Mission Doctors Association

Emergency Care Grows in Uganda

In the spring of 2010, Nyakibale Hospital graduated the first class of Emergency Nurse Practitioners in Uganda. The nurses underwent an intensive nine-month training program that was supported by MDA in partnership with the Global Emergency Care Collaborative. The event was marked by hospital wide celebration and graduation ceremony.

The graduates worked extremely hard mastering all aspects of emergency care and now are now able to provide some of the most advanced emergency care available in Uganda. The course taught a symptom-based approach to diagnosis of emergent medical and traumatic illnesses. The staff members conduct skills including fracture reduction, procedural sedation, nerve blocks, bedside ultrasonography, abscess drainage and lumbar puncture. Combined with an emphasis on improved physical exam and history-taking skills, the staff became adept at rapidly identifying and treating serious illnesses and injuries.

The Nyakibale ED continues to be busy, seeing over 6,500 patients between July 2009 and June 2010. Patient care was monitored closely during the training program and will continue to be monitored on an ongoing basis. During the final four months of the program, the staff cared for almost 600 children under 5 years old. Of this group, just over 250 children had malaria and 220 of these children were extremely ill and required admission to the hospital. The mortality rate among the extremely sick group of children was 0.9%, which is lower than any other published mortality rate for children with malaria in Sub-Saharan Africa. This also exceeded the goal mortality rate set by the Ugandan Ministry of Health.

MDA’s ongoing support of the support the emergency department has been crucial to its success. At the suggestion of Mission Doctor, Bill Walsh, a surgeon who served for three years at Nyakibale, MDA raised funds for the construction of the emergency department. Lay Mission Helper Jeff Caiola oversaw the construction of the emergency department. Mark Bisanzo, an Emergency Physician who first worked with MDA in 2005, and his wife Sheila, spent 9 months at Nyakibale leading the training program in Emergency Care.
The Ugandan staff are currently being mentored by US emergency care physicians (members of Global Emergency Care Collaborative) to train the second class of Emergency Nurse Practitioners, who began their course in September 2010. The Emergency Nurse Practitioners are passing on the skills they have learned to expand the impact of the program by providing clinical teaching and giving classroom lectures. MDA welcomes Emergency Physicians with teaching skills who would be interested in either short or long-term work at Nyakibale.

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