2002 Bali Bombings – experience and memories

Today I’m recalling the memories and experiences from ten years ago. This post is by no means a complete recollection…the things that come to mind as I write.

Sunday 13 October 2002

That morning the news services reported on the bombings…A young man who was slightly injured managed to catch a flight from Bali to Darwin and he presented to the Emergency Department at Royal Darwin Hospital. He provided the first insight for us on what happened. Later in the morning I was receiving telephone calls that we needed to meet at the hospital because Darwin may be used as an entry point for the survivors who needed acute critical care…

At Richmond, RAAF flight crew were departing in a C-130 to pick up some of our doctors and assess the situation in Bali. The initial thinking was there would be a scoop and run operation of walking wounded. The early information was vague and inaccurate. We had a general surgeon (Dr David Read) and an anæsthetist (Dr Sue Winter) take satellite telephones with them from the RDH. These two doctors were reservists and full time staff specialists at RDH. With our RDH telecommunications we were able to collect raw information from the field…

We got all the patients in the hospital in the know and many agreed to go home or somewhere else…Some patients we had to force to stay, they wanted to leave to allow their place to be taken by a bombing victim. By the end we had discharged 100 patients to make room and to free up staff…

It was spooky walking through the empty surgical wards of a silent hospital…


ADF Reservists transporting victims by air

Over the Monday morning and early afternoon, four flights of RAAF C-130 Hercules flew in and brought patients to us with burns, trauma and high speed shrapnel and blast injuries. I remember the smell of the patients, the burnt flesh. I remember how they looked, the most severely burnt patient had no ears, lips or nose. I thought one patient who was being wheeled in in front of me was dead. Then his arm moved and I knew he was alive. He did not survive. I was in the ICU before he died. His bed was gushing with fluid that was coming away from him. We later learnt he wasn’t Australian, he was Greek. Our ICU team were able to make contact with his family in Greece. They were told in his last hours a hospital chaplain held his hand, spoke, sang and prayed with him as he died.

If you’re medically or nursing qualified, the most fascinating and invigorating and spirit enhancing thing was watching specialist physicians, surgeons and their trainees along with other medical practitioners and registered nurses working together. I mean truly working together. The traditional medical referral system was halted for a day or so. Surgeons worked their science and art wherever they could. Debridement and fasciotomies were being performed in wards, corridors and operating theatres. Physicians were working as metabolic teams. They didn’t know their patients, there was no time and many of them were too sick for a relationship with their doctor. We enlisted medical students to ferry pathology results and assist in other very useful ways. The pathology and radiology areas were run ragged.

I made time to visit Building 13, my building, the Pathology Department at RDH. My close colleagues in the laboratory, my friends were working frantically. Results were needed by physicians to stabilise and resuscitate patients. Over the days my speciality interest in Clinical Microbiology was needed. The hospital in Bali did a great job but they ran out of supplies and equipment early. To keep cool and to find relief, many patients before the burns took over were conscious enough to cool themselves with water from wherever they could find it. The water wasn’t always clean. Some patients were sitting in water. Bali is replete with multi-antimicrobial resistant bacteria. The patients’ burn wounds were being infected before they left Bali. We spread multi-drug resistant bacteria around Australia as we transferred patients around the country. We had introduced an infection control nightmare. I struggled to stay on top of that plus everything else. Fortunately Darwin has the highest concentration of infectious diseases experts in the universe.

After all the patients arrived, the job was to assess, resuscitate and for the burns patients transport to a burns unit in another state…

I can remember so many inspiring stories from the days and weeks afterwards. We had visiting dignitaries from within and without Australia. We received updates from burns bosses in the other Australian centres about the patients we shared, those summaries were shared with staff so they knew the destiny and outcome of the patients they got to know briefly but intimately. The cooperation amongst the burns units around Australia was great. There was a lot of information sharing between everyone…

RTFA for the details, the progression of time and experience as it happened. I’ve left all that was happening in Gary Lum’s personal and professional life at the same time. But, it shows how he was led to his current career concerns – I think.

Move the clock forward ten years and what have we done? We have the NCCTRC. We have the Office of Health Protection. We have the National Incident Room which I manage. We have national health emergency preparedness plans for mass trauma and other events. We have evolved. We have grown.

Importantly the relationship between Australia and Indonesia has grown significantly. The relationship between Darwin and Bali has blossomed. The relationship between RDH/NCCTRC and Sanglah Hospital is fraternal and now involves regular staff exchanges. The relationship between the people of Bali and Australia has become intimate in so many ways. Whatever the motivation was for those responsible for the bombings on 12 October 2002, the result has been a development of preparedness and response from the health sector and a closer bond between the peoples of two countries and two cultures.

Gary

Thanks, Trixfred30

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