This will be the initial trip in an emerging partnership between the Emergency Department at Mount Sinai in New York and the Princess Marina Hospital, University of Botswana with the goal of building capacity in caring for acutely ill children. In November 2024, the biennial African Conference on Emergency Medicine (AfCEM) is being held at the University of Botswana in collaboration with the Botswana Society for Emergency Medicine. Pre-conference workshops, offered to local health care providers and physicians in training, will provide an opportunity to build skills and knowledge in specialty areas of emergency care. As physicians specifically trained in Pediatric Emergency Medicine (PEM), of which there is a paucity in sub-Saharan Africa, we have been invited to facilitate a workshop in the fundamentals of pediatric life support. The training will be conducted at the Princess Marina Hospital , which has a simulation center with the necessary equipment to conduct such courses, including low-fidelity mannikins and cardiac feedback devices.
Universal advanced resuscitation training programs, such the American Heart Association’s Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) have become a foundational part of the training of emergency physicians. However, these courses are expensive and equipment-intensive, making them difficult to conduct in low-resource settings (LRS). The Initiative for Medical Equity and Global Health Equity (IMEGH) was founded by a group of local anesthesiologists in Rwanda in order to develop a more practical, flexible and sustainable model for resuscitation training courses in LRS. As part of the AfCEM pre-conference workshops, we will collaborate with the IMEGHE developers to conduct and refine the pediatric-specific aspects of the training course while building the capacity of local providers to care for children. Our goal is to certify over 30 providers during the workshops in the IMEGH PALS course.
Sub-Saharan African has the highest childhood and adolescent mortality in the world. Leading causes of death include preterm delivery, infectious diseases such as malaria and HIV/AIDS, and trauma. As in most countries, these and other illnesses and injuries lead to emergency department visits. It has been well established in the medical literature that children presenting to hospitals that are sufficiently prepared and trained for pediatric emergencies have better outcomes. Foundational, standardized resuscitation training programs are one essential example of this necessary preparation. However, there still remains a paucity of PEM training programs and physicians in Africa. Therefore, the vast majority of children presenting to emergency departments are not being treated by those specifically trained in PEM. The AfCEM, offered every two years, is one important way to expand the knowledge of emergency providers across Africa. The Princess Marina Hospital, which hosts the only emergency medicine residency training program in Botswana, is an ideal location to conduct PALS training for local health care providers serving the Gaborone community.
By offering this modified IMEGH PALS course, we expect to improve the emergent resuscitative care of children by certifying providers in a globally-recognized program, but one better suited to the challenges of LRS. By increasing the number of local healthcare providers who are able to competently provide appropriate resuscitative training to pediatric patients presenting with critical illnesses across Africa, we hope to improve children’s outcomes and survival. We will track the number of providers who complete the course and will ask them to participate in pre and post surveys. These locally trained physicians will then have the opportunity to become trainers themselves, cascading skills and knowledge to other health care providers. By delivering these sessions at AfCEM, we hope to encourage other universities and hospitals across Africa to adopt the IMEGH approach and offer similar trainings at their local centers. Furthermore, we will continue to grow the collaboration between our institution and the Botswana Society for Emergency Medicine and offer support for the growth of PEM in the region and beyond.
I led a team of adult and pediatric emergency medicine physicians from The Mount Sinai Health System in New York City who taught Pediatric Advanced Life Support (PALS) to over 35 medical students, nurses, and other medical professionals as part of the biannual African Conference on Emergency Medicine. This year it was held in Gaborone, Botswana as a collaboration between the University of Botswana (UB) and Sir Ketumile Masire Teaching Hospital. Over the course of two days, we led didactics and provided hands on skills sessions for local providers to learn about and practice techniques to better care for critically ill and injured children. It was an incredibly successful project and participants where provided with materials and certificates of completion that they can share with their home institutions. We are eager to return to UB and continue sharing knowledge, experiences, and materials between our institutions!
