Save Lives with Emergency Care in Uganda

by Global Emergency Care
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Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Save Lives with Emergency Care in Uganda
Teddy administering to a patient
Teddy administering to a patient

“Big ideas come from forward thinking people and challenge the norm, think outside the box and invent the world they see inside than submitting to the limitations of current dilemmas”.-T.D Jakes

Teddy Kiire is my name. I have been working as an Emergency Care Practitioner for the past 10 years with Global Emergency Care. That’s where my story started.

Years ago, I had no idea what it would feel like to be an ECP but here I am to share with you what it feels like. It’s now my passion and I am very happy and satisfied with my career choice, and I encourage people to undertake emergency medicine as a career because it comes with personal satisfaction of knowing one’s work directly engaging with patients.

WHY IS EMERGENCY MEDICINE A GREAT CAREER TO ME AS AN ECP?

As an ECP, I initiate care for patients with urgent, higher acuity illness, traumas, and injuries to provide acute resuscitation and stabilisation of patients with life threatening emergencies.To love this career, one must understand how to recognize and quickly manage a complex patient's needs. For the time I have practiced as an ECP, I have mastered the skill of multi-tasking, prioritization, and working with a care team.

The main summary reason is that it is challenging and personally rewarding.You directly and quickly see the benefits and positive results of your diagnosis and treatment of patients with emergent conditions. You will have that satisfaction of knowing you have a big positive differences in patients’ lives and wellbeing and this aspect is what makes emergency medicine so interesting and stimulating.

Throughout my practice, emergency medicine encompasses a nice mix of diagnostic medicine and performing diagnostic and therapeutic procedures like bedside ultrasound, incision and drainage, paracentesis, and others.

CHALLENGES

The fact that emergency medicine is quite a new course here in Uganda, it’s still a lot to be done but we can’t stop being positive.

So, I personally love the challenges that come with adopting to the ECP roles. Today’s challenges as an ECP are to be able to work in a very stressful environment with high volume of patients and limited resources.

It’s amazing how the ECP role has advanced since 2008. I am grateful for the advocacy that Global Emergency Care has provided nationally within different states to clarify our roles and scope of practice, not forgetting my fellow ECPs because it was not a one day dream.

Questions that I always ask?

Why is it taking forever for the government to notice this is the cadre we need in our hospital setting? To sum it all, emergency medicine is a great career the national health care system should adopt to it as we shall not stop until we get there, “The struggle continues”!

Teddy and Glorious treating a patient in the ED
Teddy and Glorious treating a patient in the ED
Teddy Kiire in the Masaka Hospital ED
Teddy Kiire in the Masaka Hospital ED
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Teddy and her son
Teddy and her son

As we appreciate and give thanks to our mothers, fathers, brothers, sisters, sons, and daughters fighting this pandemic around the globe, I want to take this opportunity to highlight some of the extraordinary mothers working on the front lines of this pandemic.

Life has been turned upside down for the mothers working in hospitals overwhelmed by COVID-19 patients. The days of coming home to hugs and kisses from their children are gone. In its place, is a strict regimen of changing clothes, sterilizing everything, and fearful hugs with the constant, nagging fear of infecting loved ones.

Fear for our families

Dr. Heather Hammerstedt, emergency physician and GEC co-founder working night shifts in an emergency department, said her worry is constant. 

“When I get home, I change and everything goes directly into the laundry and I shower again. Only then do I risk spending time with my children, but always in fear of getting them sick. I worry about myself getting sick and dying; about my husband getting sick from me and dying; about the effect of my stress on my children; about their education during this time.”

Our colleagues in Uganda echoed this sentiment. Elizabeth is an ECP working in the emergency department in Masaka. She has not received hospital-provided scrubs said worries constantly about getting her children sick.

"After work I make sure I disinfect my shoes, wash hands very well, remove clothes for laundry after reaching home. I do this in order to avoid putting my kids at risk.

