On The Verge of Losing A Limb: A Case Of Positive Patient Outcome at KUTRRH

February 1, 2022 looked like a normal working day for Mr. Peter Karimi Maina. At 9 a.m., the middle-aged Civil Engineer went to a construction site he was supervising in Githurai 44, gave instructions to the site workers and left for another site. In-between he passed through his mother’s house in Githurai area and took some breakfast then proceeded to the second site.

The work at the second site was proceeding well and after consultations with the head mason, he left for the site’s main gate. Then disaster struck. He stepped on a stone which tilted and sent him sprawling with his arms outstretched. One arm went under the iron sheet which was part of the site perimeter wall which tore through his forearm causing grievous damage. Luckily site workers rushed to his rescue and lifted him out of the carnage. Blood was gushing out of his arm. Subconsciously he remembered some first aid lesson and asked his rescuers to remove his belt and tie it above the injured part of his arm to curtail the blood flow.

A while later, a motorbike was summoned to site and he was taken to a nearby dispensary where the best they could do was bandage his arm and add another tie-up above the belt strapped above the injury. He was then moved to another clinic where the doctor assessed the injury and declared that the damage was beyond the facility’s ability, subsequently the attending doctor referred him to Kenyatta University Training Research and Referral Hospital (KUTRRH) in Kahawa West. An ambulance was summoned and off to KUTRRH Karimi went.

At KUTRRH, Mr. Karimi was received at the Accident and Emergency Centre and quickly first aid procedures were administered, and X-Rays taken as the in charge summoned the relevant doctors who could attend to Mr. Karimi. On call were Drs. B. Mishra – the Cardiovascular Surgeon and J.P. Ogallo- a Plastic Surgeon, who after being briefed on the extent of the arm’s damage -as shown by the X Rays – instructed that the patient be prepared for theatre. Given the extent of the damage to the arm the most likely scenario was amputation to prevent gangrenous damage to other parts of the body especially the heart. After consultation amongst themselves the doctors and the nurse-Mr. Samuel Karanu decided to try another approach from amputation. They put their expertise to trial and operated on Mr. Karimi’s hand with an eye on saving his forearm. Mr. Karimi was then wheeled to the High Dependency Unit (HDU) to be stabilised as he had lost a lot of blood. After a few days, he was transferred to the Intensive Care Unit (ICU) where he spent a couple of days and another operation was performed. The specialists’ effort paid off and Mr. Karimi was moved to the wards where he recuperated for three weeks and was discharged. In a letter to the medical team that attended to him, Mr. Karimi expressed his gratitude for the level of professionalism and comfort that he experienced at KUTRRH. He wishes that the KUTRRH approach to patient problems can be replicated across Kenya for countless positive patient outcomes, as his case has turned out to be. Mr. Karimi’s only evidence of injury on his discharge was a sling on his arm. His fingers were moving and save for the sling, he could perform hand tasks like any other person. He is thankful to God and the medical team at KU Referral Hospital for sparing no effort towards the positive results he is now enjoying. Mr. Karimi’s mother was equally overjoyed by the positive outcome of her son’s case. She noted that, “from the gate through the reception to the wards at KUTRRH, everybody knew their work. I wish the standards set by the hospital leadership can be emulated across board for positive patient outcomes.”

According to Dr. B. Mishra, a specialist surgeon at KUTRRH with over 30 years of experience in various countries, countless cases like that of Mr. Karimi end up with quick amputations. However, the team at KUTRRH opted for a different alternative, granted their expertise and adequate capacity.

On her part, KUTRRH Board Chairperson, Prof. Olive Mugenda was thankful to God and lauded the medical team for their effort in saving Mr. Karimi’s arm. The Cabinet Secretary, Ministry of Health, Hon. Mutahi Kagwe also commended the medical team for their stellar efforts and success in the procedure.

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