The Rift Valley as seen by Global Rescue's deployed paramedic
Sometimes innocuous, seemingly harmless symptoms can be harbingers of something much, much worse.
The member in question was in good health before the onset of seemingly minor symptoms. He initially experienced minor headaches and a low-grade fever, but felt well enough to return to work the day after he experienced them. However, the seriousness of his condition was revealed when a colleague found him unresponsive on the floor that evening. As he entered the room, he watched as the member suffered from a series of seizures. He quickly alerted the hotel staff who called an ambulance which immediately rushed the member to a hospital in Kampala, Uganda for medical attention. Shortly thereafter, Global Rescue was notified and scrambled a medical team and aircraft from Nairobi to transport him to a facility better equipped to handle critical patients. Unconscious with his vital signs deteriorating, it was clear that the member may not survive the transport. The primary diagnosis was cerebral malaria and it was determined the best, closest location to undergo treatment was in Nairobi. The member arrived at Nairobi General Hospital in critical condition and was immediately admitted to the ICU. In addition to the transport team, Global Rescue deployed a paramedic to the member’s bedside to monitor his care and act as a liaison between physicians in Nairobi and Global Rescue’s and Johns Hopkins’ medical teams in the U.S.
For the first few days, his condition was extremely worrying: he was nonverbal, unresponsive to pain, and experienced difficulty breathing. When able to speak, he was often incoherent and suffered from short-term memory loss. During this period, Global Rescue’s paramedic spent as much time as possible with him to monitor his condition.
The treating physician confirmed that he had cerebral malaria, a dangerous and often fatal condition which develops when parasitized red blood cells form clots, thus preventing oxygen and essential nutrients from reaching areas of the brain. Serious brain damage can often be the result.
Fortunately, due to the attending physicians’ excellent care, coupled with his swift evacuation, the member continued to show steady improvement over the following weeks. He was able to communicate effectively, follow commands, and seemed generally sharper and more aware with each passing day. Though he remained dependent on supplemental oxygen to breathe, his physical condition steadily improved, and he was eventually able to stand and take steps with assistance.
Once Global Rescue’s medical team determined the member was fit to fly, transport was arranged for the member and his family to fly to Amsterdam, Holland, his preferred destination for continued treatment. They were accompanied by a paramedic during the flight and an ambulance was waiting at the airport in Amsterdam to transport the group to the hospital, thus ensuring proper treatment and care every step of the way.
Unwanted drama arose when the member’s sister was pickpocketed in Nairobi, resulting in the loss of both her and her brother’s passports. Global Rescue worked with Kenyan police to report the theft, and collaborated with the Dutch Embassy to obtain temporary passports and inform them of their arrival.
After the group landed safely in Amsterdam, they travelled to his hospital of choice to continue his treatment. Global Rescue has maintained communication and the member continues to recover.
For advice on how to reduce the risks of malaria, read this interview with Global Rescue’s African Medical Director.
Global Rescue recently responded to a call from a member filming a documentary in Duk Payuel, South Sudan, who found herself in the midst of a violent tribal conflict. Aware that security in the area of Duk was quickly deteriorating, Global Rescue security teams immediately pinpointed her location and began evaluating extraction options with local assets. Our in-house team conducted a rapid assessment of the member’s location, survival resources, means of communication, escape options, and level of threat in the immediate area. She was initially monitored and provided with around the clock advice should the situation deteriorate. After she reported escalating violence and nearby gunshots, an immediate evacuation to Juba was deemed necessary.
To complicate the situation, there were also a number of other individuals associated with the Duk Boys Lost Clinic who were not Global Rescue members but required evacuation. Arrangements were made to ensure the safe extraction of this larger group via fixed wing aircraft from a nearby dirt airstrip.
The dispatched aircraft landed at Duk Payuel just as a neighboring village was being burned to the ground. The Global Rescue member and 7 colleagues from the clinic safely boarded the plane and were evacuated to Juba, the capital of South Sudan.
