Strengthen pre-hospital emergency response services to save lives

 

A surgeon with organ delivery. [Getty Images]

If you get injured in a road accident, the first person to attend to you will most likely not be a medical doctor. Instead, you will be attended to by someone who does not understand first-aid or if you are lucky enough, by an emergency medical personnel before you can be rushed to the hospital. How fast that initial care is provided sometimes makes the difference between life and death.

Almost every day, paramedics and emergency medical technicians respond to distress calls from road accident scenes, homes, schools or offices to save the lives of the injured or critically sick before they can be taken to hospital. Yet, how often do we think about the important role emergency medical services play in our healthcare system?

In the Universal Health Coverage that President William Ruto launched during this year’s Mashujaa Day, for instance, pre-hospital emergency medical services have been lumped up as “first aid services”. Yet, this is an area that needs to be supported and put on the front banner of any healthcare provision discussions.

Pre-hospital emergency medical services are focused on providing immediate medical care and safe transportation in emergency situations. The personnel such as paramedics and emergency medical technicians receive specialised training to respond to emergencies that include trauma, breathing problems, poisoning and toxic exposures, medical, obstetric and gynaecological, behavioural and psychiatric, environmental, paediatric, and geriatric emergencies.

Emergency medical services are designed to respond rapidly to emergencies and provide immediate care to stabilise the sick or injured. They are provided in emergency settings, including ambulances and accident scenes.

We have seen such services save lives during terrorist attacks on our own soil and during the Covid-19 pandemic.

The terrorist bombing of the American Embassy in Nairobi marked the beginning of advanced emergency medical services in Kenya. After the rescue mission was over, the players were concerned that majority of the volunteer responders were not trained in first aid, limiting their scope of response.

This led to the first training of emergency medical technicians in East and Central Africa between November 1998 and March 1999. There was a lull until 2008 when the training of emergency medical technicians started again, seeing the number steadily increase to over 1,500.

Twenty-five years since the Nairobi bomb blast, Kenya still lacks an elaborate pre-hospital emergency response system, with the private sector players like E-Plus and St John Ambulance Kenya providing close to 80 per cent of the services. Little research has been done specifically on emergencies in the pre-hospital setup.

Oftentimes, emergencies are only spoken about when they happen. Policymakers, legislators, and decision-makers rarely speak about the development of policies and strategies for financing, legislation and contingency planning for emergencies.

Despite these gaps, response to emergencies during the Westgate and Dusit terrorist attacks, Covid-19 pandemic and at road traffic accident scenes, have been well managed. But the question is: How many more lives would be saved if the pre-hospital emergency response system in the country was well-supported and regulated?

The government should shift focus to strengthening the framework for interventions that need to be made between the time a sick or injured person is identified to when they get to the hospital. It should work towards a more robust pre-hospital emergency response system to complement the well-defined in-hospital frameworks, structures and strategies.

Germany, for example, has a centralised system where all emergencies – medical, fire and security – are received and dispatched. There is nothing stopping us from borrowing a leaf from such success stories.