Friday, 30 June 2017

Emergency Care Growing in Kenya


I have just attended two days of the Emergency Care Symposium at Safari Park Hotel. It was running from the 29th to the 30th of June 2017.

What many of you may not know is that in my ‘previous life”, I was an emergency care doctor and was very passionate about it. Some have even gone as far as saying that I was good at it! Though I have since moved on to Lifestyle Medicine, as I felt I would be able to have a bigger impact there, I remain passionate about Emergency Medical Care, and this conference was totally enjoyable for me.

This was the first conference of it’s kind in Kenya, driven by doctors, nurses, clinical officers, emergency medical technicians and others who are very committed to see Emergency Medical Care grow in Kenya. Under the stewardship of Dr. Benjamin Wachira, the first Kenyan Emergency Physician living and working in Kenya, the team has been able to bring all these professionals together, including even bankers and the government, and teams from as far off as Uganda, South Africa and Somalia, and put together an amazing symposium that was considerably oversubscribed.

It may surprise most people to realize that of all the fields of medicine, Emergency Care is one we are all going to need, most likely directly and personally within our lifetime, but definitely indirectly through a relative or loved one. Yet, the Kenyan Medical Board has only recognized Emergency Medicine as a specialty in 2017 thanks to Dr. Wachira’s dogged determination!

Emergency Medicine is that discipline that trains an already qualified doctor in how to recognize, treat to a very high degree of technical competence and/or refer appropriately acute emergency cases. These include everything from accident victims, acute illnesses such as malaria or pneumonia when they proceed unchecked to the point of being a threat to life, and other unusual occurrences such as drowning or chocking. Emergency Physicians are the doctors we all loved to watch in the series ER. The reality is that without the scores of highly trained Emergency Medical Technicians (EMTs), nurses and Clinical Officers (COs) out there, an Emergency Physician would be handicapped and almost useless.

One thing that has really impressed me during this conference is the manner in which so many different professionals have come together to grow this new industry. The reality is that a mature emergency system involves all manner of professionals, and cannot stand on any one person or group. With this as the inaugural symposium, we can expect a bright future for the Emergency Medicine Kenya Foundation and the sector at large.

Something that stood out for me at this conference was when Professor Lee Wallis, Dr. Wachira’s teacher and mentor, gave his keynote address. In typical professor fashion, his bird’s eye view of the sector was enlightening and humbling. He noted that in Africa, the care that will make a difference is low cost, involves training a wide selection of people in emergency care skills and not in degree courses, and working with policy makers and government towards free emergency care for all. It was clear that he carries the weight of the inequity of the sector on his shoulders and I was almost tempted to console him. During a personal conversation on the last day of the conference, he mentioned that he strongly believes we have to work smarter to identify that person who is very sick before they get worse and to the point of needing emergency care, such as when one has a heart attack. And of course, it is possible to do this.

It was exciting to learn of the 18-month diploma program in Emergency Care for COs being offered at Kijabe. I have been involved in hiring COs and I do know many of them are unemployed, or working in call centers and other places. It is such a waste of resources, in a country that is grossly understaffed in the medical facilities. Knowing these emergency trained COs will be out there is personally reassuring. As a doctor who has worked in the emergency field, I live in fear of personally suffering an accident in rural Kenya. However, there is now light at the end of the tunnel. 

Interestingly government was very well represented. We were all surprised to learn from Professor Lee that our legislation is much more advanced than South Africa’s. We heard in details what the law stipulates, and policies that are being developed in the sector. We are certainly headed in the right direction, and we pray that implementation will be fast and efficient.

The Emergency Medicine Kenya Foundation has worked on a lot of resources to grow the sector, which are freely available on their website- http://www.emergencymedicinekenya.org It is actually mind boggling how they have done all this in so short a time. It smacks of a lot of personal drive and sweat from a handful of individuals. I salute them. I have always felt that Africa needs homegrown solutions to our problems, and I applaud those pioneers who are championing this and other movements. As a people, we need to mature beyond the crippling desire of personal achievement and aggrandization and instead work to make a difference and leave a legacy.


If anyone came across anything over the last two days that they would like to criticize, I would urge them to hold their tongue, sty calm and do something to make a difference. Well done Emergency Medicine Kenya Foundation, and keep up the good work.

3 comments:

  1. Dr. Dennis, you got this down packed! Thanks for the support !

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  2. Thank you so much for this piece, it's well written and captured the heart of the symposium. Thank you for the support and though you want to run away from Emergency Medicine,we know where your heart is :-)

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  3. Everyone deserves a shot for a second fighting chance.... I lost my son at KNH.... I was the one who initiated CPR and the staff present didnt know what to do... They were looking at me crying and shouting at God as I resuscitated my baby desperately.... DCM snatched him from my arms at 2 years of age.... An illness that had started a week earlier.... I must just do this course.... I do not want any other person loosing their child or relative in my arms.... Your protocols helped me intubate, resuscitate a patient who had a cardiac arrest but had to wait for morning to refer... He suffer 4 cardiac arrests in the night with successful resuscitations..... Red cross ambulance arrived late and the patient succumbed at around half to midday from previous day at 10pm struggling..... I need more of these knowledge... It inspired me....

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