Zambia has a desperate need for emergency care delivery in every health care facility. Everyday emergencies such as postpartum hemorrhage, road traffic accidents and pneumonia in children routinely result in death because of lack of trained healthcare providers. Unfortunately, there is only a single emergency trained physician in the country for 17 million people!
I founded and lead the Global Emergency Care Initiative at the University of Colorado School of Medicine. We have partnered with the Ministry of Health to increase emergency care capacity in health facilities for frontline care providers. Unfortunately, while the Ministry recognizes the enormous need, they have little funds to be able to support emergency care education.
In September 2019, I intend to lead a group that will provide local facilitator training and the WHO Basic Emergency Care course in multiple hospitals. The course has been piloted and implemented in a few other locations in Zambia and there remains an ongoing desperate need for the provision of timely, life-giving emergency care. In a similar setting in Uganda, the implementation of this course resulted in a 50% mortality reduction in the health care facilities. Feedback on initial course implementation in Zambia has been overwhelmingly positive which is why the Ministry has requested further training for its underfunded government hospitals.
I intend to train Zambian front line providers in the World Health Organization Basic Emergency Care Course. These include nurses, clinical officers, physicians, ambulance attendants and pharmacists. I will train multiple local trainers who will continue the work after our team is gone.
I know from my work in Africa that most of these providers bear witness to many patients dying with few skills in emergency care to help them. Our data from other similar courses in Zambia and Africa suggest this proposed course will dramatically improve the skills and confidence of providers to deliver the quality emergency care necessary to save lives and decrease long-term disability.
The expected impact of this intervention is to decrease suffering and disability and save the lives of all who enter the health care facility with an emergency condition. In addition, empowering local care providers with this knowledge enables them to be their own advocates for changing the way emergency care is provided in their country. Our approach of training trainers will allow increased sustainability and provide local champions at each health facility. Our data from other courses in Zambia has proved our model of training has a high retention of knowledge and immediate application in everyday clinical work.
Our team taught both a community first aid response program in a rural location as well as the WHO Basic Emergency Care Course (BEC). The BEC course was taught to the very first class of Emergency and Trauma trained nurses for all of Zambia! We then went on to train many of them as trainers. Our team had expected 30 participants and we had 68! Gratefully, Zambian trainers we had previously trained were able to help us with the teaching load and skill sessions. This culminated in a mass casualty exercise that the students performed extremely well in. While there, we enjoyed the full support of the Ministry of Health which will enable the new trainers to really teach others. We are excited for our new nurse and physician trainers to go out to the rest of Zambia to pass on their new skills!
