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Emergency Medicine :A new Specialty in Rwanda Gabin Mbanjumucyo MbChB Resident Emergency Medicine

Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

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Page 1: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Emergency Medicine :A new

Specialty in Rwanda

Gabin Mbanjumucyo MbChB

Resident Emergency Medicine

Page 2: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Outline

• Introduction

• Evolution of Emergency

Medicine

• Challenges

• Future of EM in

Rwanda

Page 3: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Disclosure

• No competing interests

Page 4: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Rwanda

• Population 11.2 M

• 20% urban population

• 43.3% < 15yrs

• 1994 Genocide

Ref:Rwanda demographic and health survey 2010

Page 5: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Rwanda

• Fast growth

• Transition rural urban

• Epidemiology &

industrialization.

-More Non communicable

diseases and Trauma

Page 6: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Health care system

Page 7: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Emergency Care in Rwanda

• HC staffed by nurses.

• ED staffing by Gps in District Hospitals.

• Limited resources .

• Residency based only in CHUK largest referral hospital.

Page 8: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Human Resource for Health

• Support of Residency by US-

HRH/( EM -Brown/ Columbia/

SidHARTe)

• Strengthen specialized health

care workforce

• 16 Universities provide 100

Faculty members over 7 yrs.

The Human resources for health in Rwanda- A New partnership NEJM 2013

Page 9: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Development of EM

• Improve Emergency

Care delivery

• 2 Tiered

PGD 2013-2015-DH

MMED ongoing 14

students

• Recognition of EM

specialty

Ref-state of emergency medicine in Rwanda-2015

Page 10: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

ED Practice

• Pts triaged on arrival.

• ED based management

• Consult other depts. for non-EM interventions and admission .

• Research and Evidence based practice.

Page 11: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Trauma Epidemiology Research

• Male 733 (77.7%)

• Age: 30.5 years

• Most common cause of

traumatic injury: RTA 718

(76%)

– 308 (61.4%) RTA

involve motorcycles .

– 155 (30.9%) RTA

involve pedestrians .

Page 12: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

6 ambulances

6 ambulances

5 ambulances

6ambulances

6ambulances

7 ambulances

8 ambulances

5ambulances

7ambulances

7 ambulances

6 ambulances

5 ambulances

6ambulances

8ambulances

8ambulances

5ambulances

5 ambulances

6 ambulances

11 ambulances

6ambulances

6ambulances

8ambulances

5ambulances

5 ambulances

13 ambulances

5 ambulances

7 ambulances

6 ambulances

6 ambulances

Prehospital

9 ambulances

1water ambulance

912

Page 13: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Strengths

• Population satisfaction.

• M&E through Research

& QI projects

• Collaboration with

training other

specialties and

hospitals

• Shaping of health

system.

Page 14: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

POCUS as a strength

• Available US machine

• Time to imaging and

interpretation.

• Creation of US image

bank

• Faculty by PURE

Page 15: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Challenges

• Limited resources

• Overcrowding

• Lack of emergency

nursing training

• Maturing system

Page 16: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Future of EM in Rwanda• Urge for expansion to

more hospitals

• More research on

Rwandan based health

care

• Co-ordination of

prehospital, nursing and

MD.

Page 17: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Rwanda Emergency Care Association(RECA)

www.recaonline.org

“ The best time to have a map is before you start exploring ”

Page 18: Emergency Medicine :A new Specialty in Rwanda · 2016-05-11 · •Improve Emergency Care delivery •2 Tiered PGD 2013-2015-DH MMED ongoing 14 students •Recognition of EM specialty

Thank you

Murakoze