Trauma surgeons are in the midst of Cape Flats ‘bloody civil war’

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SurgeryThe bullet-riddled victims who end up on the operating table of seasoned trauma surgeon Professor Andrew Nicol’s team at Groote Schuur Hospital are casualties of a bloody civil war playing out on the Cape Flats, reports News24. Up to 90 victims a month are treated for gun-related injuries at the government-funded institution in Observatory, an average of three a day.

Between January and June, 1,995 bodies that had sustained gunshot or stab wounds were admitted to the Western Cape’s forensic pathology services for post-mortems. In June alone, 448.

The report says that Nicol, who has headed the hospital’s trauma unit for the past 20 years, has seen a steady increase in the number of trauma patients admitted over the last two decades as well as change in the severity of injuries. Single gunshot admissions are becoming rarer as patients with multiple wounds outnumber them. One of their recent patients was a woman who had been shot 20 times.

The report says fittingly, techniques developed by the military to get patients through massive trauma have been adopted. One is a shunt, which involves plastic tubing being inserted into the arteries to act as a conduit for the blood until the person is stable.

“Damage control surgery” aimed at getting patients “from death’s door” through the next 24 hours before completing the full procedure is also performed, the report says. In one instance, Nicol explained, a 16-year-old was admitted with shots to his chest, abdomen, both arms and both legs. The abbreviated procedure was used to ensure that he survived.

The report says the number of trauma admissions is so incredible that international specialists from countries with low levels of violence visit Groote Schuur for insight into how it manages emergency treatments. One trauma surgeon visiting the hospital from the UK has not seen a gunshot wound in three years.

From Monday to Friday in an average week, the trauma unit sees mostly injuries related to accidents, stabbings and the “occasional gunshot”. But, the report says, come nightfall at the start of the weekend, the trauma unit is ready for “disaster”. One trauma theatre is operational over weekdays. Last Sunday, there were four. The unit can accommodate six patients at a time, but every weekend it becomes overwhelmed with the number of victims of violence in need of surgery.

The cost of treating a gunshot wound is reportedly about R22,000. Should the patient also need orthopaedic surgery, this increases to R25,000. This money diverted to cover emergency surgery could have been spent on health care, Nicol said.

The report says a number of his patients are innocents caught in the crossfire. But it is the young patients admitted to their unit who disturb the trauma team. Child casualties aged 12 and older are admitted at Groote Schuur. Recent figures show that 35% of minors treated at the hospital had gunshot wounds.

Despite a tight budget and limited resources, Nicol pointed out that the academic hospital boasted a survival rate comparable to institutions in the US. We are very proud of the work we do. This is a fulfilling job, but at the moment it’s an overwhelming one,” he said. “We try to cope, but there is no doubt we need more staff. Everyone working here is feeling the pressure.”

News24 report

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