The Easy Day Was Yesterday

by Paul Jordan

  Once again we were on the move towards Butare following the military observer blokes. Thank God they were with us; I had no idea where the hell we were. The observer guys drove fast in their Pathfinder while I pretended to be in the Paris to Dakar rally, throwing the ambo into every corner trying to make some ground on the observers, but they always seemed to be waiting for me. This went on for another hour when Jon put his head through the adjoining window and asked how long it would be until we got there. I told him another half an hour and he informed me that they were both suffering from motion sickness in the back, and were preparing to open the hatch on the floor to vomit through. Any wonder, the way I was driving, but while I felt for them, I couldn’t stop laughing. Neither of them did vomit, but both looked like shit (and probably felt the same) once we arrived in Butare.

  When we arrived at the hospital we were told that there were no doctors on duty and that one would have to be called in. In the meantime, with some assistance from three nurses from Care Australia, we moved the sucking chest wound to a theatre we’d located. We put the bloke on the operating table and attached his drip to the drip stand — he was into his fourth litre of fluid. Jon and I went scavenging for more fluid and anything that could help this bloke, but found nothing; this hospital was worse off than we were. The patient was still bleeding quite badly when we were told that no doctor was coming, so we carried him back to the ambulance. Just as we were putting him in the ambulance, a doctor arrived, much to our relief. We got the sucking chest wound out of the ambo again and put him onto a trolley so Carol could do a proper handover to the doctor. The doctor, a Tutsi, took one look at the sucking chest wound, a Hutu, then got back into his car and drove away. We threw a few mouthfuls of abuse at this prick. After all we had been through to get this bloke to some proper medical care, our efforts were being rejected. We were at a loss. We thought of driving the bloke back to Kigali, but we wouldn’t get there until 4.00 or 5.00 in the morning. By then he’d be dead and we wouldn’t be back in time to return to Kibeho first thing in the morning. We thought of keeping him until morning and calling for a helicopter, but again he would be dead by then. All seemed lost.

  The nurses from Care saved the day by organising for the sucking chest to go to another hospital at a school called Groupe Scolaire. In the meantime, we had found a ward for the broken femur. The nurse there wanted some morphine for the patient so, while Carol organised that, Jon and I got the patient back into the ambulance. We moved off again towards Groupe Scolaire. The nurses from Care had arranged for us to be met at the front gate because the RPA providing security for the place wouldn’t allow us entry. Groupe Scolaire was only a 10-minute drive and we soon arrived at the front gate with the Care Australia nurses in front and the observers bringing up the rear. We were met at the front gate by a foreign aid worker driving a ute. We collected the sucking chest wound and loaded him into the back of the ute. There was no official handover — Carol gave the aid worker some hastily drawn-up notes and that was it. We made arrangements with Care Australia to return our stretcher to us at Kigali. The ute drove off and we never saw the sucking chest wound again. He probably died.

  I only had a general idea where I was so, once again, I was glad the observers were around as they knew the area well and took us back to the UN compound where they lived. The infantry and CCP vehicles had arrived there after being recovered from the bog and, best of all, they had a crate of coke with them. I managed to get a couple of bottles which I shared with Carol and Jon. It was a well-deserved coke that tasted bloody good; what a day! The time was 11.00 pm and we were all exhausted, totally rooted, and we still had to drive to the Zambian Headquarters. I didn’t realise how exhausted I was or how great the pressure was to get these guys to some aid, but once we had freed ourselves and had a drink of coke, I just felt like lying down and slipping into a coma. The drive back to the Zambian Headquarters took 30 minutes but seemed to take two hours. As we drove along the winding road I began to hallucinate that the road was going straight ahead. I could see the road quite clearly going straight and then I’d shake my head and realise that the road wasn’t going that way, it was going the other way. Had I not shaken myself out of this dream, I’d have driven the ambo off a cliff face. At the time, as my mind played tricks on me, I wasn’t concerned and the hallucinations attacked me the whole way back. I couldn’t ask Jon or Carol to drive; they had been working their arses off the whole way in the back of the ambo while battling motion sickness. I was so relieved to see the Zambian Headquarters gates appear in front of me.

  When we arrived back at the Headquarters we couldn’t go to sleep because the back of the ambulance looked like a butcher’s shop. There was blood and old bandages everywhere. It took an hour to clean up and disinfect the back of the ambulance so we could sleep in there and be ready to go again first thing in the morning. We’d used some of our medical supplies from the ambo so we restocked with IV bags, giving sets (used to deliver the IV fluid from the bag to the IV needle), IV needles (cannulas) and bandages. Throughout the afternoon we had used the patrol medical kits that we brought with us from the SAS, and these were open with the contents lying all over the place, so we refurbished these as well. We couldn’t wait to sleep and got our heads down as soon as the nightly brief was over. Thank Christ Lieutenant Tilbrook’s briefs were short and to the point. Jon was usually asleep when I got back to the ambo so I updated him in the morning.

