Tuesday, February 24, 2015

Medical Evacuation

Reposted from the CaringBridge site for Bayo Oyebade

When Bayo's health deteriorated so rapidly on Friday, Feb 20, my friends and I started making arrangements for a medical evacuation out of Nigeria. Thankfully we have medical insurance which will cover most of the cost. I knew it would involve a small plane which would transport Bayo (and hopefully me) to the nearest adequate facility where he could receive care. My first thought was South Africa, but the company decided to send us to Kenya.
The company was very easy to work with. We made numerous calls throughout the night to get all of the details worked out. My friends went and got our passports and took them to someone who could scan and email them. They did a lot of driving across town that night. I'm very grateful for all of the people who had their hand in the details so I didn't have to do that. Overall, I would say the evacuation process was much easier than I thought it would be. 
Our medical evacuation plane from AMREF “Flying Doctors” left its base in Kenya on Saturday morning and headed for Nigeria. It arrived in Abuja, Nigeria on Saturday evening and the crew overnighted there. Sunday morning, we left the Jos hospital in a real ambulance (though completely stripped down and empty). Bayo’s stretcher was on the floor, and I sat on the floor next to him. The ambulance driver and doctor sat in the front. We had been trying to leave early enough so we could avoid all of the roadblocks on Sunday mornings in Jos. (There are major roadblocks around churches every Sunday morning due to ongoing security threats.) However, we got a bit of a late start, so we immediately ran into a roadblock at about 6:45. At first the soldier refused to let the ambulance through so the ambulance driver started reversing on the road to find another passage, but finally the soldier relented and let us pass. It took about an hour to get to the Jos airport which is far out of the city. This was the first time I was alone with Bayo so I started to tell him his story. He was amazed, and had absolutely no recollection of those two harrowing days.
I was thankful to have some of our friends at the airport to help us navigate various issues. The ambulance would not be allowed to drive onto the tarmac unless we paid an exorbitant fee. Since Bayo was stable by that time, our friends just took him on the stretcher and wheeled him through a passenger’s normal route. The small plane flew in from Abuja about 8 a.m. There were two pilots, a doctor and a nurse on the plane. With Bayo and me, the total was 6—and there wasn’t room for even one more person. We were a bit of a United Nations team: 3 Kenyans (one black, one white, one Indian) and a New Zealander, a Nigerian(Bayo) and an American (me).  The doctor was an anesthesiologist from Auckland, New Zealand. He takes a month off from his job every year and does medical evacuations with AMREF. He really enjoys the change of pace and the challenge of the work.
The doctor from the Jos hospital exchanged information with the AMREF doctor and soon we were on our way to Abuja. It was just a 20 minute flight to the capital. They had to fly that route because Jos is not an international airport. We re-fueled in Abuja and then flew for about 1.5 hours to Yaounde, Cameroon for another re-fueling stop. We were the only plane there with any activity going on. While we were waiting, a young airport official came to get some information from us. She greeted us with “Bon jour,” and I involuntarily gave a Hausa reply of “Yauwa.” Oops! She quickly realized that none of us spoke French. She laughed and wracked her brain for a few English words, and we got the job done. I enjoyed her personality and her ability to laugh at the situation.
Bayo did very well on the flight--he was strapped onto the stretcher the whole time. He had oxygen and his vitals were constantly monitored. He was given drugs at the appropriate times. 
The original flight itinerary had another stop planned for Entebbe, Uganda. However, the pilot said, depending on the weather, we might not have to stop there. If the winds were favorable, we could make it to Nairobi without a re-fueling stop at Entebbe. He made that call in the last hour of the journey. Thankfully we were able to make it all the way to Nairobi. We landed at a small airport at about 7:30 pm (5:30 Nigerian time) so we didn’t have to deal with the hassle of the large international airport. An official helped us quickly get our visas. $50 each; no paperwork; 5 minute process. Wow!
Bayo was loaded off the plane on his stretcher and into the waiting ambulance—a completely equipped ambulance—wow. This time I sat in the front with the driver while the doctors and nurses were in the back with him.The siren was not used because Bayo was stable.
While we were on the plane I had asked the nurse what hospital we were going to. I thought she said, “Anglican.” Then I asked the ambulance driver what hospital we were going to, and I thought I heard him say, “Akakan.” I said, “Anglican?” He said, “No, Akakan.” Then I saw the name of the hospital in bold letters on top of the building: Aga Khan University Hospital. Ok! Yes,I’m a visual learner.
Bayo was whisked in and immediately attended to in a very thorough manner. After the initial assessment, I was told to go and book him for admission. So I filled out paperwork, etc. The doctor drew all kinds of blood samples and then he was taken for a CT scan immediately. After that he was taken to his room in ICU.
Let me just say: this hospital is impressive. It feels like its on par with any well-established U.S. hospital. The ICU unit is comparable to an ICU unit in the U.S. Bayo was hooked up to all kinds of electronic monitors. The doctors and nursing staff are very professional and courteous. The hospital is sprawling and very aesthetically pleasing. 
The hospital attended to him from about 8 p.m. til midnight. A second doctor met with me just after midnight and shared their initial impressions and plan. And then it was time to figure out where to stay…but that’s a story for another day.
Now, let me put in a plug for medical evacuation insurance. If you live and work overseas, do you have medical evacuation insurance? I have observed 3 medical evacuations from Jos over the years, but I never thought it could happen to us. What a blessing it is to have that option in case it is needed. Our insurance does not completely cover an evacuation, but it greatly lessens the burden. To my understanding at this point, we will have to pay about 15% of the evacuation bill. But any price is worth it to save my husband's life. 
Health Update: Bayo had a pretty good day. He was downgraded (or is it upgraded?) from the ICU to the HDU (High Dependency Unit). The doctors seemed more concerned about the blood clots on his lungs today than they had yesterday. They even suggested that the blood clots may have been the root cause of his distress in Jos. They said pulmonary thrombosis (blood clots on the lungs) could have caused that great difficulty he had in breathing. Bayo will be on an anti-seizure medication for about a month, but the doctors believe his seizures were secondary to whatever the main problem is. They are also trying to figure out why he has blood in his urine--is it just from the catheter or is it something else? Bayo had an EEG done today, but I have not heard the results yet. So far I have met 4 doctors on this particular team. I like the fact that they are really trying to solve this mystery. 
Bayo is having a hard time regaining his energy--I suppose it will take time--and some of his drugs may make him a bit lethargic. He has not been out of bed for 5 days now. Please continue to pray for complete restoration and healing.

1 comment:

Sandy said...

Hi Marybeth,

I am praying for Bayo, and for you as well. You need strength! and for the children while you are away.

Our church has been praying for you and for other Christians there in your part of Nigeria where trouble seems to be increasing.

God Bless,
Sandy in England, I follow your blog.