Dr Jill McIlraith
As a fifth year medical student at University of Witwatersrand, Johannesburg, I was one of the first on the scene when a double-decker bus carrying 72 high school students went off the causeway of a small suburban dam in March 1985. 42 children drowned that afternoon.
I lived opposite the Westdene Dam and was at home that Wednesday afternoon, having been up late the night before doing my emergency medicine attachment at Johannesburg Hospital’s Casualty Department. Hearing a woman yelling for help, I went outside to see a handful of people in the water, some clambering onto the just-submerged roof of a bus.
By the time I got to the dam wall a few minutes later, several passers-by had started to pull children out of the water, dropping them on the road before going back for others. The first ambulance arrived within six minutes and immediately called for back-up. But for the first critical ten minutes there were only two or three of us able to do CPR with dozens of blue, unconscious children at our feet. Within twenty minutes numerous fire trucks, police and ambulances had arrived, but by then we had dozens of dead children.
At one point I stood up and looked at twelve teenagers lying on the tarmac around me and thought: How do I decide who to do CPR on and who to leave? How long do I try on each person before going to the next?
I had tried to resuscitate six children by the time help arrived but they all looked the same in their school uniforms. In the chaos that followed, I never learned which ones lived and which ones didn’t. Of all the people I worked on that day, the only one that I know for certain survived turned out to be the bus driver – a Coloured man, William Horne. His passengers had been white Afrikaner school children. In mid-1980s South Africa, this added another whole dimension to an already hugely traumatic event. Conspiracy theories and allegations – and death threats to the driver – came fast and furious in the next few weeks.
The day after the disaster, I went back to my emergency department attachment, arriving an hour late, not having slept much with the events of the previous afternoon churning through my head: constant visions of dead, pale and perfectly unmarked teenagers lying at my feet in the Highveld autumn sun.
While my fellow medical students were supportive (and very grateful that it hadn’t been them), my most vivid memory of that morning was the scathing comments from the emergency department consultants as to how incompetent those first on the scene had been and how they would have done much better.
I felt battered and raw and what I needed as a young doctor in training was a more practical approach. Were there any criteria I could have applied to decide who to do CPR on and who not? How long should I have kept going on one child when others where being dragged out of the water and dumped next to me? What would they have done differently? But they were too full of their own self-importance to pay attention to the needs of a fifth year medical student. In retrospect, perhaps their bluster was part of the impotence everyone felt over the death of 42 children.
Intellectually I could see that there was probably little that would have made a difference. The number of children involved and a very small critical window period were the main determinants of the mortality rate from the moment the bus left the road.
After that first day and the hostile, critical comments from senior colleagues I did not talk about it again at medical school.
In the aftermath of the disaster, with allegations flying that the bus driver had been drunk, I had made a statement to the police. The bus driver had vomited while I was doing CPR and I had got a good mouthful of his recent lunch – cheese sandwiches with no taste or smell of alcohol – before rolling him onto his side to clear his airway. Blood alcohol and toxicology tests later confirmed this.
A year later, while on my rural attachment in the Eastern Transvaal as a trainee intern, I was summonsed to appear in the Johannesburg High Court. William Horne, the bus driver, was facing 42 counts of manslaughter.
With a week of my rural block to go, I handed over my part of the project and drove the five hours back to Johannesburg on my own. I dreaded recounting the events of that day to a court packed with parents and school friends of the dead teenagers. Many had already made it clear that they resented the bus driver’s survival.
I spent the next two days sitting alone outside the courtroom, waiting to be called. After giving evidence (the judge thanked me for my efforts at the scene, one of the few people to do so), I phoned my medical school supervisor. Medical School wanted me to return to the rural hospital for the final three days of the attachment. I refused. I said I needed some time out and that I intended to hibernate at home for three days. They backed down eventually and did give me credit for the attachment. No one asked if I needed to talk through what had happened on a medical level or an emotional level.
After a three week trial, the bus driver was acquitted of all charges. None of the evidence, including my tuppence worth, shed much light on what had caused the bus to drive off the causeway road. Horne himself had no recollection of the event, or the weeks that followed when he was in hospital with aspiration pneumonia (those cheese sandwiches again) and the several broken ribs I had given him.
None of the surviving children could shed any light on the events either. In the absence of evidence to the contrary, the judge concluded that the bus driver had had a blackout.
The only positive things to come out of the whole, horrible saga was that Johannesburg rewrote its disaster management plan to include mass drowning along with mine disasters, bombs, fires and airplane disasters. They also established a joint police and fire department dive team which had previously been thought a luxury in an inland city with no big rivers or lakes, just private swimming pools and a handful of small, suburban dams. Small they may have been, but just big enough and deep enough to cover a double-decker school bus.
Dr Jill McIlraith is a general practitioner who wanted to be policewoman or a vet, instead worked as journalist and then went to medical school as a mature student. Writing and animals continue to be a source of comfort and sanity.
This article was previously published, in an abbreviated form, in the BMJ journal Medical Humanities 2008; 34; 47-52.