Stigma from the community

Another ECP, Teddy, says she has sent her son to stay with his grandma. Between the stigmatizing from the community, and her fears for his health, she felt it was the best thing for him.

"As a result of the pandemic we're facing long shifts, since most staff are not willing to take care of positive COVID-19 patients due to the fear and the stigma in communities. It was difficult before because I didn't know how to go about it too. I was scared of going back to meet my family and sometimes I would get home exhausted, worried, and emotionally drained due to the long hours. I would come home late in the night just to avoid anybody at home seeing me because my neighbors had started isolating from my family. Until I decide to send my son to live with my mom because I was certain hw would be safe and happy there. Currently, I have to keep self-isolated so that my family stays safe. I miss my son - he used to welcome me home with hugs, and I realized I can't stop him from hugging me."

Despite these challenges, Teddy maintains an incredibly positive and fighting attitude.

“I’m glad I have the courage to treat positive patients because at first everyone was scared but I stood brave to join the team. I’m glad our patients are doing better and we will be discharging our first patient soon.”

Economic fears

While Elizabeth also worries most about the health of her family, she worries about her families’ finances as well. Supplies are much more difficult to come by.

“Its’ not easy managing family and work during this pandemic, first of all it’s expensive, and we sometimes run out of sanitizer and other supplies.”

But she concluded her remarks, as any mother would:

“But still we have to fight the battle, and together we shall win.”

Elizabeth and her son
Elizabeth and her son
Heather and her sons
Heather and her sons
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ECPs evaluating a patient at the Masaka ED
ECPs evaluating a patient at the Masaka ED

One of the most important functions of front-line Emergency Care Practitioners and other emergency care providers is public health surveillance. With the novel coronavirus front and center on our minds these days, it is a good time to reflect on some of the lifesaving clinical and public health duties that emergency care providers complete every day. More often than not, emergency care providers across the globe are the first providers that see certain diseases. They are the first to see patterns of disease emerge in populations. In Uganda where several hemorrhagic fevers, like Ebola, are endemic, they are trained to recognize and diagnose patients with these deadly diseases, so they don't spread to the general public. This front-line surveillance is essential to stopping the spread of these deadly disease across the population. 

Training Emergency Care Practitioners to diagnose and treat acutely ill and injured patients is a horizontal intervention that cuts across many disease-based interventions, like HIV/AIDS, TB, and malaria, as well as a wide variety of other public health interventions, like infant and maternal mortality, injuries, road traffic accidents, poisonings, and water borne diseases. Because emergency care clinicians usually are the first to treats patients with a wide variety of diseases and injuries, the proliferation of specialty trained emergency care clinicians will not only provide essential public health surveillance, but also improve health outcomes for entire populations. Estimates suggest that in low-income countries, like Uganda, 54% of deaths could be prevented with access to emergency care.

Emergency Care Practitioners provide essential, lifesaving services in their communities, like:

  • Treating 30,000 emergency patients per year. This was half of all the emergency care provided across Uganda in 2018.
  • Each ECP treats over 40,000 patients during her/his career.
  • Public health surveillance – ECPs are the first line of defense against infectious disease outbreaks
  • Mortality decreased by 25% in patients treated by ECPs in rural Uganda

Emergency Medicine is a vast field, encompassing a knowledge base of essentially every other discipline in medicine and a wide array of procedural skills. Recognizing the huge physician shortage in Uganda and throughout Africa, GEC is training nurses and clinical officers to provide quality emergency care appropriate to the settings where they practice. Let us all be grateful for the essential surrveilance role that our dedicated emergency care clinicans play in protecting the public's health across the globe.

Patient evaluation by ECPs
Patient evaluation by ECPs
Patient Triage in the Emergency Department
Patient Triage in the Emergency Department
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ECP - Auma Winnie - in the Masaka ED
ECP - Auma Winnie - in the Masaka ED

A child born anywhere in the world has the right to grow up and have a productive life. Unfortunately, kids aren't able to do this in many places in the world because they don't have access to lifesaving emergency care, provided by specialty-trained Emergency Care Providers. At Global Emergency Care, we are working to change this. We train the available health workforce to provide that lifesaving emergency care in places where none exists. 

