TC/0027

Volunteers flock to 'County' to aid dedicated resident staff activate disaster plan

Tyrone County Hospital fulfilled its role in the Omagh Community in the wake of Saturday afternoon's act of barbarity in the town centre.
"And it did so in a dedicated way. We did things efficiently and in a highly professional manner. I am incredibly proud of the skills, care, devotion and compassion of our staff under such horrendous circumstances. No one could have asked for more," said Dr. Clive Russell, medical director of Sperrin Lakeland Health and Social Care Trust.
"The major incident plan worked, there is no doubt about that. Although it was initially overwhelming, everything fell into place," he added.
On Monday afternoon Dr. Russell outlined to the 'Tyrone Constitution' the hospital's response to what he termed "an act of evil, which was cruel, horrid and calculated'.
He spoke of the many offers of help the hospital had received, and was continuing to receive, from both the medical profession and general public, and told of how a bouquet of flowers had been delivered to the 'County' from the Royal Hobart Hospital in Tasmania.
"It was so satisfying to see the help we received, and the offers of help we received, from the public, people offering transport, to provide blood, and bringing sandwiches," said Dr. Russell.
And he continued: "I am very proud of the people of Omagh. I am proud of their dignity, their patience, their compassion, and their kindness to those injured and maimed last Saturday afternoon."
Other key players in the hospital's Major Incident Response Scheme revealed details of the many people from far and wide, who had simply turned up unannounced and contributed to the successful implementation of the plan.
Nursing team
Husband and wife nursing team from Yorkshire, Paul and Ann Booth, who were on holiday in the area, and Dr. Robin Jackson, a consultant radiologist at Altnagelvin, also visiting Omagh, immediately went to the hospital to assist the emergency team in X-Ray.
Mr. Patrick Stewart, an Ulster Hospital anaesthetist, and, a female English doctor came from her holidays in Donegal to help, said Dr. Peter Garrett, the medical coordinator for the scheme.
A doctor from Sligo, and a neuro-surgical registrar from the Royal Victoria Hospital, who was believed to have been in holidaying in Sligo, both passing through Omagh at the time the bomb detonated, also checked in.
The hospital authorities are still attempting to pull together a comprehensive list of all those who volunteered their assistance as the heart was ripped out of Omagh.
"The response of our own staff from every department was absolutely tremendous - I have the utmost admiration for them - and we were overwhelmed by the support, and offers of support, from other hospitals in the Western Board area, the RVH, the City, Craigavon, Cavan, Sligo and Letterkenny hospitals," said Dr. Garrett.
"Not a single patient suffered because of any delay in care and attention."
'Airlifting'
Dr. Garrett added: "Without the help of the military airlifting patients, many more lives would have been lost."
Senior sister, Bridie McMenamin, the duty sister on Saturday, said she had been greatly impressed by the way all departments at the 'County' were up and running in 60 minutes.
"Catering, stores, the lab, the central sterilisation unit, the pharmacy, domestic services, the X-Ray department, and, of course, nursing and medical, were all fully operational well within the hour." said Sister McMenamin.
People, from everywhere, appeared as if out of the woodwork. Drew, one of the maintenance staff, mysteriously appeared at my elbow and helped me to get outpatients ready, fetching mattresses and other equipment." she added.
Sr. McMenamin also paid tribute to the tremendous efforts of the paramedics and voluntary services, who had responded in such a short space of time to a horrific incident.
"A social worker from Co. Down, who was somewhere locally, was among the first of the volunteer helpers to arrive at Tyrone County Hospital," she added.
Also praised by the sister was the administration back-up team at the hospital.
Her point was taken up by Mrs. Glynis Henry, clerical services manager, who came from her home near Enniskillen, and Mrs. Janet Hall, Sperrin Lakeland's public relations officer.
They said: "Thanks have to be given to all departments throughout the Trust. In order to leave the medical staff to treat casualties there was a huge back-up team on duty.
