Shanksteps #98

Shanksteps #98 The nurse called me to see someone in the ER.  The note said he had an arrow sticking out the side of his neck.  I see an old man (approx. 65 years old) pulling out on the arrow lodged in his neck.  He is pulling it out as they feel if he leaves it the barb will continue working its way deeper and deeper.  He is conscious and talks with a little hoarseness in his speech.  We went to the operating room where I explored his neck. The arrows path took it through the saliva gland under his jaw, thenpiercing his voice box with the barb caught in his larynx musculature (voice box muscles).  I free up the barb and pull out another 1.5 inches of metal, rusty with years of nonuse.  Air bubbles up through the blood collecting there.  His larynx was pierced through and through.  After leaving a drain and closing over the hole, I finish that surgery.In the past the story goes that two brothers were living in the valley.  One decided to move into the mountain beside the valley.  In doing this he gave his brother the right to cultivate his land in the valley if at the end of each year he gave a portion of the crops to him.  Thus the villages of Mauvmi and Oupi were created separate.  For many years at the end of the growing season the Mauvmi people have given the Oupi grains and animals for their yearly debt.  Two years ago the Oupi people didn’tdistribute the goods evenly and so discontent arrived in that they didn’t receive their share.  So last year they were going to fight.  The local authorities were able to calm everyone down and a war was avoided.  Now this year they decided to claim their land and work it themselves.  So both villages are claiming this land as theirs.  So they organized a village war.  The Oupi have had problems with other villages in the past so others are joining in too.  The men would go with their bows and arrowsand stones and fight against the other men.  Oupi had a distinct advantage of being on the mountain.  Stones and boulders made it difficult for Mauvmi to attack.  But some harm was done and some houses burned and some clubbed and stabbed.  None arrived at the hospital for the first three days of fighting.  Apparently for the Oupi to arrive here the hospital is to go through hostile territory.  So they aren’t coming.The second casualty was the next day.  He had an arrow lodged in his back that came out on his way to the hospital.  Listening to his lungs he had a pneumothorax (a collapsed lung) but was breathing well.  He had a 6mm hole in his back on the right side.  I decided to watch him but he wanted to leave.  He refused anti-tetanus serum and when the guards were changing he snuck out of the hospital.Last night I was called to see a man with an arrow in his leg.  He had been shot in the front of the leg in the medial aspect.  Fortunately for him the vessels were missed and I was able to take it out within a few minutes of anesthesia.I heard that yesterday they decided to prolong the war for 10 more days.  They are now fighting on a battlefield.  It’s edges are marked, with two sides opposing.  The women and children are staying at home.  But may venture into the other village to steal goats, sheep, sacs of millet, or other things.  The men enter the fight by selection.  They use some magic spells to know who should enter and won’t get shot.  Apparently there is a large crowd around the perimeter just watching the war go on.When the deputy or chief of the village go near they try to shoot at them too.  I’m not sure why more hasn’t been done by the government to stop it.  They have been there some, but when they turn their backs they are right back at it.We hope all this will stop soon.  Fortunately its only localized to their area.  Greg