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Phil Seidenberg, Global Rescue's African Regional Medical Director, talks to Anthony Acerrano and Sports Afield about ways to reduce the risks of malaria. With 5 years spent living and working in Zambia, he has encountered and treated his fair share of cases.
Because malaria is rare in the United States, we don't hear a lot about it, save for periodic media sound bites that are largely negative and often unsettling. The news is usually bad news. For instance: More than 350 million people contract malaria each year, and about one million die from it. Meanwhile, drug-resistant strains of malarial parasites are said to be on the increase, making the disease harder to prevent and more difficult to cure. Every year, according to the CDC (Centers for Disease Control and Prevention), approximately 1,500 American travelers are diagnosed with malaria after their return to the States. And, the CDC claims, "Travelers to sub-Saharan Africa have the greatest risk of both getting malaria and dying from their infection."
Yikes. That remark made me wonder: What, in fact, is the actual malaria risk for someone visiting Africa's hunting countries? And what are the best ways to safeguard against the disease? Also, if one does contract malaria, what's the likely prognosis? Is a full cure likely? In sum, how concerned or worried should we be about the risks and dangers of malaria?
To get the best possible answers to these questions I wanted to talk with someone who knows the subject in practice as well as in theory. Since few American doctors ever see, much less treat, an actual case of malaria, I opted to go to Africa--if only by phone this time--to interview a working authority on the subject. Dr. Phil Seidenberg has lived and practiced medicine in Zambia for five years. For the last 3 1/2 years he has been African Regional Medical Director for Global Rescue (see below) in the capital city of Lusaka, where he has encountered and treated many cases of malaria.
Unsurprisingly, Seidenberg confirms that malaria is endemic in most of the hunting countries, and agrees that the disease should be taken seriously by everyone visiting Africa. That's the simple part. The specifics get a bit more complicated.
As most of us know, malaria is not a uniform threat even in Africa. The risk level varies region to region, and often is variable within a country or province.
"For instance, West Africa is generally high risk," says Seidenberg, "as are parts of Ethiopia; while Botswana is low risk. I've never seen a malaria case from the border area [with Zambia and Zimbabwe] of Botswana. Another anomaly is South Africa; they don't have much malaria."
Read the full story here.
In early September, 2009, Global Rescue received a call from the father of a 22-year-old American woman who was trapped in the house of a local family in Kampala, Uganda, where she worked with a non-profit organization. As he spoke, ethnic rioting was unfolding on the road below his daughter’s window. He asked that she be extracted from the house and evacuated back to the United States if the unrest continued and her life was endangered.
Global Rescue dispatched to Kampala a former Navy SEAL with operational experience in East Africa, to lead an indigenous team of security experts and put an extraction plan into place to evacuate her if necessary. The teams entry into Kampala was timed for the early morning hours when the streets were calm.
Kampala’s rioting was a response to the government’s refusal to allow the tribal king of Buganda entry to visit an area north of the city. Stores were looted, cars burned, and at least 24 people were gunned down by police. Some foreigners had already been evacuated from downtown locations.
The team’s first task was to positively identify the location of the young American’s room on the edge of town, evaluate its security, and reconnoiter the routes in and out. With the aid of local translators and security operatives, the team successfully negotiated the checkpoints on the main road that led past the American Recreation Area – a narrow street that previously had been completely obstructed by roadblocks and rioters – and mapped out a secondary route that led from the rear of the house to an area not far away that could serve as a helicopter landing zone.
The team then placed its helicopter pilot on standby. He had been conducting evacuations already from the roof of a downtown hotel. Together they established a plan to airlift the member if necessary to Entebbe International Airport or, alternatively, to a safe haven if the airport were closed.
Ultimately the king decided to call off his visit, the riots soon subsided, and the young woman and her family decided that her environment was safe enough to continue to work in Uganda.