SARBHANG

Dengue patient, who ‘died’ en route to Thimphu from Gelephu, is recovering in ICU

25 October, 2009 - His pulse was weak and thready. His face had turned blue and the blood pressure had dropped to an unrecordable low. He was, according to his relatives and wife “dead” for about an hour.

This was the condition of Karma Wangdi, 39, when the ambulance carrying him reached Sarpang from Gelephu. He was referred to Thimphu after being diagnosed with dengue fever. The ambulance immediately returned to Gelephu.

Doctors call this condition dengue shock syndrome, a severe form of dengue infection. Dengue (bone ache) fever is a disease caused by a virus transmitted to humans by the bite of dengue-infected mosquitoes.

“After days of dengue infection, there will be loss of fluid and blood pressure starts dropping. That triggered the shock,” said the head of the anaesthesiologist department at the Thimphu referral hospital, Dr Gosar Pemba. “If not handled immediately and aggressively, it can threaten life, because organs start failing.”

This was on October 19. The next day, he was brought to Thimphu and admitted to the intensive care unit (ICU).

“We kept him overnight on the ventilator. Next day he was able to breath on his own. We didn’t replace any blood. His breathing rate was quite normal and his lungs had cleared,” said Dr Gosar Pemba.

Karma, who is recuperating now, said that he must have acquired the infection when attending a meeting in Phuentsholing. “I knew it was dengue and I went to the hospital,” recalls the father of two. “But I wasn’t admitted and, only after visiting several times, was I hospitalised.”

According to ICU records, Karma had consulted the doctors in Gelephu on October 10 and 12. He was, however, admitted for suspected dengue on October 18, said Dr Norbu Wangchuk. “When we referred him, his condition was stable. But he was quite panicky.”

Karma, who had also fainted at the Gelephu hospital toilet, said he doesn’t remember much about the trauma he went through. “I knew I wasn’t feeling well and felt like the upper half of my body was paralysed. And, when I woke up, I was surrounded by friends, who were taking turns pumping oxygen manually into me.”

Gelephu hospital’s only ventilator meanwhile is not working according to Dr Norbu Wangchuk.

But the hour-long shock had panicked and convinced Karma’s wife and relatives that he had died. His wife, who was with him in the ambulance, had already called her relatives and some had even pitched tents to receive them. “I received a call from her saying that he had died,” said Karma’s brother in-law, who lives in Tsirang.

While Karma’s condition is improving, his brother-in law, Dorji Tshering, who is attending him at the ICU, said that he should have been referred earlier. “It was already late by the time he was referred to Thimphu,” said Dorji Tshering. “If they didn’t have the facility at Gelephu hospital, they shouldn’t have kept him there too long.”

He said that Karma’s wife was even forced to sign on the referral sheet, stating that the risk of the patient wouldn’t be borne by the hospital.

The administrative officer Karma Yehsey said that usually patients and their attendants refuse to travel all the way and decide to return halfway. “And later there are chances of them saying that we didn’t refer them at all. That’ why we ask them to sign,” said Karma Yehsey.

Karma’s wife however refused to sign the form. When Karma was admitted, he wasn’t breathing properly and his condition was quite serious, said an ICU nurse. “But now he’s improving,” said the nurse.

By Sonam Pelden in Kuensel

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