当地时间2023年1月10日中午13：30，第32期中国（江苏）援桑给巴尔医疗队（奔巴点）队员们参加Mkoani地区医院落成庆典观礼返回驻地准备吃午饭。驻地的门铃急促地响起来了，大家不由会心一笑，这个时间正是当地耳鼻喉科医生的求助时间点。我立刻打开驻地大门，正是耳鼻喉科医生Omar, 他汇报说，有一位年轻女性，不慎被金属鱼叉自鼻翼部刺入颅内，从60公里外刚成立的Micheweni医院转诊过来。
      我连午饭也没吃，赶到五官科门诊后，大吃一惊！只见患者面容极度痛苦，不停地呻吟着，双手托着长约1米的金属鱼叉，惊恐地看着每个走近她的人。我先安慰患者，叫她放心，一定会竭尽全力帮助她解决问题。经过一番安慰，患者情绪逐渐平稳下来。我仔细查看了病人的情况，发现金属鱼叉约有1米左右长，直径接近1厘米，自左侧鼻翼部刺入，穿过鼻中隔，进入右侧鼻腔，一直到达右侧鼻咽部，具体到什么位置，不能看清。

      经过阅读患者的X线片，我发现鱼叉带有倒刺，非常锋利，倒刺已全部刺入组织内部，尖端已接近颅底。我立即联系CT室进行CT扫描，确定鱼叉经过的确切组织结构。不巧的是，CT机正在进行检修，无法使用。我再次对患者进行了详细的专科检查，并在阅片后仔细估算出鱼叉尖部应该到达右侧鼻咽部，颅底的骨质应该没有破坏。
      权衡再三，我制定了一套救治方案：在局部麻醉下，扩大鱼叉在鼻部的进入口，暴露倒刺后将其取出，同时做好大出血的抢救准备。同时联系医疗队副队长蒋金华，全体中国援非医疗队员到医院待命，一旦有意外，全力抢救。
      紧接着，我和科室两位staff一起，给患者注射了局部麻醉药，扩大创口，找到倒刺并暴露，然后一举将鱼叉取出，患者耐受很好，局部有较多出血，经过鼻腔填塞凡士林纱条后出血停止，缝合创口后救治结束。患者各项生命体征平稳，收住院进一步治疗。
      我们第32期援桑给巴尔医疗队（奔巴）9名队员驻扎在Pemba岛Abdulla Mzee 医院，每天都会遇到各种急诊患者，8位医生都是24小时on call，随叫随到。由于地理位置的特殊性，危重患者几乎无法转诊到岛外就医，在现有医疗资源和药品极度缺乏的情况下，医疗队员只能凭借丰富的经验和高超的技术，依靠团队的力量成功抢救了一例又一例的危重患者。

Remove the harpoon skillfully in Pemba island

 At 13:30 on January 10,2023, members of the 32nd China (Jiangsu) Aid Zanzibar Medical Team (Pemba Point) had attended the completion ceremony of Mkoani Regional Hospital and come back to their yard for lunch. The doorbell rang quickly, and it was the local otolaryngologist,named Omar, who asked for help. He reported that the patient was a young woman who was accidentally stabbed into the skull by a metal harpoon and was transferred from Micheweni Hospital, which was just established 60 kilometers away.
 Dr. Qian Jian did not eat lunch, rushing to the clinic department . He was surprised by the patient who was in extreme pain, keeping moaning, holding about 1m long metal harpoon in her hands, looking at everyone who approached her in horror.  Doctor Qian first comforted patient and then gived her trust. He assured her that he will try his best to help her solve the problem. After a while, patients mood gradually smoothed down, at this point,  Doctor Qian carefully chected the patient, surprised to find that metal harpoon about 1m long, close to 1cm in diameter, since the left alar, through the nasal space, into the right nasal cavity, has reached the right nasopharynx.  After reading the patient's X-ray, Dr. Qian found that the harpoon had a sharp barb that had all penetrated into the tissue, close to the base of the skull . Qian Jian immediately contacted the CT room performing a CT scan to determine the exact tissue structure that the harpoon passed through. Unfortunately, the CT machine was undergoing maintenance and cannot be used. Dr. Qian again conducted a detailed specialist examination of the patient, and after reading the film, carefully estimated that the tip of the harpoon should reach the right nasopharynx, and the bone of the skull base should not be destroyed.
 After serious consideration, Dr. Qian formulated a treatment plan: Under local anesthesia, expand the entry mouth of the harpoon in the nose, remove the barb; Prepare for the rescue of massive bleeding; Contact the deputy captain of the medical team, Jiang Jinhua and keep all the medical team members  standby; Once there is any accident, immediately rescue the patient. Then, Dr. Qian Jian and two staffs from the department fistly gave the patient local anesthethesia ,expanded the wound and found the barb ,exposed it. Then they removed the harpoon at one fell swoop. The patient tolerated it well and had more local bleeding. The bleeding stopped after nasal filling the vaseline yarn, and the treatment was finished after suturing the wound. The patient's vital signs were stable, and he was hospitalized for further treatment.
Nine members of the 32nd Zanzibar Medical Team (Pemba) were stationed at Abdulla Mzee Hospital on Pemba Island and encountered various emergency patients every day. Eight doctors are  on 24-hour call. Due to the particularity of the geographical location, critically ill patients can hardly be referred to medical treatment outside the island. In the absence of existing medical resources and drugs, the medical team members can only rely on their rich experience and superb technology to successfully rescue the critically ill patients based on the strength of the team.