Redressing the balance in Uganda’s Emergency Care system; Consensus from the July meeting.

Uganda like many countries in the world is always experiencing events that pose an immediate risk to health, life, property and environment.

Emergencies and in their great sense disasters come in various ways; Road carnages, conflicts and acts of terrorism claim lives in their hundreds. While most of the events are due to factors that can be controlled by man, natural causes like the landslides of Eastern Uganda, floods and droughts have also left the country in great despair. These states of emergency always shock the country in impact and receive wide media coverage. However, underneath these, there are unreported singular emergencies of heart attacks, Strokes, Obstetric and pediatric emergencies etc. continue to disable and claim lives in thousands.

Components of an Emergency Care System

The first WHO meeting on Emergency Care Systems was hosted at WHO headquarters in September, 2015. The Geneva Meeting ratified a framework of essential components and functions of emergency care systems. The basic components include; Prehospital Care at the scene of injury and during transport to a health facility, Hospital care in the emergency room and during admission.

On the 19^th July, the Uganda UK Alliance and Manchester University convened a similar meeting to develop consensus for strengthening the emergency Healthcare system in Uganda. The much needed meeting had representation from most stakeholders in emergency Care including; the ministry of Health, directors of various hospitals, office of the prime minister, universities, Police and ambulance services. The W.H.O extended guidance during the meeting.

Emergency Care in Uganda

The assessment for Uganda’s emergency care system in the meeting was led by W.H.O’s Dr Teri Reynolds and Dr Darren Walter from Manchester University. The assessment identified several gaps in emergency care and other structural challenges were highlighted by the commissioner Ambulance Services, Dr Waniaye and the permanent secretary ministry of health.

Some of the gaps in the basic components included; Lack of proper Scene care and First aid, inadequate and dysfunctional ambulance systems for patient transport. Ultimately the lack of emergency facilities country wide with gaps in care in the existing ones was startling.

The gaps in the processes of care aside, there are many challenges in the Governance and system organization of emergency Care. The poor coverage of emergency care services Nationwide, lack of policies and Agencies to coordinate the systems were all part of this dangerous dynamic.

The meeting also discussed funding and Legislation to guarantee Universal access to emergency services.

Prospects

The meeting that lasted 2 days ratified a number of action priorities to guide development of a countrywide implementation plan. The process also involved identification of resources and processes to achieve the set goals. These priorities included; training and equipping of Prehospital providers of care, increasing coverage and quality of ambulance services, revitalizing emergency facilities in health facilities in resources and training of healthworkers. System Governance priorities high on the agenda included; Expansion and operationalizing of the ministry’s directorate, fast tracking policy formulation and establishing dedicated budget streams for emergency care.

The technical working group is being formulated which will soon roll up their sleeves to start the long journey of redressing the balance in emergency care services in Uganda. The hopes are high and with support many lives will be saved.