Emergency Medicine in the Developing World

Global Health Blog – December 2011

I just got back to Botswana after attending the Emergency Medicine in the Developing World conference in beautiful Cape Town, South Africa!  It was exciting to meet so many emergency physicians, residents, paramedics, and nurses from across Africa.  Emergency Medicine (EM) is one of the newest specialties in the world with a 30-year history in the United States, and a 10-year history in South Africa.  EM training programs have recently launched in Ghana, Tanzania, Ethiopia, and in Botswana.  The conference was a good opportunity to compare notes, share experiences, and discuss future collaboration.  We even have our own medical journal now, the African Journal of Emergency Medicine, and my team from Botswana co-authored a paper describing the history of our work:
Development of Emergency Medicine in Botswana

Alongside academic EM training programs, we are all working to build acute care, emergency, and pre-hospital services in our respective countries.  The sustainability of these models will depend on the success of our advocacy in demanding these services from the health systems in which we work.  New international campaigns focusing on road traffic injuries (the decade of action for road safety launched this year) and non-communicable diseases will hopefully overlap with and reinforce our efforts…

The conference focused on these issues and others, including evidence based emergency care, point of care diagnostics (e.g. ultrasound), and appropriate technology for resource-limited settings.  Ultimately emergency medicine will develop in unique ways in each country, depending on local needs, resources, and burdens of disease.  None of us expect things to happen overnight, but facing the challenges of sustainability and government support, we were inspired by the experiences of Dr. Lee Wallis, a professor of emergency medicine at the University of Cape Town and an early champion for the specialty in South Africa.  He quoted St. Francis of Assisi during his conference address:  “Start by doing what is necessary; then do what is possible; and suddenly you are doing the impossible.”

In late October 2012, we will revisit our progress at the African Conference on Emergency Medicine, in Accra, Ghana.  I hope to be there!

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Amit Chandra, MD, MSc is an Emergency Physician living in Gaborone, Botswana.  He is a lecturer at the University of Botswana School of Medicine, and a founding faculty member of Botswana’s first emergency medicine residency program.  Dr. Chandra studied economics at McGill University in Montréal and development studies at the London School of Economics before attending medical school at the Eastern Virginia Medical School.  His current research projects involve global health education, HIV emergencies, aviation emergencies, and trauma and road safety in Southern Africa.  In 2010, he co-edited the Tarascon Global Health Pocketbook, featuring chapters on topical and regional issues in Global Health.  He also serves as a reviewer for the Bulletin of the WHO and the African Journal of Emergency Medicine.
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References:
www.decadeofaction.org
www.afjem.org
www.who.int/nmh/en/

 

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