Hospital at ready for NZ victims

By ANGELA GREGORY

The burns service at Middlemore Hospital is preparing for New Zealanders injured in the Bali bomb blast, some of whom will need months of treatment.

Although the number of victims was still unclear yesterday, Middlemore burns surgeon Michael Muller said he had been told by colleagues and witnesses in Bali that New Zealanders were among those burned.

"I am preparing for the worst."

The country's other burns units, in Hamilton, Wellington and Christchurch, would be warned they might need to take some wounded.

Mr Muller, an Australian on contract to Middlemore, said he had spoken to a colleague in Sydney, who was awaiting a planeload of 12 burned victims yesterday afternoon.

"That is a huge number of patients."

Mr Muller, who has been to Bali, said the hospitals there would be overwhelmed. Supplies would run low.

News reports said the hospitals were in chaos. Treatable patients were dying because of a lack of blood supplies, medical equipment and staff. Australian medical staff were being ferried in on special flights.

Many survivors of the blast suffered horrific burns. Reports talked of wounds dripping with ooze and limbs with blisters the size of golf balls.

The blast probably instantly incinerated the nearest patrons at the Sari and Paddys bars, then flame would have seared the eyes and flesh of those further back.

The roofs at both bars fell in, raining burning debris on survivors. In the hospitals of Bali - good by Indonesian standards, poor by Western - the victims lay in stifling heat with no air conditioning.

Mr Muller said prompt quality treatment was crucial for burns.

"You've got to get it right from the start."

Witnesses said it was likely many people who suffered horrific burns did not have access to the golden standard treatment - immediate fluid, bandaging and pain relief.

As the local hospitals struggled, patients may have died agonising and perhaps preventable deaths.

For others, the road to recovery is now that much more difficult.

It does not take long for a person who has suffered extensive burns to dehydrate, go into shock and die.

The odds of recovering are directly linked to the size of the burn and the speed of treatment.

The larger the burn, the more quickly dehydration occurs.

The risk of infection, especially when shrapnel is involved, is another major danger.

Infection can lead to fatal septicaemia, or blood poisoning.

Patients with superficial burns are likely to be in more pain than those with deep burns, whose nerves would be burned off.

Many of the injured are being airlifted to Australia, but their treatment in the air is hampered by altitude problems and difficult access.

Mr Muller said: "Nothing really works properly ... You have to use pumps for the drips, and there aren't a lot of pumps."

Mr Muller said the Australian-New Zealand Burns Association of which he is president had been preparing for a major burns event.

The concern to have plans in place was heightened by the September 11 attacks, he said.

Severely injured burns victims who do not have enough skin for grafts will be treated with a revolutionary new "spray on skin".

Cells from victims are grown and then sprayed onto their wounds, which helps the skin regenerate.

The first patients were being operated on yesterday at Royal Perth Hospital.

Bali messages

New Zealand travellers in Bali, and their families in New Zealand, can post messages on our Bali Messages page.

Foreign Affairs advice to New Zealanders

* Travellers should defer travel to Bali

* NZers in Bali should keep a low profile and remain calm

* Foreign Affairs Hotline: 0800 432 111

Feature: Bali bomb blast

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