Oct 15, 2014
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You subscribed to email updates from Saving Lives With Emergency Care in Rural Uganda by Global Emergency Care, a project on GlobalGiving. Here's the unedited update from the field:

Importance of Training Local vs. Importing Foreign
By Tom Neill - Operations Director
Alfunsi & Owen reading an x-ray in the ED
Alfunsi & Owen reading an x-ray in the ED

GECC has developed a sustainable, train-the-trainer model that educates nurses to become Emergency Care Practitioners (ECPs) to provide quality acute care in order to save lives. However, this train-the trainer model was not the initial model that GECC developed to increase access to acute care in Uganda. Our original model was a failure and taught us some very important lessons about education, capacity development, health system strengthening, and international development in Uganda. We attribute our initial failure to our continued success today.

In the beginning, Global Emergency Care Collaborative was founded to help raise funds to construct an emergency department at a small, rural hospital in southwestern Uganda. The GECC founders, four emergency physicians from the U.S., thought that opening an emergency department would drastically reduce the incidence of preventable morbidity and mortality in the surrounding communities. After the construction of the only emergency department in all of Uganda, a U.S. emergency physician, working for a different non-profit organization, was slated to volunteer at the hospital for a three-year period. According to the original plan, this physician was going to manage the day-to-day operations of the new emergency department and train the providers at the hospital in emergency care.

Looking back, one of the most surprising aspects of our plan to us was the lack of long-term vision. We knew the positive impacts that a functioning emergency department would have on preventing deaths from malaria, pneumonia, trauma, and other sources, but we were very green when it came to the long-term planning of a sustainable program that would earn the trust and buy-in of the local community. The plan from the outset was to have a foreign emergency physician at the hospital for the first three years to get the program up and running and provide training to local providers, although no formal curriculum was created.

What unfolded is the physician and his family arrived in Uganda shortly after the emergency department opened, and for personal reasons, they were forced to return home a month later. We had a newly constructed emergency department in rural Uganda with no one trained to run it. After intense self-reflection and dialogue, we determined that a program that was dependent on one individual was in no way a sustainable way forward.

Our solution was to train an inaugural class of local providers with a formal curriculum. Not only were local nurses trained in the necessary clinical skills, but they were also trained to become educators to teach the incoming classes of nurses. By designing and implementing a train-the-trainer model, GECC developed a replicable model that serves as a model for emergency medicine development in other similar resource-limited settings.

Although our failure was a problematic beginning for the organization, it forced us to strategically rethink our mission and vision to design a program that is successful, replicable, scalable, and affordable. We learned about the importance of long-term planning and engaging the local community and used this initial failure as a springboard for inventive problem solving and creative visioning. Had we not learned from this failure, our organization would not have learned the importance of building local capacity through education, and the 25,000 patients that have been treated in the past several years would not have received the life-saving care they desperately needed.

We are writing you today because today is a very important day for GECC. Today and today ONLY GlobalGiving is matching every donation (up to $1,000) to GECC by 30%. Starting at 9am Eastern, every dollar you donate will provide us with $1.30 to expand our work training ECPs to provide life saving care in resource limited settings. We are at a critical juncture as our expansion in Nairobi, Kenya needs $100,000 to move forward and our scaling up in Uganda needs a similar amount to get the program up and running at one of Uganda's ten Regional Referral Hospitals. We plan to fund these expansion programs with a combination of grants and donations from people like you - so every dollar counts! Donate HERE

Thank you for your continued support and for creating sustainable change and improving the lives of others around the world. We assure you that your hard earned dollars will be used to expand our life saving ECP training programs in Uganda and Kenya. As always, please tell your friends and family about the important work that you are doing through your support of GECC and ask that they get involved as well. Together we continue to change lives.

With gratitude,

Tom Neill, Operations Director, GECC
ECP's Jovita and JB reviewing an x-ray
ECP's Jovita and JB reviewing an x-ray
Mother and son at the ED
Mother and son at the ED
Sisters at the ED
Sisters at the ED
Continuing education with simulation exercises
Continuing education with simulation exercises
ECP- Owen in the ED
ECP- Owen in the ED


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About this project:
Saving Lives With Emergency Care in Rural Uganda
by Global Emergency Care
Global Emergency Care Collaborative (GECC) trains healthcare providers in emergency care to prevent unnecessary deaths in rural Uganda. Due to a healthcare worker shortage in Uganda, many patients die from treatable diseases and injuries such as pneumonia, diarrhea, and trauma. GECC has a sustainable train-the trainer model that educates Emergency Care Practitioners (ECPs) to provide quality acute care in order to save lives.
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