  On Saturday we arrived at Kibeho at 7.45 am and were informed by a Jordanian UNICEF worker that the hospital was overrun with patients and that the MSF workers were not there. At this stage the UNICEF worker was the only foreigner in the camp. Carol, Jon, Rob Lucas (a nurse) and I went down to the hospital and saw about 100 IDPs who had either been shot or macheted or both. It was absolute chaos. I’d never seen anything like it in my life. There were bleeding IDPs all over the place. Their wounds were horrific. The first woman I saw had been hit in the face with a machete. The machete had gone through the bridge of her nose down through to her bottom jaw and all of this was resting on her chest, and she just sat there and looked at us with desperate eyes. ‘Fuck me,’ was all Jon and I kept saying to ourselves. There were people with massive cuts to their heads, to their arms and all over their bodies. One man had been hit across the head and his brain was clearly visible, yet not damaged. Later I saw a local nurse just fold the skullcap and skin over and sew it up. There were people with bullet wounds to various parts of their bodies, some with several bullet wounds and some just lying on the ground in a huge puddle of blood in the last stages of life. I saw a large box of bandages sitting alongside the IDPs and started to hand them out in an attempt to get them treating themselves. We just didn’t have the numbers to treat them all. The situation was just beyond huge, beyond anything I could ever have imagined. Yesterday we had nothing; today we were overwhelmed.

  Most of the patients were located in an area between two wings of the hospital, and we were pretty much covered from view and from the gunfire which we could hear coming from the other side of the hospital. Carol and I had a talk about the situation and agreed that she would return to the compound to prepare the CCP, and we’d triage the worst of them and send them to her on stretchers carried by the ever-faithful infantry. Jon, Rob and I started the triage process. But where were we to start? In the end we just grabbed the nearest patient who looked bad and gave him/her a priority of one, two or three — one being the worst. But we’d start on one person then another would appear in far worse condition. At times we were called on to play God and put people to one side whom we thought wouldn’t survive or would take too much time to save when that time could be better spent saving two or three other IDPs.

  Back in the compound, Lieutenant Tilbrook had organised his defences around the compound itself and had also established communications with AUSMED Headquarters. At this stage a mass casualty evacuation was declared.

  The Jordanian UNICEF guy wanted to point out some more casualties outside th
e hospital in the town courtyard. I saw about 30 people there; some were dead, but most were in the final stages of life. So I rolled them onto their sides to improve their airways and at least give them some chance. It had rained through the night and all the bodies were lying in pools of muddy, bloody water. Large numbers of IDPs began approaching me at this time with freshly inflicted injuries. This concerned Jon and me. It meant that the gunfire we could hear close by was directed at these people. People were being shot and killed in our vicinity, so we decided to re-enter the hospital and work on what we could manage for now. The Jordanian kept saying, ‘What about this one?’ and ‘What about that one?’

  ‘Yeh, wait on mate, there’s only three of us,’ I yelled over the sound of gunfire. ‘Here, grab one of these and start bandaging someone.’

  Jon and I continued triaging patients. I was treating a woman by the name of Maria (I remember her name because she was in the back of the ambulance all day) who had been shot through the hand and into her right lung. Her hand was quite a mess, but she only had a small hole in her chest about the size of a 20 cent coin. My first response was to treat her hand, but soon remembered the priority of treatment and began to treat her sucking chest wound, although there wasn’t a lot of air or blood coming from her chest. I listened to her chest with my stethoscope, and even though I really had no idea what I was doing, I knew the lung wasn’t working properly — this made her a priority one.

  Jon drew my attention to the patient he was treating. He had a very deep cut across his eye and through his face and another very deep cut through his chin and into his throat. Jon completely bandaged his face and had no fear of not maintaining an airway because the man was breathing through the slice in his throat. The man was fighting Jon the whole time and became difficult to manage, so he left him and moved on to another who wanted help.

  Jon, Rob and I continued to prioritise patients when the infantry arrived and stretchered the indicated patients back to the Zambian compound where Carol had prepared the CCP to handle the incoming patients. Most of the infantry had never seen a dead person before and certainly had never seen such ruthless carnage but, just like everyone else, they drew down the emotional curtain and got on with their business. The Infantry (in true grunt style) were tireless in their efforts stretchering the patients back. Quinny, the communications guru, managed to establish communications with AUSMED Headquarters and began the lengthy and tiring process of trying to get an immediate AME. But, with the gunfire and mortar fire in the background, the UN refused to allow one of its helicopters to land at a hot landing zone.

  Jon continued to process patients for the infantry lads to carry back. I took a moment and watched him work. He was moving through the injured, rapidly identifying those who needed immediate help, patching them very quickly, pointing them out to the infantry lads and then moving on to the next unfortunate. He was like a machine — it was unbelievable how quickly he adapted to the situation. This playing medic stuff wasn’t our core skill. We were SAS operators filling a gap that needed filling. We were using this opportunity to improve our medical skills which were just a small part of the expertise required of each SAS soldier, and Jon was doing some really great stuff this morning. He was smooth, calculated and compassionate when required.

