Emergency medicine is a young specialty in Tanzania. Many district and regional hospitals have had no emergency department and few doctors with formal training in resuscitation. Since 2017 our volunteer emergency medicine physicians have worked alongside Tanzanian doctors and nurses to change that, teaching skills that work with the equipment and staff a hospital actually has.
Our work began at Mpwapwa District Hospital, near Kingiti village. In partnership with the district government, we found that most of the hospital's gaps came down to training, equipment, or both, so we worked on the two together. We trained local physicians and ancillary staff in the fundamentals of emergency medicine, starting with structured triage and the same systematic, rapid assessment and intervention that emergency medicine physicians use with every critical patient. Because so many patients arrived with major trauma, sepsis or obstetric emergencies, we set out to build a resuscitation room with basic equipment. We also worked to expand the use of bedside ultrasound in medical, traumatic, and obstetric emergencies, and to improve obstetric surgery practices, with more reliable indications for, and safer execution of, cesarean sections.
Our teaching and clinical training initiatives utilize African Federation of Emergency Medicine materials, especially its Handbook of Acute and Emergency Care, and other local Tanzanian medical resources. The aim is for Tanzanians to lead and teach this work themselves.
Today our focus is Bugando Medical Centre in Mwanza, a much larger hospital that receives patients from regional and district hospitals across Tanzania's Lakes Zone.