"Telephonists, receptionists, admin., and porters, and we also had help from the Red Cross, St. John Ambulance Brigade, the Order of Malta, and offers of help from the Samaritans.
Perfection
Dr. Russell said the hospital's major incident plan had worked to perfection from the moment it was set in motion by Mrs. McMenamin.
In her role as nursing co-ordinator for the plan, Mrs. McMenamin moved to open the outpatient department's doors, shortly after the bomb exploded in Market Street.
She said she had known it was the 'real thing' when she heard the bang and had taken three nurses with her from Medical Ward 12 where she had been on normal duty with Sister Anita Quigley.
"I sent the three to casualty while I went to the reception area to open the co-ordination office. I then intended to open outpatients, but, when I reached the backdoor of A & E the first casualty was also arriving," said Sr. McMenamin.
It was Mrs. McMenamin's own niece, who had been brought in by two of her friends.
"Vehicles were drawing up all the time and, within four or five minutes there were as many as 30 patients in casualty, some with very obvious serious injuries," the sister said.
'Mock run'
"We had a mock run not too long ago. but it did not prepare me, nothing could have prepared you for what came into the hospital on Saturday," she added.
The small unit of A & E staff on duty, along with the casualty medical officer began seeing patients, assisted by the three nurses brought there by Mrs. McMenamin.
Meanwhile, Dr. Russell was on his way to the hospital from his home about five miles away.
He said he had heard the explosion at his home in Donaghanie while gardening, and had immediately attempted to contact the hospital by telephone, but the bomb had disrupted the telephone services. "I then used my mobile, and the switchboard told me to come in at once," Dr. Russell said.
When he arrived at about 3.45pm with his wife, Judith, a part-time doctor in the ENT department, he was met by a chaotic scene.
"It was unbelieveable. What we saw was horrendous. There were many patients already there, and others were arriving in waves, by cars, vans, and ambulances. Some were carried in on doors," Dr. Russell revealed.
In the event, he was about to begin a 10-hour tour of duty, which finished with a 2am Sunday morning ward visit, accompanied by Miss Kate Law, of ENT, who had worked throughout the day after also responding to the explosion.
"We had transferred out the last patient by helicopter from our own helipad sometime after 1am, and we decided we should look in on all the bomb injury victims," said Dr. Russell.
Also on that ward tour was Dr. Garrett, who had been on duty in the morning. He had gone home, but returned to activate his role. In all he managed just four hours sleep overnight on Saturday.
Mrs. McMenamin, continued on duty until 6.30am on Sunday morning, having commenced her normal rota, which had been due to finish at 5pm on Saturday, at 7.30 that morning.
"Adrenaline keeps you going in situations like that, you don't feel tired," she said.
The co-ordinating sister had opened outpatients, and was surprised to meet the two 'Sligo' doctors at the door.
"It was full within five to eight minutes, and I knew then we had to get other areas open. Sister Quigley opened Ward 6, and I co-operated with Dr. Russell to get equipment, dressings and other material gathered. The sheer volume of people was the problem," said Sr. McMenamin.
Thronging
The medical director estimated that at its busiest, up to 1,000 people were thronging the wards and corridors of the 'County'.
"Initially casualties came in waves, for up to two hours, and then the anxious and distressed relatives began arriving, also in waves, looking for family members. We had to organise door duty staff on the wards."
Dr. Russell confirmed Sr. McMenamin's and Dr. Garrett's accounts of the 'unattached' staff who had reported for duty.
Doctors, who had been driving through town, junior doctors from Londonderry, and others from Belfast, some who had worked in Omagh in the past, nurses from Altnagelvin, and a nursing sister from Cookstown, he said.
He went on: "Seamus McAleer, (a native of Curr) a clinical oncologist at Beaver, came in, and a clinical psychologist from England, on holiday in Donegal, also got in touch, offering to attend.
"At one time we had 14 anaesthetists in the building, our own two consultants, Drs. Reuben Lasingh and John McGuinness, and they were joined by 12 others.
"And the response from our local GPs was fantastic. They came in from Omagh, Fintona, Carrickmore, Gortin and elsewhere."