In fact, our recent research shows that for every $117 invested in our program, one child's life will be saved. This is incredibly compelling evidence for the importance of this program. Not to mention a very small sum of money to save a child's life. Our goal by December 31st is to raise $58,500 to save the lives of 500 children, and we need your help to get there!

Our ECPs save the life of 1 out of every 26 children they treat. Without this program, none of these children would have survived. Not only that, but it only costs $117 to save the life of one of these children. 

To put a name and face to the statistics is the following story about Precious. Precious was sick; too weak to hold her head up, too tired to cry as her father carried her into the emergency department. What follows is the story of how two of GEC's Emergency Care Practitioners, Deus and Teddy, saved Precious' life. Her story represents that of thousands of other children whose lives have been saved by ECPs. >>> Read more about Precious' precarious journey

Your support today makes our lifesaving work possible.

Mother & Daughter in Emergency Department
Mother & Daughter in Emergency Department
ECP - Kiire Teddy - working on a patient
ECP - Kiire Teddy - working on a patient

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Brad Dreifuss and Tom Neill representing GEC
Brad Dreifuss and Tom Neill representing GEC

The GEC team was honored to participate in Uganda's inaugural Emergency Medicine Conference from August 1st - 3rd, 2019 in Jinja, Uganda. This exciting step in the progression of emergency medicine development in Uganda was excellently organized by the Emergency Medicine Society of Uganda. 

GEC is proud to work alongside our many incredible partners to build Emergency Medicine in Uganda, which is why we were honored to sponsor the conference alongside with other partners, as well as participate in several session at the conference.

GEC's Masaka Program Coordinator - Rashidah Nambaziira - gave an excellent talk about interprofessional collaboration and the importance of setting clear goals and specific objectives, determining specific roles, clear communication and accountability, and effective utilization of skills and strengths. In addition, successful participatory engagements are created via mutual respect, sharing leadership and decision making, and inter-professional teams in collaboration. 

Dr Bradley Dreifuus, GEC's Director of Partnerships & Innovation, led an evocative discussion on compassion in healthcare and better patient outcomes. He highlighted the mechanism of action for compassion having beneficial effect on patient outcomes which were grouped into four categories: physiologic effects, psychological effects, enhanced patient care, and enhanced quality care. 

Tom Neill, GEC's Executive Director, presented the excellent work of the GEC Research Team in his talk about Emergency Care Research in Low and Middle Income Countries. He highlighted GEC's experience in building a reserach program as a quality assurance initiative to better understand how to provide improved care for patients and improved training for Emergenmcy Care Practitioners. 

Charles Ndyamwijuka, GEc Reserach Associate, did a great job presenting on the lessons learned from GEC's research program over the past decade, including the importance of local partnership, engaging local stakeholders, creating a shared vision and creating partnership with like-minded funders.

Overall, the conference was an overwhelming success for Uganda's nascent emergency medicine community and system development. We look forward to building on the strengths of today, to help strengthen the emergency medicine system in the coming years.

Rashidah Nambaziira on professional collaboration
Rashidah Nambaziira on professional collaboration
Dr. Brad Dreifuss on Compassion in Healthcare
Dr. Brad Dreifuss on Compassion in Healthcare
Tom Neill, ED, on Emergency Care Research in LMICs
Tom Neill, ED, on Emergency Care Research in LMICs
Conference located at headwaters of the Nile River
Conference located at headwaters of the Nile River
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Global Emergency Care

Location: Oak Park, IL - USA
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Twitter: @globalemergcare
Project Leader:
Tom Neill
Oak Park, IL United States
$30,071 raised of $50,000 goal
 
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