Within minutes of the blasts from fireworks display at Puttingal temple in Kollam district around 3.30 am Sunday, the first alert had gone out to Thiruvananthapuram Medical College Hospital (TMCH), just over 50 km further south in Kerala. Around 5 am, the first patient arrived, by 7 am it had received nearly 150 victims, many fighting for life, and charred and mutilated bodies.
By 10 am, it had “surplus” doctors outside operation theatres (OTs), “Even the last grade employees, who were not alerted, had arrived voluntarily. While senior surgeons, professors and postgraduate students stood in OTs for hours, without food or water, doctors from private hospitals had arrived on their own to handle ward patients,” said a senior doctor.
A hospital that never witnessed an emergency mock drill had risen to the occasion, with support from officialdom, and in the end been able to save many lives.
“I had never seen such mass casualty in my life. Most cases were of life-saving emergency,” said Dr M Anas. “Using two operation tables, we completed three crucial surgeries before 7.30 am, even as 35 cases waited outside. Another six tables were readied in two hours.” By 5.30 pm, they had completed 24 critical surgeries. “We followed only universal precautions and life-saving emergency measures. We had to conduct some initial surgeries without enough blood because the wounds were severe…donors had just started arriving,” he said. By noon, the TMCH blood bank was full.
A senior surgeon who monitored at least 10 surgeries said this quick response system helped save many lives.
At ground zero, only two doctors were on duty at Kollam hospital when the explosions occurred, said R Ramesh, Director of Health Services, Kerala. Within minutes, more doctors reached, and many had arrived before daybreak from other districts. Ramesh said hospitals in Kollam and Thiruvananthapuram had streamlined the system in the first three hours itself. “Our first priority was taking care of crucial injuries, which was done in the first four or five hours itself,” Ramesh said.
Eighty-seven people were brought dead at Kollam hospital in the first three hours. “The challenge before us was postmortem, as there was no forensic surgeon. Soon, we arranged 10 postmortem tables and a senior forensic surgeon, Dr Bindu Samuel, was brought from neighbouring Pathanamthitta district,” he said.
In the next eight hours, Dr Samuel’s team completed 88 postmortems and handed over the bodies to relatives, Ramesh said.
However, lack of preparations and emergency provisions did raise challenges, and that, doctors said, is something that needs to be addressed. “If we had disaster mock drills and a separate protocol and wing for mass casualty management, we would have reacted even better,” he said.