Near dinner time, the phone rang as usual, colleagues informed me there was something urgent and needed my hands. The patient was a little girl, general appearance was critical, no chest ups and downs, appeared to have no breathing. Even to the neck with a quick touch, no pulse, but still felt the warmth remained slightly. Patient's father said when the girl was found unconscious, she was taken to the hospital as soon as possible, but also spent more than an hour to successfully reach the hospital. I had no idea whether the warmth was actually from the patient or from her father who tightly held her body in his arms. Because of this bit of warmth, we decided to start cardiopulmonary resuscitation (CPR) to her, although the hopes were extremely slim.
Colleagues rushed to patient, bagging air by Ambu Bag, opening the intravenous access and injection of adrenaline immediately. I was responsible for external cardiac massage, I realized her body was much smaller in her age, my palm even bigger than her entire chest.
As time passed, second to second, I felt her temperature slipped away from my fingers gradually and getting faster and faster. I still remember when we announced the death to her father, his eyes were empty. He asked for a warm blanket and, said there is very cold outside, blanket is used to wrap the body and shipped her to home. We did not refuse, and we had no point to refuse, this was the last thing we can do for the girl. She was only five years old.
Back to the house, the food had gone cold, but the girl 's temperature still left in my hands. I understand more why MSF opens the project here. Where I work is called Chaman, in Pakistan 's northwest border with Afghanistan 's eastern border. Due to political, security and various reasons, the healthcare system here is very fragile, lack of medical facilities and difficult to access. I am now running an emergency room without x-ray, no electrocardiography (ECG), no ventilator, and no defibrillator of course.
All materials, equipment and drugs that I can easily acquire in Hong Kong hospital become very valuable here. Treatments to patients always rely on our experience, as well as better use of the limited resources. On the order hand, geographically, we are at the border between Pakistan and Afghanistan, and there is a conflict, year and year, in Afghanistan, thus their local health care system suffered a huge damage before. The hospital I work is not only for patients in Pakistan, but also the attendances from Afghanistan. However, due to security reasons and the distance involved, the Afghan patients often take a long time before they can go to the hospital for treatment, and are often too late.
This is my place of work - Pakistan's Chaman. MSF is the only Non-Governmental Organisation here providing medical services.