For five months, 26-year-old Gulem Mohamud Hersi’s head turned into a battlefield for his brain and its unlikely opponent, a bullet. In the end, he survived.
Gulem is a resident of Mogadishu, the capital of Somalia. The east African country is a victim of a turbulent civil war and prolonged humanitarian crisis. On one particular morning, Gulem was walking past a shop on a busy street in Mogadishu when a stray bullet struck him in his head. A bullet projectile measuring 3 cm in length and 1 cm in width penetrated his brain. It is suspected that the bullet was fired from a Russian-made RPK gun.
He was taken to a local hospital where doctors tried to extract the bullet from the front portion of the head and failed, for it was lodged in the most critical area, near the brainstem, which connects the cerebrum with the spinal cord. The bullet was lodged almost 3 cm deep in the brain.
“He was in a coma for 2-3 days and lost control over bodily functions. The doctors in Somalia told us that they cannot treat him as it was a complicated case,” said 44-year-old Abdiwal, uncle of Gulem.
For the next few days, the distraught family members saw Gulem’s condition deteriorate. After some research, they pinned their hopes on the Indian medical industry and airlifted the patient to India within a month of the accident. Gulem was accompanied by his uncle and brother. The trio took an apartment for rent in Hyderabad and approached top hospitals in the city feigning helplessness due to the nature of the injury.
“Everyone was scared to perform surgery on him since it was very risky for the patient,” said Abdiwal.
The doctors at Hyderabad-based Care hospitals took up the case and performed a complex 12-hour surgery to remove the bullet. “This was an extraordinarily rare case. The bullet was lodged in a highly sensitive and critical region of the brain. The surgery required utmost precision and planning. Successfully removing the projectile without compromising vital brain functions was a significant challenge,” said Dr Laxminadh Sivaraju, Senior Consultant Neurosurgeon of Care hospitals who led a team that performed the surgery.
“We had to take the risk as it would be a problem for the patient if the bullet remains in the brain. He also faced the danger of lead poisoning. We had to clean the area off the liquid metal oozing out. We used a near microscope to remove the bullet without damaging the blood vessels which could have turned fatal for the patient. Usually, bullets are stuck in the skull without damaging the brain and are removed but this is a one-of-its-kind as the bullet was near the brain cells,” said Sivaraju.
If the operation went south, the patient had every chance of experiencing paralysis or worse death. However, no blood transfusion was needed for Gulem who is on the path of recovery now.
“Even we are surprised with the remarkable recovery. Usually, patients need to be put on ventilator support after such complex surgeries. He was under observation for just 24 hours and his vitals were fine. In three days, he started recovering.”
Fifteen days post-surgery, Gulem has movements in his legs and hands and is undergoing physiotherapy. “We are very happy and cannot wait to see him go back to what he was,” said Abdiwal.