  Meanwhile, in the courtyard and around the hospital, the firing escalated and we were ordered to return to the compound. We left the hospital, informing the MSF workers who had finally shown up, that we were leaving to work on the casualties we had. The MSF workers decided to stay and were subsequently caught in the battle and couldn’t leave the hospital. Once again, it was the under-appreciated infantry who had to go and pull the MSF from the hospital. In doing so, Lieutenant Tilbrook took fire from a sniper. Corporal Brian Buskell was quick to take a sight picture on the sniper, but to take the shot would have endangered the lives of further IDPs and the sniper slipped back into the crowd.

  The work continued in the compound with many casualties walking in themselves. At about 10.00 am, some of the IDPs made a run for it through the re-entrants surrounding the compound. We watched (and could do little more) as these people were hunted down and shot. The RPA were terrible shots and, at times, were within 10 metres of the running IDPs and were still missing their targets. If the RPA managed to wound an IDP, they would save their bullets and bayonet the IDP to death. The RPA had RPGs (recoilless rockets) sited up on the next ridgeline which they were also firing into the IDPs. This went on for two hours until all the IDPs who’d made the break were either dead or dying. This was all happening about 300 metres away from us which was, unfortunately, too far for us to go and help them. As I watched the IDPs being bayoneted to death, I could only imagine how much it would have hurt having a bayonet continually thrust into your body — not to mention the fact that you were dying at the time. It was a slow, painful, horrible death that the young infantry guys were forced to watch as, under the UN mandate, they could not intervene. I say ‘forced’ because it was happening right in their line of sight.

  As patients were stabilised, they were loaded onto the Unimog truck where Nico the medic was looking after them; those deemed critical were loaded into the ambulance which, by now, had become a makeshift intensive care unit. The treatment was quick; we went from one patient to another. If someone was having trouble, another person would come and help or, if it was serious enough, Carol would come and help. But she was in great demand, so it was a matter of doing our best without her.

  It was now about 10.00 am, the firing had intensified and it had begun to rain. But the work continued, with the infantry providing and holding a secure perimeter. Everybody was either behind a truck or a sandbag wall working. We strung up hutchies to keep the rain off the patients and, if we needed to clean their arms for an IV line, we simply hung the arm out in the rain. I moved to a position behind a sandbag wall to see what was going on when I noticed the Zambians trying to tell a young boy to get down to the ground. I could see the boy about 50 metres away. He was frightened and confused with everyone yelling at him and the bullets flying all around him. So, with my weapon in my right hand, I bolted out of the compound, grabbed the boy around his waist with my left arm and ran back. All the while, some pricks continued to take pot-shots at us. I tried to get him to lie down, but he kept babbling something to me, so I kicked his legs out from under him, motioned that he should stay there, and went back to see if the infantry needed any help. Damn, that was a pretty crazy thing to do, but if the UN wouldn’t let me use my weapon to protect these people, then I was determined to use my body. I returned to the boy after five minutes and saw him flat out on the ground with a glazed look in his eyes. Nico said, ‘He’s dead, Jordo, leave him.’

  ‘What? How can that be?’

  Terry came over and we both saw him move and that was good enough for us. We started to work on him and were later assisted by Carol. We could see blood in his mouth and eventually found a small piece of shrapnel in his right lung. I put a mask on his face and forced air into his lungs with the attached bag, while Carol managed to get a cannula into his femoral vein to provide him with more fluids — his other veins had shut down, so the femoral vein was the best access to the circulatory system. We got him breathing again and then put him into the ambulance where he was watched closely until he was evacuated that afternoon. Later we found that his mother had told him that, if they should be separated, he should run to the mazungus (white people) which he had tried to do.

  As the work continued, an IDP ran into the compound with no apparent injuries. I was walking across the compound to assist the infantry on the perimeter when this IDP ran straight at me. I raised my weapon to fend him off, but he grabbed it and I found myself wrestling with him. His eyes caught mine as we wrestled with my weapon. He had a look I will never forget: a look of true and absolute terror. It was an alarming thing to see in the eyes of a grown man. I tried to pacify the man as I knew he didn’t mean any harm. I could have rammed my size 11 boot straight into hi
s chest, but I didn’t want the other IDPs seeing an Australian soldier assaulting an IDP. The Zambians, however, do things a little differently. A Zambian soldier decided to help me by kicking the IDP in the head. It was good kick, plenty of height and nice momentum, and connected with a horrible thud. The IDP’s eyes rolled back in his head, he let go and collapsed to the ground unconscious. The Zambian gave me a big toothy grin. What could I do? ‘Thanks, mate,’ I said and continued on my way after rolling my unconscious friend onto his side. The Zambians didn’t piss around with these people; they had been in Kibeho for six months and knew them better than we did.

  Everyone was flat out. We had no time to eat or drink all day. Those who managed to pick up a water bottle went around and poured water into the mouths of everyone else who had blood up to their elbows. We drank water periodically, but no-one ate at all during the day. There was no time and I don’t think any of us noticed our hunger anyway.