Emergency Medicine in Uganda is our flagship urban project. The project hopes to make in-roads to develop the speciality of emergency medicine within the country, bringing it to the attention of international development agencies and create the gold standard of emergency care provision in a low resource African settings.
Uganda is a sub-Saharan African country that has been through a lot over the last 40 years, and yet it is now a stable economical hub for the region, and is developing and progressing every day.
Over the last 25 years, the population has doubled to 37.5 million, with exponential expansion in industrial activity, the use of road vehicles and large city populations living in close quarters. As a result of this rapid expansion there has been a huge increase in the amount of major trauma from road traffic collisions and industrial accidents, alongside the countless medical emergencies related communicable diseases.
Yet despite this development and resultant increase in population, there are currently no trained emergency medicine physicians in Uganda. Emergency departments are in place, but they are poorly designed and lack adequate nursing staff. These departments are overseen by surgeons or other specialists that are stretched to their limited in their own area, and not skilled in emergency medical care provision.
The result is the under-recognised unnecessary death of patients from treatable conditions such as malaria, pneumonia and trauma, the scale of which would be labelled as catastrophic anywhere outside of these low resource settings. GEM believes that all lives are equal, and therefore if it would be unacceptable anywhere else in the world it remains unacceptable in Uganda.
Kampala is the central hub of Uganda, with a 1.8 million person resident population and significant commuting population from the surrounding region. The city’s hospitals serve not only the regional health needs but act as referral centres for treatment of patients from the whole country.
The emergency services that exist bring patients for initial assessment to Mulago Hospital, the National Referral Hospital for the country. The emergency system within this facility lacks funding, coordination, clinical support, medical equipment and emergency physician expertise, and as a result is constantly overwhelmed by the demands of the population.
Mulago Hospital is supported by Makerere University, which houses one of the top medical schools in Africa, whose staff assist in the daily onslaught of patients from all over the country. The hospital staff recognise the need for patients to have immediate access to triage, diagnosis and treatment of trauma and medical emergencies. As such emergency medicine has been recognised by medical staff as an area that they wish to develop, specialise in and use to reduce the morbidity and mortality they see every day.
GEM understands that every country’s health system is different, serving different populations with culture specific problems. We endeavour to provide local staff with the tools to sustainably develop their own emergency medical care system. We believe that practitioners must question their own medical practice in order for it to develop and produce improvements in clinical outcomes. GEM aim to deliver teaching that will enable staff to ask the right questions, get the right results and ultimately reduce mortality of hundreds of thousands of patients each year.
We believe that given the right support, Uganda has the staff, motivation and drive to attain a regional standard of excellence in the delivery of emergency care. In order to achieve this we will use an innovative approach of educational package delivery on the ground, local and remote clinical support, quality care improvement methods and audit/research education. Through a developing partnership GEM is also working to support Makerere in their development of to a Masters in Emergency Medicine (MMed EM) programme to allow for progression of the speciality in the country.
The first phase of this project will involve a visit of the senior clinical advisory team to Kampala in May 2017. During the visit a full educational and care improvement needs assessment will be performed alongside consultation with those currently providing emergency care in the hospita. Further details will be available regarding the project following this visit.
For further information about this project please contact us.
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