UVa medical group helps save victims of attack in Rwanda

A medical group visiting Rwanda from the University of Virginia found its schedule of conferences interrupted earlier this month when it was called on to care for victims of a pair of grenade attacks in the country’s capital, Kigali.

The group had wrapped up for the day and was at dinner when news of the attacks came. It was first reported to them as gunshot injuries.

When they got to the hospital, the three — a surgeon, a nurse and an undergraduate research assistant — found dozens of victims.

“There were about 30 people just kind of strewn about the hospital, laying on the floor,” recalled Tristan Stapleton, the research assistant. Stapleton will be a third-year student at UVa this year, having transferred from Piedmont Virginia Community College.

They immediately started sorting the wounded, deciding who should get medical attention first, in a process known as triage. They wrote patients’ vital signs on their chests and wrote on their arms numbers marking in which order they should be treated.

“The ones who weren’t completely shell-shocked, they were very resolute,” Stapleton said.

One patient was brought to the hospital dead, said Dr. James F. Calland, associate medical director of trauma services at UVa.

Stapleton was working with the UVa nurse. He isn’t a formally trained medical care provider, but he’d picked enough of the basics up here and there: a mom in nursing school, taking a CPR course.

“You walk into the situation, and you don’t really think, you just kind of act, you know,” he said.

One patient’s suffering proved especially memorable.

“This guy in particular was just writhing in pain,” Stapleton said. “He was screaming at the top of his lungs.”

A Rwandan resident translated the man’s screaming: “Please, just cut my leg off. Please just cut it off.” The man wrapped his arms around Stapleton’s legs and squeezed as hard as he could, Stapleton said.

Calland did a few surgeries that night. Among them was the man who had begged for amputation, who turned out to have painful, but not life- or limb-threatening, bleeding into the muscle of his leg, which the doctors were able to relieve.

Later, the surgeon was back at the hospital to check on the victims. He was pulled aside by a high-ranking government official and, when the country’s president, Paul Kagame, toured the hospital, was introduced.

The attack took place against the backdrop of a country that saw a horrendous genocide in the 1990s, in which members of one ethnic group, the Hutus, killed thousands of members of another group, the Tutsis, along with Hutus who favored an end to the region’s civil war. The Tutsi have since regained power in Rwanda, wrote Denise Walsh, assistant professor of politics and studies in women and gender, in an e-mail. The existing regime is authoritarian, she said.

“Election outcomes in Rwanda are not uncertain,” she wrote, noting that in 2003, Kagame won 95 percent of the vote.

She also noted, however, that there’s no clear motive for the attacks and that grenades are not hard to come by in the area.

Calland said he hopes to continue his work in Rwanda, where there are 30 surgeons for an area with the size and population of Virginia. He said he wants to help improve the country’s ability to train its own surgeons.

One of his residents will be headed to Rwanda in August to spend a year examining the surgical system in the country.