– October 2013 BOLIVIA –
WARNING: This post contains shocking passages
The road winds through the vast and lifeless hills of the Altiplano. A young man of twenty-seven or twenty-eight enjoys the afternoon sun, riding a flashy, shiny, speedy motor cycle. The road is newly paved, smooth and wide. On either side there is a large band of flat dirt and then a deep trench for water flow-off in rain season. Beyond that, some houses and dry shrubs. This high up in the Andes there are no deep canyons or drop-offs, the land is pretty flat.
The road goes downhill on this stretch. He turns into a curve, leading him to the left. His speed is much too high and he notices he can’t make the turn this way. So he hits the brakes and starts leaving a skid-mark on the asphalt. The bike is still upright when its wheels hit the dirt. Maybe he sways a little from left to right, trying to maintain his balance. It doesn’t matter any more. He rides into the 50cm deep trench. The front wheel folds itself up against the ridge as if it were made of clay. Samuel gets launched off his seat. Samuel is not wearing his helmet, or if he is he didn’t buckle up and it was soon knocked off his head.
Maybe he tumbled down the trench for a bit, but it seems that his body crashed chest- and face first straight into the concrete bottom of the ditch. It seems that he slid forward in that position only a little bit, that he remained there, motionless, with a lumpy bloody mass slowly dribbling from his nose and mouth.
WHAT WE SAW
All jolly and in good spirit, we had set off on an easy drive (164km) from Sucre to Potosí. In the back seat we had two girl friends chatting, getting to know each other. David and I were smiling, enjoying the scenery and some mellow music.
“A motor bike crash.”
David suddenly says.
He pulls over almost immediately.
“Do you want to give first aid?”
Not too long ago I had shared with him how I would want to offer help in case we would come across a situation like this. Traffic incidents are worryingly common in these parts, where people tend to drive as kindergarteners.
Here was the moment. I opened my door, pulled out my first aid kit from underneath my seat, and set off at a slow run toward the scene.
I saw two men standing at the road-side water ditch. Perception of vehicles seemed irrelevant, so I focused on people.
Getting closer I began to understand the victim was in the trench. Were there multiple victims? There was one broken motor bike and I saw two cars near by. The cars seemed to be undamaged and had no one in-, or near them in need of help.
Showing my first aid kit to the two bystanders, I offered to help. They gestured to the ditch, which I couldn’t see into yet.
Two legs were appearing as I got closer. A torso.
Please move, if only a little. Please… be moving!
He was helmet-less and I stared for a second or two at the back of his head. He was laying face-down in this rather deep trench and these two other men were just standing by… looking at it.
I jumped in, explaining that I know first aid.
“When did this happen?”
“Just now. A minute ago.”
Understanding I could not work in the narrow space of the ditch, I asked their help to lift him out.
“If you could stabilize his head, we will lift him out.”
We had to act quick. Seconds count in these situations.
So I stood behind the still body and got a good grip around his chest. Turning myself, his back now rested against my chest. I pushed up from a crouching position and lifted his body out of the gutter. One of the men took his legs, while the other gently held the head.
I had to lay down on the ground, so as to let the victim stay flat. His body was almost wholly on top of mine, and I felt his weight and warmth. We let him slip off of me, onto the dirt.
He was conveniently on his side. Within seconds I had him in a stable side-position and could start figuring out what help he was in need of.
No breathing. I shook him slightly and saw his eyes were half open, staring into the distance.
Shit, he’s dead. Come on, buddy… give me a sign of life.
By now, David had turned up and started encouraging me from a small distance. He crouched down in the corner of my eye and helped maintain my concentration.
‘Do what you learned, follow the steps. Stay focused.’
David inquired if an ambulance had been called. It was coming from Sucre, 31km away. They would only be ten minutes.
I couldn’t walk away and say ‘He’s passed on, there is no point in trying.’ My conscience would have haunted me forever; what if he had revived if I’d tried, at least I could have tried! Anyway, the ambulance was coming soon, and I only had to try to keep the blood circulating until medics arrived…
The injured man’s sweater was torn and pulled up onto his chest. That had to be unzipped first. The white T-shirt underneath had many holes in it from the impact. His torso was heavily scratched and a little bruised. Bruises mean a man’s blood was still circulating after an impact.
No further visible injuries, though I noticed a large, smudgy patch of blood on my trousers. Even later, I was never able to figure out where that blood had come from.
I checked pulse three or four times and held my ear very close to his face, trying to pick up on any trace of breathing. One of the men also checked pulse and thought he felt some. Hope!
But he was wrong. In all likelihood what he felt was his own pulse in his fingertips, pressing down on the kid’s throat. Try it on a table, if you press down hard enough and even wood has a heart beat.
I had walked over, thinking I might help apply a bandage here and there, or perhaps offer some comforting and stabilizing. Worst case, mouth-to-mouth…
Turned onto his back his mouth slightly opened. I tilted his head backwards and pushed up his neck to clear the air ways in case he might catch breath again. I had to open his mouth further and reach in with my fingers to make sure his tongue was not blocking the way. His tongue was blue and had teeth marks pressed into it. Looks like head trauma.
I forgot to put gloves on, because we were not dealing with a wound, but rather the greater issue; a man slipping into permanent death.
I ripped apart my first aid kit and got the mouth-to-mouth piece ready. Fortunately our kit is kept very organized and within seconds I could start blowing air into his system. The device has a large patch of plastic foil around the mouth piece, to cover the face. That was helpful because there was thick blood around the nose and mouth. That made it slippery, but it worked fine. Close the nose, clear the throat, blow. I couldn’t get any air in.
