In emergency situations, life or death is often determined within the first few minutes of a crisis. The medical knowledge and expertise of first-responders, coupled with a reliable emergency response infrastructure, can make a critical difference when an unexpected illness, accident, or widespread disaster occurs.
According to the World Health Organization (WHO), death rates from accidents and cardiac incidents are three times greater in Central Europe and the nations of the former Soviet Union than in the United States, and three to four times greater in some African nations. A lack of well trained first-responders and weak emergency response infrastructure greatly contribute to these high mortality rates. As a result, many developing countries are now prioritizing the improvement of pre-hospital and hospital-based emergency care in their health system reform efforts.
AIHA’s Emergency Medicine Program
AIHA has more than 20 years of experience working in close collaboration with governments and healthcare institutions around the globe to build sustainable human resource and institutional capacity to effectively provide emergency medical services. We began working with local stakeholders in Eurasia in 1993 to create sustainable capacity to effectively respond to emergencies that range from routine medical cases and traumas to mass causalities and disasters. Through this effort, we provided technical assistance to support our partners as they established a network of 16 Emergency Medical Services Training Centers (EMSTCs) spanning the region. EMSTCs use a uniform curriculum designed to fit into existing national structures and contexts to best support the rapid acquisition of life-saving first aid and urgent care skills.
In 2010, through our HIV/AIDS Twinning Program, we adapted our EMSTC model to meet the needs of the Ethiopian healthcare system, establishing the country’s first Emergency Medicine Training Center in collaboration with our partners at the Addis Ababa University School of Medicine.
In the African context, a significant proportion of the people who seek emergency room care are living with HIV, so the standard curriculum has been augmented with additional training in HIV-related complications, including acute opportunistic infections such as pneumocystis pneumonia and tuberculosis.
Selected Program Results
- The training center at Addis Ababa University has trained more than 4,024 healthcare workers and medical and nursing students in both adult and pediatric emergency medicine since it opened in February 2010.
- AIHA, in collaboration with the Zambian Ministry of Health, the African Federation of Emergency Medicine (AFEM), and the University of Cape Town, launched an emergency medicine training program. With technical support from AFEM, twinning partners at the Zambian Defense Forces (ZDF) are leading the design and implementation of emergency medicine curricula for health professionals throughout the country, which will eventually be integrated into the National Health System.
- AIHA kicked off a series of emergency medicine workshops for faculty at the Defense Force School of Health Sciences in August 2013, training 23 in Emergency Medicine Tier II. Tier III training was provided to 15 staff members, five of whom have been selected as lead EMS trainers for the School of Health Sciences. These master trainers will also conduct field training at health facilities throughout the country. In the summer of 2015, the partners will work to roll out these trainings to the community level.
- AIHA collaborated with the Central Children’s Hospital of Tbilisi in Georgia to establish the first modern and client-centered pediatric emergency room in the South Caucasus region. This center served as a model for the pediatric emergency department established at Addis Ababa University’s Tikur Anbessa Hospital in 2012 and one established by AIHA partners at the University Clinical Center of Kosovo in Pristina in 2013.
- Also in Georgia, the Tbilisi EMSTC established three satellite centers to extend its reach in rural parts of the country. In addition to training doctors and nurses, these facilities also offer first aid courses for non-medical professionals, including oil pipeline workers, sailors, and police officers that generate income and help ensure sustainability.
- The twinning partnership between Addis Ababa University and the University of Wisconsin at Madison launched an Emergency Medicine Fellowship Program. To date, four Ethiopian physicians have completed the training in adult care and two completed training for pediatric care. In addition, four RNs completed a similar fellowship for nurses, greatly expanding local capacity to train others in emergency medicine.
- The Ethiopian twinning partnership designed an emergency medicine subspecialty training program at Addis Ababa University, graduating the first cohort of four residents in October 2013. These physicians are the first subspecialists in emergency medicine on the continent to graduate outside of South Africa. As part of this program, the residents traveled to Cape Town, South Africa, for six-week observational attachments at selected hospitals associated with Stellenbosch University. Routine activities included emergency medical services, aero-medical services (MedFlight), trauma, observing insertion of chest drains, ETT, and laceration repair.
- Partners also developed a parallel Masters Nursing Program in emergency medicine, complete with a similar clinical attachment at Muhimbili Hospital in Dar es Salaam, Tanzania, which has to date been completed by 34 Ethiopian nurses. Together, the Ethiopian and American emergency medicine specialists have been working to strengthen nursing practice at Tikur Anbessa Hospital. Nurses who completed the Masters Program have assumed leadership roles at hospitals across Ethiopia, as university lecturers and clinical trainers, and even with the Federal Ministry of Health.
- In October 2012, the Addis Ababa University partners established the Ethiopian Society of Emergency Medicine Professionals (ESEP), a joint effort of the Federal Ministry of Health, the AAU School of Medicine, and their twinning partners at the University of Wisconsin. That same month, ESEP hosted the first continuing medical education conference on emergency medicine ever held in Ethiopia.
- Starting in 1993, AIHA and its twinning partners established 16 EMSTCs in 12 nations spanning Eurasia. During their first decade of operation, these institutions provided practical, skills-based training to nearly 40,000 healthcare practitioners, first-responders, students, and other groups.