Among them were Dr. Irfran Hassan, chairman of the Omagh Health Centre GP's committee, and others such as Dr. Nigel Pollock, and Dr. Kenny Hicks and his wife.
On the nursing side, staff appeared from Drogheda, the Erne, and Dundalk, while offers came from the Beaumont in Dublin, Letterkenny, and many other hospitals in Northern Ireland.
"We also had faxes of support from many hospitals, and all Belfast Hospitals have offered the services of doctors to stand in," Dr. Russell disclosed.
Relatives dead
One nurse who came in on her day off, Staff Nurse Marita Crawford, later became aware that her brother, Gareth Conway, was one of the missing.
And Mrs. McMenamin said she became aware at midnight that her sister-in-law's brother, Brian McCrory, was also missing
Mr. Conway, an 18-year-old student, and Mr. McCrory, a 54-year-old father of three, were among the 28 dead.
'"In a way our work had protected us, because we never heard the full extent of the what had happened until much later," said Sr. McMenamin.
Picking up his account, Dr. Russell said that shortly after his arrival patients were on the ambulance bay floor, and in A & E, and staff were already engaged in TRIAGE.
He explained: "Doctors were assessing for severity of illness or injury, and organising and prioritising treatment. Some were directed to outpatients, others more seriously ill were taken immediately to the Intensive Care Unit and Recovery.
"We opened Wards, 5, 6, 7 and 8, and patients were taken there, too. But we soon realised we were running out of space, and we had to open Wards 1, 2, and 2A, which are normally closed at weekends.
"Notes were made on all patients, they were attended to, their wounds dressed, and drips put up. Once in a ward they were re-assessed, and decisions taken on injury severity, and who should be transferred on."
Transfers of those requiring major surgery or the very serious ill, were by ambulance or army helicopter, which were involved in numerous shuttle runs.
Dr. Russell said ambulances had arrived at the hospital from across the Province, and their duties were superbly, and independently, coordinated.
"They were excellently controlled. When we needed either an ambulance or helicopter, it was there immediately. I can't praise those involved highly enough," he stated.
Patients were transferred on to the Royal, Altnagelvin, the Erne in Enniskillen, and the Ulster Hospital, while it was subsequently discovered that some casualties had been taken direct from the bomb scene to the South Tyrone Hospital in Dungannon.
At the 'County', in the meantime, doctors and nurses were allocated to each ward, and each patient allocated a nurse, some of whom Dr. Russell said he had not seen for years.
"They had worked at the hospital years ago, but many had since retired. Other doctors and nurses came in from off-duty," he said.
Prioritised
The most seriously ill were resuscitated, stabilised and prioritised.
"This cycle went on during the entire evening, with patients then being taken to theatre or transferred," said Dr. Russell.
Two theatres were operating, with the hospital's own consultant surgeon, Mr. Dominic Pinto, in one, and Mr. Rodney Payton, consultant surgeon at South Tyrone, in the other.
Mr. V. Rao, associate specialist, was also involved with theatre work and in A & E, and the hospital's third theatre was opened later in the day.
On Sunday two full rosters of theatre work were carried out.
"Sunday is a blur - visitors, repeated re-assessments and stabilisation, press conferences, and all the while normal emergency work went on unhindered and uninterrupted," said Dr. Russell.
He said he had been impressed by a very genuine Deputy Prime Minister, Mr. John Prescott.
"Mr. Prescott showed real support and concern for the patients and staff," he added.
Other visitors included Irish President, Mrs. Mary McAleese, Archbishops Eames and Brady, and local clergy.
"Things have been much more controlled today," said Dr. Russell on Monday. "We transferred one lady from ICU to the City Hospital, otherwise our remaining 21 patients are all stable."
But he warned: "The shock is now wearing off. Staff who got by on adrenalin are now beginning to come to terms with the reality.
"Everyone involved has known someone who was brought in, or who has suffered, died or been bereaved.
"No one in Tyrone County Hospital will be untouched by what they have seen. We will grieve as others have grieved, because we are part of the community."

Publisher: TYRONE CONSTITUTION

Ref: TC/0027

Published Date: 20-Aug-98