One man stayed crouched with me on the other side of the body. Several times I asked for his help.
“Please hold up his neck. Please put something under his head. Please turn his hips.”
Still no pulse.
‘There is no time to hesitate, do what you always thought you might to one day, but realistically hoped to avoid… ‘ I felt scared but knew I had to move on to the next step: CPR
One, two, three, four, five, six, seven……..
Putting my hands to the chest, I felt concerned but not frightened. There was nothing that could get worse with this man, what I was doing could only help.
My hands were in the right place when I applied heart massage. You practice on dummies and can never tell what a real chest will feel like or how you will respond to a real injured person. I am content with the calm I was able to keep. I just couldn’t remember how many counts between sessions, so I followed my instinct. Now and then I attempted to get some air into the lungs, but it seemed impossible.
More people gathered around while others drove past. We were far away from any urban area.
One of our friends had come over to look, the other kept a distance and stayed with the truck.
Going back and forth between heart massage and attempts to give air, I soon gave up the mouth-to-mouth. There was no point if I couldn’t create a pulse. At the last try I did get some air into his lungs, but it came back out with a wet burping sound as soon as I touched his chest. Later I realized this likely meant his lungs had filled up with blood. From then on, I concentrated on the heart.
I had been going on like this for over six minutes and knew that it was likely to no avail. Somehow I couldn’t stop. Not quite yet.
Just one more time… one more.
Your senses tell you it is over, but your heart is not yet willing to give up! What if I am really close to getting him back?
But the people had started shaking their heads… it was over.
For one last time I checked for a pulse. Nothing. I knew that, but hope had kept me optimistic.
Now I saw him for what he was; a dead man in front of me. I held his forearm, dropped my head and shook ‘no’. I briefly looked around. At least fifteen men and women had now accumulated at the scene. Murmur went quiet and it was accepted that the young man had died.
His name was Samuel and he died for no reason at kilometer thirty-one on the road from Sucre to Potosí in Bolivia. He was born in 1985 and died on November twelfth, 2013, around three o’clock in the afternoon.
Now I could start sobbing. I drooped off with David and cried while others took a jacket and covered late Samuel’s face. We sat down by the side of the road and I realized I’d been pressing on-, and putting my mouth to, a dead man.
The two initial bystanders (I think, actually they may have been different men) had been very helpful. I felt comfortable working most of the time, except for a few instances. I believe the people there had some confidence in what I was doing as they did not interfere or continue CPR after I had stopped.
One of the men retrieved the kid’s ID-card and mobile phone and started calling family and friends.
“Are you acquainted with Samuel (…)? Please, I need to know. There has been an accident.”
I believe I also caught in one of these conversations that the motor bike had been borrowed.
I would like to change trousers now. And some sugar would do me good.
A car pulled up ten minutes later, with a physician on board. He put his stethoscope to the biker’s chest and for a minute there was some consternation; there appeared to be a heartbeat and shallow breathing! This sounded so surreal to me that I had to walk over and verify. False hope, the man was wrong.
Washing the little blood off my hands only a hundred meters away from the dead youth, I started crying again. Only briefly, and after we had all hugged we decided to move on.
A half hour had passed since we’d arrived, and no ambulance was there yet. There was nothing more we could do and no-one seemed to think it necessary for us to stay. We drove off.
Men in Bolivia of that age rarely don’t have a family and children. His relatives will be very sad tonight and soon another little concrete monument will be erected to adorn the already crowded road-side cemetery…
Later on David told me he’d found out the man had been there, laying face-down in the trench, for eight or ten minutes before we’d arrived. That long! This made me realize that he was quite surely beyond help by the time I got there.
Only now I realized how physically close I had been to a dead man. My face pushed onto his, trying to get air in. Pushing down so hard on his chest that it made the rest of his body shake. All I had seen of death so far was my grandmother all made-up in her casket and granddad a few hours after he’d passed away.
I couldn’t tell you how I felt afterward. There was a strong sense of sadness for this man’s passing away. And stress (shock?) from having been so close to death. Dizziness made me sit down and breath deeply and I felt a bit sick to the stomach. Sitting in the car felt constricting; I needed more space around me to breathe.
But what overwhelmed me was a feeling of dissatisfaction. I had not been able to help the man how I would have liked. And I was upset! Seeing a young man who just lost his life -completely unnecessarily- is upsetting enough, but to understand that the people who first arrived had just left him there… face down in the gutter… for ten minutes! It was getting me.
David has seen four dead men so far on his travels through these parts (including today’s) and he recounted that it was the same every single time; people just stand around, and watch. They call the ambulance, yes. The family, yes. But there is no understanding of how they can help and how important first aid can be.
This confrontation with the Latin-American way of dealing with a wounded man has left me rather frightened. If we are ever to be involved in a crash or other accident, no help can really be expected from these people.
It does make a difference dealing emotionally with what happened today, that the man had surely been beyond rescue to begin with. It would have been a far more traumatic experience if he had had a pulse or been breathing slightly upon arriving. If I would have attempted to help him while he was still alive, and had seen his life slip away under my hands, it would have been much harder to cope with.
His Death Could Have so Easily Been Avoided
If he hadn’t speed-ed, he wouldn’t have died.
If he had worn his helmet, he wouldn’t have died.
If the first people present would’ve administered first aid, he might have lived
Road from Sucre to Potosí – Km 31
November 12th – 2013