I will be going to Nairobi, Kenya to join a national NGO called Emergency Medicine Kenya Foundation (EMKF) to teach local healthcare professionals ranging from MDs to Emergency Medicine Technicians to Nurses to Community Health Workers emergency medical care through the use of simulation. Emergency medical care has historically been neglected throughout the world. In Kenya, EMKF has been supporting the government and healthcare providers build capacity for emergency medical care provision over the past 10 years. Simulation is a mainstay of Emergency Medicine (EM). It provides experience, education, and skill acquisition through simulated environments that are stressful and high-risk while being safe for the patient and practitioners. In medical education, simulation is well supported by evidence to be an excellent method to teach and reinforce critical skills for excellent care provision.
I will be working with EMKF to host these Emergency Medical Care simulated trainings for learners of varied levels so as to more widely expose healthcare providers to different medical scenarios and cases. This will allow providers to practice their medical, communication, leadership, and procedural skills so as to be ready for when a real-life emergency faces them. Additionally, I will also be teaching other providers HOW to organize and effectively teach simulation based cases and incorporate them into medical education as a whole so as to create a sustainable ecosystem for the furtherance of this method of teaching and thus emergency medical capacity in Kenya as a whole.
Emergency Medicine Kenya Foundation (EMKF), the NGO I will be going to work with, works in 47 out of 47 counties in Kenya. By working with them, I will be able to directly teach multiple sessions in Nairobi to the local healthcare providers who serve the entire city. These workshops will be held both at Aga Khan University, affiliated hospitals, and in the community. However, more importantly, I will be able to teach EMKF associated healthcare providers HOW to teach and lead Emergency Medicine (EM) simulation cases and thus create a sustainable infrastructure of simulation based EM education. Through continuing work, EMKF plans to bring simulation throughout Kenya so as to strengthen the emergency healthcare services as a whole by enhancing the clinical education and capabilities of their healthcare providers.
Kenya currently has an intersection of low health expenditure as a % of GDP (4.55% vs a world average of 10.3%), low density of physicians (0.98 per 10 000), and a high rate of preventable deaths (approximated to be 57 people who die every hour due to lack of emergency medical services). By providing emergency medical simulation based training to healthcare providers of all levels we will be able to strengthen healthcare provision in a low-cost and scalable fashion. The immediate healthcare providers I will personally be training will work in Nairobi as well as the villages surrounding Nairobi to address healthcare disparities rampant in both urban and rural contexts.
In Kenya, 57 people die every hour due to lack of emergency medical services. It is proposed that by building and implementing an efficient emergency healthcare system this number could potentially be reduced by half. Emergency Medicine Kenya Foundation (EMKF) has the existing infrastructure and local healthcare capacity to scale simulation education in an effective manner throughout the country to directly address this population rapidly. As stated above, they are based in 47 out of 47 counties in Kenya at the national and local governments as well as at district hospitals. Thus, the expected impact is nationwide.
By working with Emergency Medicine Kenya Foundation (EMKF), I was able to identify that simulation based training is a need for them that will aid in their healthcare capacity building as well as knowledge acquisition. Through these sessions I hope to both 1) better prepare the group of 150-200 healthcare providers I will work on training as well as 2) strengthen the notion and idea of simulation based education within the healthcare system as a whole. While I will be present for initial simulation based trainings, the core local team will continue to utilize the curriculum I will develop with them and expand on it using the principles of simulation education. After returning, I will be working with the team to fine tune and answer any questions they have as they iteratively practice the skill of teaching simulation cases.
For myself, I look forward to being able to work with interdisciplinary teams within new cultural contexts. I strive to be able to teach and learn in a manner that creates an inclusive environment, and am excited for an opportunity to further these skills. Both these soft skills as well as hard medical knowledge I expect to sharpen during this experience will invariably better my ability to be a compassionate and caring physician.
Thanks to the Doximity Foundation's funding I had the privilege to go to Kenya, first to Nairobi and then to surrounding counties, to first teach Mass Casualty Training, then to teach Simulation in Emergency Medicine as well as Point of Care Ultrasound in Emergency Medicine to residents, and then finally to join as a pioneer of Kenyan Emergency Medicine travelled around the country to different counties to implement the initiation of an Emergency Medical Services System.
For the Mass Casualty Training, I worked with a physician from Nairobi to train nurses, clinical officers, and other physicians in Mass Casualty prep at surrounding county hospitals. My teaching appointment was for the resident physicians in emergency medicine at the Aga Khan University Hospital in Nairobi. These teachings will be furthered throughout their care daily in the emergency department. Finally, while working on the implementation of Emergency Medical Services policy, I am grateful to have had the opportunity to interact with and aid county members at all levels in bringing a flushed out EMS system to their vicinity. Over the coming years, the work that Emergency Medicine Kenya Foundation has been doing, work that I was but a minuscule part of for a month, looks to expand and keep growing! I am so excited to see where things will go.
