Health Equity and building robust Emergency Systems

Annet Alenyo Ngabirano was enjoying the community medical placement in the 4th year of medical school. Placed 60km from the nearest hospital, in the lush hills of Uganda, the days were filled with vaccination drives, local outpatient clinics and lazing about. That was until a frantic nurse burst into the room and rushed the three medical students to the bedside of a severely sick and dehydrated infant. There was no doctor. There was no senior nursing staff. They no training, no equipment, no backup, and no resuscitation area - yet this small group of 4th year students were the only hope this small baby had. After trying to gain IV access for over 30 minutes, Annet felt exhausted, overwhelmed, under equipped, under resourced and alone. This is emblematic of where Emergency care in Africa has come from. Over 85% of the world’s population live in Low and Middle Income countries. Health statistics in these countries are characterised by numerous deaths from treatable time-sensitive illnesses and injuries resulting from inadequacies in health systems, particularly Emergency Care. However, across the world, Emergency Care continues to grow, and every country has a story to tell. There are similarities in our stories: the overwhelming sense of responsibility, the exhaustion and feeling of being undervalued. But there are also glaring differences in quality. Africa can be better and it should be. 2017 marks 10 years since the first Emergency Medicine Physician graduated in Africa. From one single Residency program in 2007, there are now 11 more in 9 of Africa’s 54 countries. 2009 saw the formation of The African Federation for Emergency Medicine (AFEM) supporting Emergency Care development across Africa. AFEM’s projects include: - The biennial African Conference on Emergency Medicine (AfCEM), the only scientific conference on African emergency care. - The Annual Consensus Conference that addresses various aspects and challenges of Emergency Care in Africa. - A quarterly international, peer-reviewed journal, publishing original research on topics relevant to Africa, freely available online and offering free publication support to African researchers through Author Assist. - Supadel, a peer-to-peer sponsorship program funds attendance of practitioners to AFEM-affiliated conferences on African soil, allowing them to network and learn valuable lessons in Emergency Care to improve systems in their countries. Emergency Care is a specialty that allows our humanity and compassion to touch and connect with people - not just patients, families, and communities but the whole of humanity. It brings us together. By recognising Ubuntu - the belief in a universal bond of sharing that connects all humanity – Annet knows that Emergency Care in Africa can, should and will be better.

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