Health Ministry pilots project to reduce deaths at regional hospitals

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The Ministry of Health with support from the Korea Foundation for International Healthcare (KOFIH) has embarked on training health workers operating in Regional Referral Hospitals to reduce the high death rate of patients in the emergency department from the current 60% to 10%.

The health ministry and KOFIH earlier dispatched a core team of at least 100 health workers for a six-month training of medical personnel and administrators in Korea under Dr Lee Jong Wook Fellowship program, according to Beatrice Oling a senior administrator attached to Mulago Hospital and a beneficiary.

KOFIH has provided about sh200m to support the pilot project at Masaka Regional Referral Hospital on emergency care management and trauma including another related project aimed at easing People with Disability (PWD) and elderly access to health care services in Masaka.

The project using a World Health Organisation (WHO) model is targeting achieving the 60% to 10% mortality rate of patients at the emergency unit by 2040, according to Dr Alfonse Omona a general surgeon and head of the project.

Speaking during the closure of a three-week training of 30 health workers from Masaka Regional Hospital at Maria Flo Hotel in Masaka City, Dr Omona said the project will roll out to the entire country with approval from the health ministry.

“We need to train at least every health worker in the country on specialized emergency cases and trauma especially accident causalities in the units to reduce the preventable death, 60% death rate at the emergency unit is such a big number,” Dr Omona said.

“We are training health workers to specialize in stabilizing traumatized patients admitted with life-threatening conditions in the first six minutes,” he said.

He said health workers need the skill to identify and treat accident victims who were admitted to emergency in the first minutes to prevent death.

“I recently noticed health workers panicking with accident patients after a global bus accident, some of them did not know how to handle the patients and that is how we end up losing causalities,” he said.

The Ministry of Health Commissioner in charge of emergency healthcare, John Baptist Waniaye said the project was timely saying the majority of the health workers lacked adequate skills in the management of emergency trauma cases to ably control the high fatal rate.

He said the training project will continue in regional referral hospitals across the country. He urged the health workers to focus on their caring attitude towards the patients.

Dr Winnie Ouma, the emergency specialist on trauma and accident management noted that many of the health workers lack basic life-saving skills for emergency patients admitted after fireout breaks, accidents, infants, and the elderly.

“The first 60 seconds and 60 minutes of traumatized patients are crucial to determine their chances of survival. We term it golden house management, it’s important for our health workers to quickly detect the danger areas for proper treatment and management,” she said.

She said many patients die as a result of blocked airways. “Majority of our nurses are not skilled to handle advanced trauma accident emergency cases. We have scenarios where a patient is short of oxygen we need to skill all of them, especially the midwives,” she said.

Other significant challenges in trauma accident emergencies include internal bleeding and damaged kidney, liver, and respiratory that force patients into shock after the accidents.  KOFIH has procured a CT scan for Masaka Hospital Emergency to be used in identifying injuries and diseases.

Dr Gonzanga Ssenyondo, a gynaecology consultant and head of the maternity department in Masaka Regional Referral Hospital said some health workers make the mistake of rushing to apply the drip on emergency patients.

“It’s wrong to rush to apply the drip on accident patients in an emergency yet managing their airway would be better, skilled health workers can easily detect and manage such cases to increase the chances of patient survival,” he said.

He said the project objective is to train the majority of pre-hospital personnel and emergency department staff in identifying all life-threatening trauma conditions of patients to meet the targeted 2040 fatal reduction from 60 to 10%.

Elizabeth Natukunda a nurse at Masaka Hospital said the training has enabled them to handle the patients better from accident scenes to the hospital to prevent deaths by identifying the five life-threatening injuries and management.

Dr Alfonse Omona said Mulago National Hospital is among the hospitals with mass admissions of trauma accident emergencies, especially from Boda-Boda victims’ burden.

He also cited conflict areas among those with critical trauma emergency patients.

“I first experienced a trauma emergency case in my village with a victim suffering from an arrow shot in his abdomen, I handled him without my supervisor, and that situation inspired me into surgery specialization.

He regretted that in many accidents patients referred from upcountry die on the way to Kampala Mulago.

Dr Omona said the challenges of trauma emergency management caused the initiation of a national training and management strategic plan that will address the high fatal prevention.