week one

Well  I have finally returned as I promised in April. A few tough months.

The 14,000 word paper has been written and some presentations delivered, the blog has been published and I spoke at the RCN conference in Birmingham 1 day before about the SA trauma experience, and the Florence Nightingale conference is next March as I have been asked to present the travel scholarship award section.

Returning is heart warming and familiar in Cape Town- the roads, the people, the culture and table mountain covering the landscape with such presence and power. Deep breath of the mountain and sea air, its good to be back in this beautiful city, especially as I know my way around confidently competing with the mini bus taxis.

Nervous and excited my 2^nd conference to present, this much bigger - the international emergency care conference in Cape Town.

Day one USAR Urban Search and Rescue at the Disasters Management Centre Tygberg Hospital, so good to see Prof K again very pleased to see him, also met Trevor Glass chair International Search and Rescue Advisory group INSARAG  and disaster management Australia an experienced S African, among other lead Drs and profs. Excellent day lectures on USAR and then off to a disaster site for practical exercises- like my last weekend antics USAR training in the UK, nicer place though.

The warmth on my skin from the cape sun and the warmth from the SA people is delightful. And so prepping for the conference, and seeing old friends and influential leaders.

Now the international conference centre in Cape Town is an amazingly large grand professional high tech building stretching a part of the city – I looked up with a slight feeling of anticipation followed by a feeling of  exhilaration. The Emergency Care conference was a proficient affair, clinicians and profs from around the globe attending. The medical stalls and stands where impressive and displayed the latest technology and expert clinical management. Good to meet the medical/trauma leads again- EMSSA/ENSSA, Net.Care, kind hearted welcome backs from the organisers and praise on my paper they had read.

The ENSSA leads delivered powerful SA nursing presentations and even quoted Barleycorn 2011 in the lectures and thanked me to the crowd. The passion of the subject is something I agree with and hope to make a difference too. My humility augmented even more.

I have also been able to spend time with the INSARAG United Nations medical and operational working group- where USAR medical and operational leads representing different countries come together to discuss and create INSARAG methodology and guidelines. 

And so onto the conference day I spoke at 17^th Nov- my name published to present in the thick distinguished international conference document. No pressure then..

Nevertheless thankfully it went very well and the audience where receptive on my presentation on USAR- ensuring medical competencies. Prof K was very pleased who run the USAR seminars – that was really good, his praise is one from a experienced professional who is head of EM J’Burg and FIFA, USAR in SA and that’s just for starters. In a male dominated doctor environment I was a political pawn- my subject, gender and profession!

So now to relax, chill before I head back to J’burg to work prehospital and back to Bara!!

Saving Soweto - 24 Hours of Trauma - 9 Jan 09 - Part 2

Saving Soweto - 24 Hours of Trauma - 9 Jan 09 - Part 1

At the end.....

Rain followed to Cape Town! Alas…… so only tiny bronzing for me but rest in the Cape… sun appeared for my last two days though!

Last trauma meeting pleasure to meet President Trauma Society/Clinical head of trauma and transplant surgery Elmin Steyn what a lovely lady!! Very informative and knowledgeable, very lucky to have spent time with these trauma leads in SA. I also was shown around the Vincent Pallotti trauma/emergency unit and met the manager. J 

So 7 weeks later….

2 cities- Cape Town and JHB

9 hospitals private and government

4 airports

4 heli pads

1 response car

5 ambulances

Many prehospital shifts

Many more clinical hospital shifts

1 blogg

114 photos

£1000 on car hire

£400 on airtime

Signed numerous disclaimers on my life

9 meetings with SA trauma and medical leads

68 destinations into my GPS… and only 4 times dummy out of mouth in getting lost.. okay perhaps 5 J!

I recommend if you would like the clinical and cultural experience…. you have to come here! You need 3 prerequisites as stated by the infamous Prof K:

1) Thick skin

2) Sense of humour

3) Good personality

That man is always right…. You will then have a rewarding adventure!

Many thanks to the Professors, trauma leaders, EMSSA/ENSSA, Trauma Society, GS Hospital, Bara Hospital, Private Mediclinic, Net.Care, Stellenbosch Uni, Wits Uni, prehospital- western cape metro, Gauteng- heli, ER 24 ……and to all those who put up with me, looked out for me and the wonderful friends I have made and relationships strengthen ….. I am very sad to leave, very sad….!!!!! L

South Africa is beautiful and very moving, it encompasses all of the aspirations of the people to seek progress and improvement- with hope in its heart despite the challenges. I have had the pleasure to experience the real life of South Africans condemned to suffer extraordinary violence and disfigurement and disease, whilst the country itself is a beautiful landscape and offers great promise. You work hard at life here, but the rewards are endless, the South Africans love their country very patriotic and will fight for their rights, liberty and power. I have the up most respect for all here…. Be heard as you have to expel a voice here. It kind of reflects my own values.

The paper now needs to be written for journals international and UK …. Presentations carried out UK and SA- recommendations and experiences passed for others to learn.

I have learnt personally, spiritually and professionally I wish to pass this on sharing and growing, with international collaborative working for the nursing profession and the benefits of patients worldwide.

And so the travelling ups and downs, idiosyncratic moments, challenges, pushing the boundaries of the self, the achievements, the inspirations…

But most of all my humility has been augmented……

Homeward bound……. Not ready to leave… L

Who knows what will come of this….

I certainly will be back that’s booked already….

The journey hasn’t ended its only beginning……. J J

JHB.... WILL and onwards

Now my car…. Firstly I have got a speeding fine and secondly when my hire car was delivered in JHB it was brand new … yes brand new. On returning huge dents which look like I have run someone over as red sand is splashed up the side…. I didn’t nor did I crash it!

I did go out and see Goldfish live... well done SA!

My flight from JHB... jeez its a confusing airport I had to pay a dude to direct me to the car rentals. Anyway as I boarded the flight as I was the last on because I let everyone else get on first?! There then appeared to be no overhead bag storage, so the air stewardess preceded to march of with my bag, laptop and all- I did spit a small dummy out as I felt slightly uncomfortable about all my belongings taken off me after all I had survived JHB so far. My fears where somewhat confirmed 1 hour into the flight when I asked the girl for my bag... my bag please... where did you put it?.... silence then denial she took it for me... so I had to go through every overhead locker in the entire plane. As you can imagine after 45 locker heads later and lots of banging and redness from the air crew I finally found my bag.... incidentally the whole plane clamped with relief... probably because I didn't take their bag!! Note to all please...

Wow I am exhausted from JHB and worked so much but what an amazing experience…. the culture, history, violence, crime, the disregard for life, corruption, inequality, poverty, expectation, racism and classism- an anthology all living side by side. The differences are vast and I have understood why it is that way - culture heritage seasoned with a long history of apartheid and some politic drives- its all multifactoral! A stunning country full of contrasts embedded in a beautiful land.

Onward to Cape Town to rest, see the sun, table mountain and one more trauma meeting …. wonderland city at its been quoted, one of the most beautiful place’s in the world I believe. J

I would like to reflect on one of Nelson Mandela’s quotes;

WILL

“There are few misfortunes in the world that you cannot turn into a personal triumph if you have the iron will and the necessary skill’

That’s why I am here, how this adventure came about, in your darkest moments you can conquer and grow stronger but hey that’s another story!...

And it’s not over yet!......