20 Dec 2020

"We have a trauma patient in the ER," the nurse came to inform us while I was seeing consults just outside the operating room and Andrew was operating. "Okay, bring him here." The patient was carried in, bleeding through a bandage on the back of his head. I removed the gauze and found blood and another gray-white substance seeping from the wound. I placed a new dressing temporarily until Andrew could finish his current case and bring this one into the operating room. The patient was still alert, answering questions, and seemed to have no neurological deficits. Maybe he wasn't even aware of the seriousness of his wound. Today, Andrew would get to be a neurosurgeon.

Another trauma in the ER. No, two more in the ER. Arrow wound this time. Superficial--cleaned, dressed, and sent home. Another patient with gunshot wound to the shoulder. X-ray showed a shattered distal clavicle and empty space where the AC joint should be. But he wasn't bleeding much, and had no deeper injuries. Wound care, pain medications, and prophylaxis. I continued seeing other routine consults and then went to the administration office to sign some paperwork. I heard a wail go up from a crowd that had gathered just outside the hospital gate. "Did someone die?" "I think it was the patient in the OR," the accountant offered. No! I hurried back to the OR pre-op area and found him alert, breathing, and talking normally. Apparently the crowd was mourning a newcomer who had died immediately on arrival. How many people were involved in this??

We see knife wounds and arrow wounds periodically from skirmishes between farmers and ranchers, but this was more firepower than we were used to and more victims of the violence at once than I was used to seeing.

Over the next few days our friends and coworkers told us of family members killed in the fields, took days off to go to funerals, and were afraid to go out to certain areas or at certain hours. We stayed on the compound. Not that we had time to leave the compound anyway. A similar situation had happened in a village not too far away a couple of years ago, but this time it hit very close to home.

Then, just as suddenly as it began, the cattle herders moved out to another area to break the cycle of violence. Local authorities enforced the peace. Patients began to venture out again to seek medical care for normal things like malaria.
War is over for now.