Friday, 21 June 2013

Life-saving lessons for Ugandan first responders


Participants in the ICCU training course for first responders
According to the World Health Organization's Global Status Report on Road Safety, Uganda loses more than 9000 people a year in road crashes. Despite - or contributing to - such a high death toll, Uganda has no formal pre-hospital emergency system. According to Ugandan trauma staff, the emergency services are insufficient and there is limited capacity to manage the injured. Many casualties arrive at health facilities by any means of transport possible such as motorcycle (boda boda), police trucks and private cars. Fewer than 5% of patients arrive by ambulances because few exist and those that do are privately owned and prohibitively expensive for most Ugandans.
Many patients arrive after the “golden hour” – the critical first hour after the injury has occurred, during which medical intervention is vitally important. Currently, pre-hospital care is given on a voluntary basis by police, drivers, community people and bystanders near crash scenes. The majority of trauma victims who die do so during the pre-hospital stage. The WHO has recommended training of lay persons as first responders, especially in settings where formal emergency systems are absent. Pre-hospital care can be improved by training lay persons such as local leaders, community volunteers, teachers, and police officers, in simple but vital life-saving skills, such as clearing the airway, arresting bleeding, immobilizing fractures and so on. The knowledge attained by laypersons in pre-hospital training and coupled with locally available supplies may form a useful first step towards formalizing Emergency Medical Services in Uganda.

With funding from the Road Safety Fund’s small grants programme, the Injury Control Center- Uganda (ICCU) is undertaking first aid training in local communities to strengthen the front-line response to road traffic injuries. Six training sessions are planned under the Road Safety Fund/ICCU First Responder Training Programme. The first session, held in a community living alongside the Masaka Highway, was a three day workshop for 46 participants including community and religious leaders; village health workers; teachers and pupils; and local community forces. Two sessions will be directed to police officers, two further sessions for local communities and one for ‘train the trainers’. The courses include both theory and hands-on practice, accompanied by a handbook prepared by ICCU for the project.

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