Ugandan died of blood clots

By Opiyo OloyaONE could only imagine what was going through the mind of Ms Mariam Kyambadde as she boarded the Sabena flight at Entebbe Airport bound for Montreal, Canada. Whatever she was thinking, it likely was not about her health or that she would soon enter the annals of Canadian medical history. She was just another passenger on a long haul flight across the oceans, and that was that. Yet Ms Kyambadde was dead within 24 hours — in fact, she collapsed unconscious less than half an hour from touch-down, as passengers were being told to get ready for landing in Montreal. Frantic flight attendants performed cardiopulmonary resuscitation (CPR) on the dying woman while the pilots were granted immediate landing priority. Alas, by the time the Sabena jet taxied to the terminal where it was met by a bevy of super efficient Canadian emergency personnel, Ms Kyambadde was far beyond help. That was in August 2000, almost a year-and-half ago.It has taken Quebec coroners that long to find the causes of the unusual death of the 45-year old Ugandan. In a January 30 report, following a thorough investigation of all the medical facts that left no stone unturned, the coroners released their findings. According to coroner Line Duchesne, Kyambadde died of blood clots in her lungs that were caused by problems arising from travelling in a passenger plane.A detailed autopsy revealed that Kyambadde had large blood clots in the blood vessels of her lungs that originated from her legs. Toxicology tests found no traces of alcohol or drugs in her body. In other words, Kyambadde was a healthy person when she left Entebbe, but became the first confirmed victim in Canadian medical history to die because of a condition whose correct medical name is “deep-vein thrombosis” or DVT. Also known as “economy class syndrome” or “travellers’ thrombosis”, DVT can affect travellers on long-haul flights by causing blood clots in the legs after long periods of immobility. “The main factor is the prolonged immobility of a person in a small space that allows little movement of the legs and body,” the coroner wrote.Though Kyambadde like most air-travellers had probably never heard of this peril of modern travel, DVT is alarmingly more common than previously thought. According to an article in the UK Daily Telegraph, doctors who carried out a study at Ashford Hospital in Surrey believe more than 2,000 people a year die from travellers’ thrombosis in Britain. An Australian surgeon has been quoted as saying 400 people a year landing at Sydney airport suffer from serious cases of blood clots. A story in the New York Times in October 2000, estimated that five million Americans a year are afflicted by blood-clotting thrombosis caused by prolonged immobility. Citing various sources, the writer indicated that close to 800,000 Americans are hospitalized a year. Just a scanty two months after Kyambadde died, DVT gained worldwide attention after the death in October 2000 of Emma Christoffersen, a 28-year-old Briton who returned to London from Australia where she had attended the Olympic games. After completing the 19,000-kilometre, 20-hour flight, Christoffersen collapsed at Heathrow Airport and died before she reached hospital. Autopsy would later reveal that, like Kyambadde, the healthy outgoing Cristoffersen had developed a clot in her leg on the Qantas flight, which floated through the blood into her heart. Christofferson’s mum now heads a lobby group, Victims of Air Related DVT Association, which investigates suspected cases of DVT, and is advocating for wider seat allowances and for airlines to publicize preventative measures. Last year, Collins Solicitors of London, a British law firm filed a lawsuit on behalf of 30 passengers who have suffered from “economy class syndrome” or blood clots on long haul flights. It was the second such class action lawsuit, which came in the heel of another lawsuit filed by an Australian law firm against KLM, Qantas, British Airways and the Australian air safety body, CASA, over the issue. While it is unlikely that Kyambadde’s family will ever collect any financial compensation from the now bankrupt Sabena Airlines, the coroners’ findings into her death have sent ripples through the airline industry. Many in-flight videos now encourage passengers to get up and stretch. Dr Toshiro Makino who heads the New Tokyo International Airport clinic says passengers, whether first or economy class, should drink water instead of alcohol to prevent dehydration — a common cause of blood clots. Meanwhile the British Department of Health has issued guidelines which encourage air passengers to bend and straighten legs, feet and toes every half-hour while seated, take short walks when it is safe, and when possible get off the plane for a walk during short stopovers.Kyambadde did not know any of those tricks; but as Canadian coroners later noted, her death could help save thousands worldwide.