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(11/26/2002) The Bali International Medical Centre (BIMC), provides primary health care and emergency services for tourists, travelers, and Bali residents and has earned itself a well-deserved reputation for "doing things right" in placing patient care before all other considerations. Modern, clean, and well-equipped treatment rooms, 4 fully equipped ambulances, and a medical staff that undergoes continuous training upgrading - are part of what makes BIMC different.
Fortunately, for those who sought emergency care in the aftermath of the terrorist attack of October 12th, the professional teamwork of the BIMC staffers may have made all the difference.
balidiscovery.com retells the events as they unfolded on that fateful night. This is a story of uncommon valor in the face of unthinkable human suffering.
Some readers may find the graphic nature of this report upsetting. Reader's discretion is therefore advised.
The doctor is In
It began like most Saturday nights. The night shift of nurses, drivers, and doctors were settling in, expecting another routine weekend evening characterized by the intermittent visit of party-makers suffering from the ill-effects of too much alcohol, the occasional motorcycle mishap, and the odd case of Bali Belly. With a modicum of luck the call for their services would be few and nicely spread over the course of the night, permitting ample time for each patient work-up and treatment.
Tragically, however, the coming hours unfolded in ways that no could have ever imagined and in ways certainly no member of the BIMC team will ever forget.
11:20pm - Saturday, October 12, 2002
At 11:20pm, just moments after a loud explosion was heard across the entire southern part of the island, the BIMC receptionist received an incoming call from one of their staff doctors who had been driving down the street where the bomb had just exploded. Immediately on the scene, she called the clinic telling the medical team to stand by - she was enroute with three seriously injured victims and more cases were certain to follow.
In keeping with the Clinic's disaster plan - a Red Alert was now in effect. Calls were made to all staff doctors, paramedics, nurses, and drivers ordering them back to the clinic located less than 2 kilometers from ground zero.
11:45pm – Saturday, October 12, 2002
Responding to the Alert, Steph, BIMC's New Zealand nurse, arrived at the Clinic to survey a scene of unimaginable havoc. She joined a team of 10 doctors and 15 nurses who managed to gather at the clinic within 25 minutes after the blast.
As they rushed through the front doors they were greeted by the sight of casualties. Bodies completely filled the Clinic, laying on any available piece of open floor. Their numbers were such that simple movement by the medical staff among the injured was difficult.
Newly arrived in Bali was emergency care specialist Dr. Art Sorrell of the UCLA Medical Center in Los Angeles, on a one month teaching stint at the BIMC. His assignment, part of an ongoing program of critical care training provided to the Clinic by the world's recognized leaders in trauma care.
Did the worst night in Dr. Sorrel's distinguished career at the UCLA prepare him for the scene he now surveyed? Patients suffering massive trauma, severe burns, some with missing limbs. Sobs and screams of pain filled the rooms and corridors, as did the unforgettable smell of burning flesh.
Phase One - Triage
Dr. Sorrell and Sister Steph took the lead role and triaged the patients. Followed in close step by members of the medical team, they threaded a path through the maze of bodies. The most critically injured already had IV lines started. Depending on their individual condition, secondary IV's of Morphine, Pethadine, antibiotics and saline solution were administered.
Phase Two - Primary Survey
As Dr. Art and Sister Steph commenced their second sweep through the battlefield scene they clutched forms and papers as they began full primary surveys of the injured. Clothing was unceremoniously cut off the patients; notation for those who could communicate or had identification were made recording name, age, country, extent of injuries, and listing any medications already administered.
Three of the victims had stopped breathing, their vital signs returned through quick resuscitative work by the Clinic's staff. Similarly, patients with severe burns to the face and neck area were put under close observation, anticipating the potential need for emergency intubations and ventilation.
Once the most critically injured and severest burn cases were sufficiently stabilized, David, the BIMC's paramedic, coordinated the dispatch of ambulances ferrying patients for delivery to the operating theatres of local hospitals.
The estimates of the burns suffered by the patients and treated at BIMC ran between 30 to 90% of total skin area.
Patients continued to come through the door in a steady stream throughout the night and early morning hours. In all, over 70 patients were treated by the Centre with the less severely injured and walking-wounded dispatched across the street to the nearby SOS Clinic, who called to volunteer their underutilized patient capacity.
Many of the injuries were appalling. One patient, an Australian man arrived with his legs missing and a metal bar protruding from his chest. His injuries so severe that he died a short time later in an ambulance while being transported to a local Hospital.
Outside the Clinic, nearly 1,000 people had gathered. Welcomed volunteers stepped forward offering to help the medical team deal deteriorating sanitary situation resulting from dealing with so much carnage in a single evening.
Phase Three - Sunday Morning, October 13, 2002
Seven hours after the start of the crisis, the most critically injured patients had been stabilized and assigned to the care of the Sanglah General Hospital and other hospitals. The new day, however, brought a new stream of patients, initially treated at area hospitals and clinics and now seeking continuing care from the BIMC. These cases included minor burns, shrapnel wounds, perforated eardrums, and the shell shocked and traumatized.
A much needed re-supply of emergency drugs from the BIMC's Australia supplier arrived, courtesy of Garuda Indonesia. These drugs, particularly supplies of Morphine and Pethadrine, were desperately needed by local hospitals. BIMC shared its precious supplies of drugs and dressing with any local hospital who requested them. Likewise, their doctors and nurses were dispatched to local hospitals, including Dr. Sorrel who worked a non-stop 3-day stint at the Sanglah General Hospital's Intensive Care Unit.
Post Traumatic Stress
The days following the tragedy saw the BIMC turn its attention to its own staff and those members of the community who responded to the tragedy. Tearful and traumatized doctors, nurses, cleaners, guards, and receptionists - all underwent a series of counseling sessions provided over a two-week period after the attack. Professional trauma counselors, provided by the Australian Government, are available to any member of the local community who feels he or she needs their assistance in coming to terms with the tragedy.
The folks at BIMC, heroes in any sense of the word, are typical of countless others local resident who personally prevailed amidst the destruction of October 12.