This trip will be a new partnership between the Emergency Department at Mount Sinai in New York and the Princess Marina Hospital, University of Botswana with the goal of improving care for acutely ill children. In November 2024, the African Conference on Emergency Medicine (AfCEM) is being held in Gaborone, Botswana in collaboration with the Botswana Society for Emergency Medicine (https://www.afcem24.org/). 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 basic and advanced 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 and Pediatric Advanced Life Support have become a core part of the training of emergency providers. However, these courses are expensive and equipment-intensive, making them difficult to conduct in low-resource settings (LRS). Furthermore, as they were developed in high-income countries (HICs), they are not always entirely relevant to a LRS. In response to this, 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 presenting with life-threatening conditions. Our goal is to certify over 30 providers during the pre-conference 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.
Made by possible with this travel grant, I was able to travel to Gaborone, Botswana to attend the African Conference on Emergency Medicine, or AfCEM 2024. Myself and 5 Emergency Medicine colleagues from Mount Sinai Hospital in New York City taught a pre-conference workshop focusing on pediatric emergencies using a curriculum by the Initiative for Medical Equity and Global Health (IMEGH). Over 2 days we were able to certify 38 medical providers (including nurses, residents, and attending physicians from several African countries) in Pediatric Advanced Life Support. It was an amazing 2 days filled with hands on simulations and skills stations, presentations, and small group learning. The participants were knowledgable, eager to learn, and inspirational to be around. They were provided with the course materials including hand outs and posters to bring back to their institutions and continue the learning. Our goal for this project was to improve outcomes for pediatric emergencies and we are very optimistic that this incredible group will do just that! Thank you to the Doximity Foundation for this opportunity of a lifetime!
