R report
// african ems
want to help african em? think local. One of the greatest threats to African emergency care development is an imported, Western understanding of the standard of care. If outsiders want to have a positive impact on African emergency medicine, we need to talk less, listen more, and focus on local talent and resources.
by jason friesen, mph, emt-p
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ecent events in Africa have highlighted the continent’s ongoing and urgent need for improved emergency medical care. Examples—both positive and negative—include the Ebola crisis, several terrorist attacks, inaugural consensus statements from the African Federation for Emergency Medicine (AFEM), the U.N. Decade for Road Safety Action, and, perhaps most importantly, the sustainable development goals’ (SDGs) inclusion of injuries and maternal mortality as priority health concerns. The attention is welcome, for better or for worse, when
the routine disasters that emergency medical providers specialize in make it to the international news cycle, raising awareness and questions. One can’t help but hope that the billions of dollars spent on HIV/AIDS, malaria, and tuberculosis in Africa will one day be matched with funding to address routine emergency medical conditions. But how would Africa respond if such a thing were to come to pass? A Nigerian physician described in a New York Times opinion piece what may represent the prevailing sentiment: “We need to put in place systems to provide lifesaving care for accident victims [so they can] be moved to a fully equipped hospital — one with X-ray machines, CT scanners, a burn unit — within the space of 45 minutes. We need at least 10 of these proper hospitals [in Nigeria]. We need to improve our roads, and we need a high-quality ambulance system to drive on them. And we need paramedic schools…” He concluded the article by calling for an African response, with international support, adding: “It’s time the global public-health commu-
nity paid attention to Africa’s urgent need for emergency medical care.” But where the global public-health community joins Africa on the path to quality emergency care is exactly where things begin to get complicated. Chief Complaints In 2009, I started a nonprofit organization, Trek Medics International, to donate equipment and ambulances and offer prehospital emergency medical training in lowand middle-income countries. Over the past seven years, along with a growing community of emergency medical professionals in multiple countries, Trek Medics has given its undivided attention to the challenges of providing emergency medical care in resourcelimited settings. We have learned a great deal about local response, international support, and how attention from the global publichealth community gets translated into community programs. We have also learned that much of conventional wisdom falls flat when tested in the real world—that equipment, training, and ambulances have very little www.epijournal.com
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