野戦病院と化した医療現場　医師「終末戦争そのもの」　レバノン大爆発

【ベイルートＡＦＰ＝時事】レバノンの首都ベイルートの港湾地区で4日に起きた大爆発は、市内の病院を「終末戦争」さながらのカオスに陥れた。（写真はレバノンの首都ベイルートの港湾地区で4日に起きた大爆発で破壊された市内のワルディ病院の病室）
　市中心部のオテル・デュー病院で５日、ＡＦＰの取材に応じた外科医、アントワーヌ・カーバン氏は、患者と同じように頭に包帯を巻いていた。６０代後半のベテラン医師は普段自分が勤務する病院でこの日、患者の側にいた。
　「負傷して道路の真ん中で血を流している人もいれば、病院の中庭に倒れ込んでいる人もいた……昔、国境なき医師団（ＭＳＦ）でアフガニスタンへ行ったときのことを思い出した」「ハルマゲドン（キリスト教の終末戦争）そのものだった」
　大爆発による負傷者は４０００人以上。市内各地の病院も激しく損壊した。その病院に負傷者はよろめきながらたどり着き、あるいは運び込まれた。４日夜、病院はどこも負傷者であふれていた。
　今回の大爆発によって、すでに新型コロナウイルスの流行と深刻な経済危機の中で悪戦苦闘していたレバノンの医療機関に、さらに大きな負荷がかかっている。
　４日午後６時（日本時間５日午前０時）ごろ、職場近くのコーヒーショップにいたカーバン医師は、爆風で２０メートルほど吹き飛ばされた。自分の病院は数分で負傷者があふれかえり、見知らぬ人がバイクで他の病院へ急送してくれた。１時間ほど待たされた後、路上で頭の傷を縫ってもらった。

■「娘さんはもう死んでいる」
　一夜明けても、現場の混乱は収まらなかった。降り注いだガラスの破片でけがをした人々が、壊れた機材やがれきであふれるオテル・デュー病院の廊下を一晩中さまよっていた。
　子どもの容体を必死に尋ねる母親たち。他の病院から移送された妻の様子をすがりつくように尋ねる老人。聞こえてくるのは耳障りな携帯電話の着信音と、疲れ切った声で交わされる会話。大抵は爆発をどう生き延びたかという体験談だった。
　オテル・デュー病院のジョルジュ・ダバール院長によると、同院では４日に少なくとも３００人の負傷者を治療し、うち１３人が死亡した。１５年にわたったレバノン内戦中、医学生だったダバール医師は「当時でさえ、昨日のような光景は見たことがなかった」と述べた。
　ある少女の家族のことを思い出しながら、ダバール医師の声は震えた。「幼い娘を助けてほしいと運んできた父親に、娘さんはもう死んでいると言うのは本当につらかった」
　病院では少なくとも５人の看護師が死亡し、医師や患者数人が重傷を負った。「この国のもろもろの状況、それからコロナウイルスの流行のせいで医療チームはすでに疲れ切っていた」「けれど昨日の危機的状況を前にして、みんな素晴らしい団結を見せた」とダバール院長。調理師から保守係まで、スタッフは一丸となって病院を開け続けた。

■新型ウイルス患者の避難
　一方、ベイルート最古の医療機関の一つ、聖ジョルジュ病院はもっと不運だった。天井は崩れ、割れたガラスが降り注いだベッドの上に電気の配線が垂れ下がっていた。
　「うちの病院は診療を停止した」と医局長のエイド・アザール氏は言った。「今の経済状況では、修復にどのくらい時間がかかるかも分からない」
　スタッフは夜明け直前までかかって患者を避難させ、機材や書類を運び出した。患者の中には、非常に慎重な移送が必要な新型コロナウイルス感染症（ＣＯＶＩＤ-１９）治療中の患者２０人も含まれていた。
　野外病院と化した中庭では、血まみれの白衣を着た医師らが、爆発のショックに陥った人々を手当てしていた。「まさに次々と負傷者がやって来る中で、患者でいっぱいの病院を丸ごと避難させるほど難しいことはない」とアザール氏は述べた。「病院のスタッフ自体負傷していて、私たちは自分の病院で働く人々も移送しなければならなかった」
　爆発によってエレベーターは止まっていたため、医師らは９階分の患者を一人ずつストレッチャーに乗せて運んだ。電気も水道も止まっている中、看護師らは大きなリスクを冒しながら全力で救命措置を提供した。
　「病院の電気は通常２４時間ついている。それが真っ暗闇になった」という臨床専門看護師のララ・ダヘルさん。「昨晩は携帯電話のライトを頼りに負傷者の縫合手術を行った。どうやってやったのか分からない。こんな状況は初めてです」 【翻訳編集ＡＦＰＢＢＮｅｗｓ】
〔ＡＦＰ＝時事〕（2020/08/07-13:16）

