Fledgling Paramedics

It’s been a remarkably varied week. I’ve popped about on a couple of interesting retrievals, my favourite being for a poor sick young girl needing medevac out of Arusha in Tanzania next to Mt Kilimanjaro. We flew in the unpressurised Caravan plane and stayed low under the air traffic. I had stunning views across to the Rift Valley and the landscape was laid out like an incredibly detailed model. The tiny farms and homesteads could easily be made out with tiny people fussing around their tiny livestock (just to clarify, they aren’t actually tiny, they were just very far away) and I got a few good snaps from above.

I also had a late night retrieval into Addis Ababa in Ethiopia which was horrendous and I won’t go into. Maybe I’ll tell you over a beer someday (or more likely while lying on a therapist couch) but suffice to say it all turned out ok in the end.

Through our mutual friend Dr Stevan Bruijns I met up with one of the senior Emergency Physicains at Aga Khan Hospital Nairobi, Benjamin Wachira and he asked if I would represent AMREF and help out

with a teaching conference for the Kenyan Council of Emergency Medical Technicians (ambulance paramedics to you and I) as he was the Medical Director for the fledgling organisation. It has been largely funded through the John Hopkins University in the USA.

Kenya has had it’s fair share of major incidents in the last couple of decades. To name a few – the US embassy bombing in 1998 and the civil violence in 2007, not to mention the thousands of able-bodied and

The scenario set up by KC-EMT - remarkably realistic!

productive members of Kenyan society who die on the roads every year. There has always been one thing missing from the response capabilities and that has been the lack of a recognised ambulance service. Currently there are only a few agencies which train and deck out their own ambulances. There is no 999 you can call. They are a bit like the A-team ‘If you have a problem, if no one else can help, and if you can find them....maybe you can hire The Ambulance-Team’.

 Following the disaster in 1998, a group of people came together to train and become Emergency Medical Technicians and last week I was privileged to watch them hand over the accepted ‘standards’ for ambulance equipment and personnel to the government. It will mean very little until the government actually fund ambulances and recognise EMTs as skilled health workers. But Rome wasn’t built in a day.

The event was well attended by passionate EMTs, all hungry to learn and it was a pleasure to be involved as the AMREF Flying Doctors representative. The first day was spent in talks and teaching clinical skills stations then the second day was the competition. The KCEMT put a great effort into producing a realistic Road Traffic Accident scenario simulation for each of the teams to demonstrate their skills. I was really impressed! The winners of the competition could not have been faster at assessing and stabilising the scene. They rapidly had the patients strapped up, as stable as they were going to get and whisked off to the fake hospital.

The prize giving had typical African flare with lots of speeches of thanks and some of the biggest trophies

I’ve ever seen. Then just as I had escaped for lunch, the DJ got going and while I was discussing the future of Emergency Medicine in Kenya with the member from the MoH, everyone started to dance apparently. It was certainly more fun than being an ALS instructor!

I hope that the enthusiasm of the fledgling society continues and gains momentum. One day soon, I hope that people in Kenya will come to expect an Ambulance to come and rescue them in their hour of need. A robust Emergency Medical Service simply cannot exist without skilled paramedics to bring patients to us in their ambulances. It’s still a long way from Ben’s vision of Emergency Care in Kenya but, as above, it’s the first steps and it’s a very exciting future.