The story of Bhutan Emergency Aeromedical Retrieval (BEAR) begins in the fall of 2016. A 14-year-old boy fell from the roof of his house near Trashigang (in eastern Bhutan), breaking his arm and ribs, and tearing his right lung. Breathing quickly became a struggle. Running to the scene, the health assistant examined the boy and called for immediate helicopter evacuation to the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu. On the way, however, his lung completely collapsed, the flow of blood to his heart slowed, and he stopped breathing. I was on duty when he arrived at the emergency department of JDWNRH. His heart was still beating, but after 45 minutes of effort, we were unable to save him.
We were heartbroken. Not only could his death have been easily prevented by timely resuscitation and emergency care, but he is one of many who could have been saved with the right treatment at the right time. Discussing the case with our most veteran resuscitation nurses, I wondered: What if we could deliver ICU-level emergency care anywhere in the country within an hour? What if we were to create a helicopter-based emergency team?
Seven months later, after many meetings and presentations, preparations, and trainings, WE ARE LIVE!
On May 31, 2017, we received our first call from southern Bhutan, where a 47-year-old woman was speared in her chest by a gaur. Her friends immediately informed the village health assistant, who called the BEAR team into action. We mounted onto the helicopter, but were stopped by the weather. Storms blocked our way. We were devastated! We know that patients with these wounds rarely survive more than a day without treatment. She barely survived the night, but at daybreak we went for her. We landed and reached her side by 7 am–she was in severe respiratory distress and in shock. Her right side was soaked with blood. She had been fighting all night long, and when she saw us, she had little left to give. She fell unconscious, stopped breathing, and her heart rate dropped to nothing. Then in front of the civilian crowd, the health assistants, and the flight team, we resuscitated her. Our team was smooth and calm while we vented her chest, gave her IV resuscitation meds and ventilatory support–all in an open field. We finally got her back and kept her under anesthesia until our return to Thimphu. Last week, she walked out of the hospital, smiling and laughing with her husband. She is alive. And our debt to the 14-year-old Bhutanese boy we lost last October has been repaid.
In the following weeks, you will hear several stories of people we have served across Bhutan. We are overwhelmed by the support and encouragement we have received. Here is what the Prime Minister of Bhutan His Excellency Lyonchhen Dasho Tshering Tobgay had to say about us.
Dr. Charles Haviland Mize, Mr. Kiran Biswa Diyali, and Mr. Lhab Dorji––The BEAR Team