Roadtrip to reach hospital in time

Roadtrip to reach hospital in time

When they can't fly, the critically ill face long and painfully bumpy overland journeys to hospital. This firsthand account from Chad shows the reality of road travel for patients in crisis.

It’s now 18:00, and dark outside. We have just passed through our sixth checkpoint on the way to the city, and the paved road is not too far away. The man in the back seat wedged between his relative and a nurse is still alive and responsive, despite the last eight hours of driving over rough roads. Although he doesn’t know it now, he won’t make it to a hospital until the early hours of the morning.

Setting off

Our journey started at around 9:45 in the morning, when we left to pick up a very ill man to take back to N’Djamena. When we arrived at his house, his relatives were all gathered around him, crying and singing sad songs because they didn’t know if they would ever see him again. He had been very sick for at least a month, and they had expected him to die several weeks ago.

The nurse that we brought with us had given several units of IV fluids to try to improve his condition for the trip, but he was still unable to stand. Some relatives helped him to the vehicle and arranged everything for him inside, while others decided who would go along. With limited space in the truck, we couldn’t take everyone who wanted to come. 

Finding fuel

Finally, everything is ready, but everyone is crowding around the truck so we can’t move. Slowly we move out and set off on the sand track. After about an hour, we stop for fuel. As the only fuel store in the village is closed, we have to wait for the shopkeeper to come from his house and unlock his store for us. As we wait, another person appears in hope of a ride, and everyone has to make room on the already crowded truck. All the time, the clock is ticking for our patient.

'With all of these delays, we know that we will eventually run out of daylight, but there is not much that we can do.' 

The fuel arrives and is poured into the truck from jerry cans, and we set off again into the desert. Two hours and a bathroom stop (without the bathroom) later, we stop at a larger village for a quick meal. The patient can’t get out of the truck and instead takes a short nap as the rest of us eat. Afterwards, we go outside of the village and make another stop to care for the patient. With all of these delays, we know that we will eventually run out of daylight, but there is not much that we can do.

Checkpoints, diversions and delays   

A few kilometres on, we are stopped at a military checkpoint. Due to recent rebel activity in the country, everyone is being checked for weapons. After some hassle, we are released to continue on our journey. The road in this area is really just a collection of sand tracks about a kilometre wide that continually separate and reconnect. We try to pick the best path, but sometimes we hit a small ledge or hole that shakes the entire truck, threatening to knock off some of the passengers in the back. Other times we are bogged down in the soft sand and have to use the four-wheel drive to get out.

We finally arrive at the village that marks the beginning of the paved road. We stop to drop off a young boy, but his relatives aren’t nearby, so we wait another half hour for someone to show up. Once on the smooth paved road, we are able to move a little faster, but we still have to go through more police stops. On the way, we also pass several military convoys and armoured cars returning to N’Djamena.

Off-road race against time 

Further along, we end up leaving the paved road because it has so many potholes that ironically it is faster to go on the sand in dry season. As the sun begins to set, we realize we have taken a wrong turn, so we stop and talk to a man driving a horse cart. He assures us that the two roads will converge soon, so we continue on.

By this time, it’s quite dark, but we can see the road because the sand tracks are deep. As we get closer to the city, the ground gets harder, and it becomes easy to lose the tracks we are following. We drive slowly and watch carefully, using the GPS and occasional passing car to guide us. If we lose the path, we won’t be able to continue, as there are many obstacles near the road.

Journey’s end

This time, we were able to find the tracks again every time we strayed from the main path. The last trip we made, we lost the road altogether and wasted two hours before we finally found another road into the city. This trip we are stopped by a patrol looking for people who are bringing wood into the city. After explaining our mission, we make it past this checkpoint only to arrive at a small bridge with another police checkpoint.

This is where I changed vehicles and headed to my house, making it back by 20:00 that night. I was told that the patient did not arrive at the hospital until after midnight. It had been a long day for all involved, and I’m sure that everyone was relieved when he was safely in hospital.

'A few kilometres on, we are stopped at a military checkpoint... After some hassle, we are released to continue on our journey.'

A different outcome?

I wish there could have been a better ending to this story, but sadly he passed away later that week. A lack of good healthcare and the long journey by road certainly didn’t help increase his chances of survival. One of the doctors caring for him later mentioned that ‘things would probably have turned out differently if he had been treated earlier.’

A better option would have been to fly back, but without any airstrips near the village, it was not possible. Looking back, I wonder if MAF’s services could have changed the ending of this man’s life. It’s easy to see the need for reliable and affordable air transport when you experience what happens without it.