His head bandaged just like his patients, Dr Antoine Qurban said Tuesday's enormous blast brought Armageddon to Beirut's overwhelmed hospitals in chaotic scenes reminiscent of a war zone.
Wounded people bleeding out in the middle of the street, others lying on the ground in the hospital courtyard -- it reminded me of my missions with Doctors Without Borders (MSF) in Afghanistan many years ago, he said of his volunteer stint with the medical charity.
The surgeon was among more than 4,000 wounded people who staggered or were taken into badly damaged and massively crowded hospitals across the devastated Lebanese capital on Tuesday evening.
The huge explosion has piled even more pressure on Lebanon's strained health sector, which before the disaster was already struggling with a wave of coronavirus cases and a severe economic crisis.
It was Armageddon, Qurban, who is in his late sixties, told AFP outside the Hotel Dieu Hospital in central Beirut.
The facility is normally his place of work, but on Wednesday he was among throngs of patients, following up on a gash he suffered Tuesday night.
Qurban was at a nearby coffee shop when the blast hit around 6:00 pm local time, flinging him some 20 metres (60 feet) across the room.
His own hospital was overflowing within minutes with wounded, so a stranger on a motorcycle zipped him to another facility.
After an hours-long wait, a medic stitched up his head wound in the street.
- 'She's already dead' -
The scenes were no less chaotic on Wednesday, as people wounded overnight by falling shards of glass sought treatment, weaving between smashed equipment and piles of debris in Hotel Dieu's hallways.
Mothers asked desperately about the fates of their wounded sons. An elderly man begged for news of his wife, who had been transferred from another hospital.
A cacophony of cellphones rang, and fragments of exhausted conversations could be heard, usually retelling survival stories.
A miracle kept him alive, one woman was heard saying, while a man with a bandaged leg handed a blinking cellphone to his sister, telling her simply that I can't talk anymore.
Hotel Dieu treated at least 300 wounded Tuesday and registered 13 dead, according to its medical director Dr George Dabar, who was a medical student there during Lebanon's 15-year civil war.
Even then, I didn't see anything like what I saw yesterday, he said.
His voice cracking with emotion, Dabar told AFP the hardest moment was telling families their loved ones had died, with nothing left to be done.
It's so hard to tell a father carrying his young daughter and trying to save her that she's already dead.
According to Lebanon's health ministry, two hospitals were rendered completely out of service and two more were partly unusable.
At least five nurses died, and several medics and patients were severely hurt.
The medical teams were already exhausted by everything that has happened in this country and by the coronavirus pandemic, Dabar said.
But to face yesterday's crisis, they came together with amazing solidarity.
From cooks to maintenance workers, Dabar said, the entire staff was working side by side so Hotel Dieu could stay open.
- Evacuating COVID-19 patients -
The St. George Hospital was not so lucky. The blast left the facility, one of Beirut's oldest, with collapsed ceilings and electrical wires hanging over beds showered with glass.
We are not in service anymore, said St. George Hospital's chief of staff Eid Azar.
Amid the current economic situation, I don't know how much time it will take to repair, he told AFP.
Staff worked until just before dawn to evacuate patients, equipment and files.
We did a hospital evacuation, which very rarely happens, and which included the highly sensitive transfer of 20 patients being treated for COVID-19, he said.
Azar said the emergency operation reminded him of Hurricane Katrina, the devastating natural disaster that hit the US in 2005.
The courtyard was turned into a field clinic, where doctors in bloodied medical robes treated shell-shocked people in the open.
There's nothing harder than evacuating a hospital filled to the brim with patients while even more wounded are coming, said Azar.
The hospital staff itself was wounded and we needed to transfer our own employees.
Medics carried patients from nine separate floors one by one on stretchers, as the blast had knocked out the elevators.
Without electricity or water, nurses took great risks to provide whatever life-saving support they could.
The hospital lights are usually on 24 hours a day -- it was completely dark, said clinical nurse specialist Lara Daher.
We stitched up patients by the light of our cellphones last night. I don't know how we did it. I've never seen anything like it.