A
Tipping Point
Building
Uganda’s Emergency Care System-A milestone in our Baby steps!!
“A
tipping point is that critical point in a process or system beyond which a
significant and often unstoppable effect or change takes place.”
(Malcolm
Gladwell; The Tipping Point: How Little
Things Make A Big Difference)
For Emergency Medicine development in Uganda, that tipping point was on 5th December 2014-A visit from the African Federation for
Emergency Medicine (AFEM) President, Prof Lee Wallis.
Our special guest was here to observe and support
Uganda’s progress in developing our Emergency Care system. A short impactful
visit!!
 |
| L-R: Dr.Joseph Kalanzi, Prof. Lee Wallis, Prof. Harriet Mayanja, Dr. Tony Stone Luggya |
The
evening of 4th December 2014
In the One hour it takes from Entebbe Airport to
Kampala City, we discussed the development of Emergency Care systems in low
resource setting and shared various experiences from the Residency Grant program
in Tanzania; the establishment of a communication system for an ambulance
service in Zambia; the establishment of a training center for Emergency
Medicine short courses in Ethiopia; to a One million South African Rand EMS
service in the Western Cape. Our pace and mood for the next few hours was set!!
8:00
am: Speke Hotel Kampala
The breakfast that morning was nearly half as
enjoyable as what we discussed while we had it– Emergency Medicine Uganda, its
formation, and impacts. I explained to our guest the social media campaign we
embarked on 2 months ago and its impact on advocacy, networking and partnerships
for a stronger Health system. He on the other hand, offered much needed and
appreciated guidance.
10:00
am: Rubaga Hospital
First stop after a hearty breakfast was a
Private Not for Profit hospital in Kampala-Rubaga Hospital.
We visited the
Emergency Department and the enthusiastic staff working there. Among other
things we discussed improved trauma care through a streamlined data collection
process, developing major incident plans for hospitals and improving the emergency
care capacity for nurses working in the Emergency Department
11:00
am: Makerere University College of Health Sciences:
Lessons from Countries with already established Emergency
Care systems show that the process has been a direct result of efforts by National
Emergency Medicine Specialty3 groups. Makerere University is one of
the oldest Universities in Africa, and has trained majority of Uganda’s
Doctors. It will be the academic spine for training and capacity building for
Emergency Medical Care.
 |
| Prof. Lee Wallis, Dr. Tonny Stone Luggya, Prof. Nelson Sewankambo |
Key points discussed: Masters in Emergency Medicine
program, creation of an EM skills training center as well as development of
research capacity in EM for the university.
1:00
pm: Mulago National Referral and
Teaching Hospital:
 |
| Prof. Wallis and Dr. Cornelius Ssendagire: Mulago Hospital ICU |
Mulago Hospital is Uganda’s largest and National referral
Hospital. Our guest had the opportunity of meeting some members of the Hospital
Rapid Response Team-A brain child of the Anesthesiology department.
This team of dedicated and self driven Junior
anesthesiologists and Residents have taken it upon themselves to fill this much
needed gap in patient care- and they are just a phone call away.
2:00
pm Ministry of Health
Emergency care like all other aspects of health requires
government support and strategic planning and for sustainable development. The
Ministry of Health was therefore an important place to visit.
In addition, Uganda is in the process of developing
our National Ambulance Service (UNAS), a process being led by the Ministry of
health.
 |
| At the UNAS office |
5:00pm Total Uganda
We rounded up thie
day with a visit to Total Uganda; a private company that is in the process of
building its capacity in Emergency medicine. Private Companies have the
resources to invest in capacity building for their own Staff or for others through
Corporate Social Responsibility initiatives like individual scholarships or
even funding an entire Emergency Medicine training Program in a University,
like the case of the ABBOTT Fund at Muhimbili University in Tanzania. For any
Company interested in investing in Health Care, Emergency Medicine is a truly
worthy choice!!
5:00
am And just like that…..we
were on the road back to Entebbe.
This time the discussion was about funding. How do
we get funding for a system that is, like we say in Uganda, “having birthing pains”
We brainstormed many options from Mass campaigns
like the telecommunication companies to sitting back and hoping for that
Philanthropist. An interesting attempt at answering a difficult question in 45
minutes!! Well, Emergency Medicine Uganda (EMU) has taken up this challenge.
A
final note:
Thank you Prof. Lee Wallis for coming down to Uganda
and always being an inspiration.
We are thankful for the support from AFEM and all our
friends building the Emergency Care system with us. Together we are tasked to
create order out of the chaos (Linchpin, Seth Godin).
The Formation of EMU- a key group of individuals was
inspired from regional meetings4, 5 that illustrated the need for
focused meetings on emergency care development. Our journey of a thousand steps
has started.
References:
1. Kobusingye,
Olive C., et al. "Emergency medical systems in low-and middle-income
countries: recommendations for action." Bulletin of the World Health
Organization 83.8 (2005): 626-631.
2. Anderson
PD, Suter RE, Mulligan T, et al. World HealthAssembly Resolution 60.22 and its
importance as a health carepolicy tool for improving emergency care access and
availabilityglobally. Ann Emer Med 2012;60(1):35–44
3. Elizabeth
L. DeVos , Vicken Y. Totten , Lisa
Moreno-Walton , C. James Holliman , Terrence Mulligan ,Gabrielle A. Jacquet ,
Gautam Bodiwalla. How to start and operate a National Emergency Medicine
specialty organization.African Journal of Emergency Medicine Volume 4, Issue 4,
December 2014; Pages 200–205
4. The
first East Africa Regional Meeting on Acute and Emergency CareReynolds, Teri
A.Sawe, Hendry, Kalanzi Joseph et al.African Journal of Emergency Medicine ,
Volume 3 , Issue 4 , 155 – 156
5. AFEM
consensus conference 2013 summary: Emergency care in Africa – Where are we
now?Reynolds, Teri A. et al.African Journal of Emergency Medicine , Volume 4 ,
Issue 3 , 158 - 163
By Dr. Joseph Kalanzi
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