Choice of life or death at Balasore hospital after train disaster in India

Balasore State Hospital, closest to the site of India’s worst rail disaster in decades on Friday night, was the scene of tough life-and-death decisions by medical staff.

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Almost every minute, the siren of an ambulance outside Fakir Mohan Medical College and Hospital announced the arrival in the emergency room of a new group of injured people, most of them seriously in the state of Odisha, in east of the country.

The doctors had to make diagnoses in an emergency, hoping to save some and lowering their arms for others.

It was “a situation of war, with an incessant flux”, confides to AFP doctor Sibanand Ratha, three days after the tragedy.

“All the patients had severe trauma, with head injuries, amputated limbs, chest injuries and breathing difficulties,” says the 35-year-old doctor.

Others were on the verge of death when some had already expired. Saving lives was the priority. “But there was too much haste,” he regrets.

Teams “had to decide who to give the highest priority,” he admits, meaning those with the greatest chance of survival.

“We must not say it, but, as a doctor, we know when a patient will not survive,” he confides.

Friday went as usual when all medical staff received a requisition message, even calling on those on leave to go to the hospital immediately.

The doctor knew it was a train accident, but he did not expect this magnitude, “could not have imagined it”.

He “worked tirelessly as the evening turned into night and then the next day too.”

Medical teams attended to “400 to 500” people on Friday night, he said, “although we didn’t count, but the ambulances were pouring in.”

“We were stabilizing patients and sending them to intensive care. The less critical cases were transferred to orthopedics,” he continues, “anyone with head and chest injuries was taken to surgery.”

Blood donations by townspeople organized at midnight “really helped”, he says, as well as the supply department which worked through the night to ensure that all the necessary drugs were available.

At least 275 people lost their lives in the crash and of the 1,175 injured, 382 were still being treated at various state hospitals as of Monday.

Those in critical condition have been transferred to larger, better equipped hospitals in the state capital Bhubaneswar area, but many have been admitted to Balasore hospital.

On Monday, it was still crowded with survivors and relatives looking for loved ones, besides the ordinary sick.

Local medical staff have continued to work overtime since the collision and it will take a few more days for the situation to stabilize.

It was the day off for Kshitiz Guglani, a 25-year-old orthopedic surgeon, requisitioned like the other staff. He has barely given himself a break since.

Most “patients present with polytrauma,” he says.

Anil Marandi, 29, a laborer from a tribe in Jharkhand, showed staff at the main assistance office passport photos of his brother, brother-in-law and a friend, who were traveling in one express trains.

“I have only found two bodies so far,” he said in tears. “I’m still looking for the third one.”

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