STEVE COOK MBBS, FANZCA, CSC
BALI BOMBING

When the Sari nightclub in Bali was bombed on 12 October 2002, over 200 people were killed, among them 89 Australians.

Steven Cook was with the RAAF team that departed the next morning. Initial casualty estimates suggested there were five severely injured.

When the team arrived in Denpasar, they were informed there were approximately 100 seriously injured and most were still at the local hospital which was struggling under the pressure.

There was poor information on casualties, long retrieval distances, severely injured and under-resuscitated patients, austere environments and limited equipment.

A casualty clearing station was established at the airport and ADF medical teams were sent to Sanglah Hospital to retrieve casualties. Sixty-six critically ill patients with severe burns, blast and shrapnel wounds were evacuated in five separate aircraft over 16 hours. Multiple operations were performed in an austere field surgery environment.

The experience in resuscitation and retrieval inspired Cook to pursue a career in anaesthesia.

SUSAN WINTER CSC, MB, BS, FANZCA, FCICM, GCHE
BALI BOMBING

Susan Winter was watching a report on CNN about a bomb that had gone off at the Sari Club in Bali.

Within 12 hours she was in Bali with a RAAF evacuation team. Half the team set up an Aeromedical Staging Facility at Denpasar airport. The rest, including Winter, went to Sanglah Hospital, to triage and evacuate.

“Personnel and equipment were limited.   Most of the patients were badly burnt, and pain and tissue preservation were the priority.”

We gave morphine by protocol, and ketamine to facilitate fasciotomy and escharatomies where necessary. As oxygen was limited we hand-bagged the ventilated patients…”

Winter was on the second flight back to Darwin with 22 patients.

There were many lessons learnt from this evacuation. The improvement of facilities in Darwin, the creation of the National Critical Care and Trauma Response Centre, and the development of better evacuation plans were a direct result of the Bali bombings.