Universal emergency care could soon be a reality

Residents of Siaya look at a county water ambulance. PHOTO| FILE| NATION.

Kenyans will soon be able to access emergency care services at any hospital in the country, a Ministry of Health official has said.

According to the head of the division of health emergencies and disaster risk management Dr Simon Kibias, the ministry will soon launch the Emergency Care Policy 2018 - 2030, to boost universal access to emergency medical care.

“The Constitution, Health Act and the soon-to-be-launched policy, highlight the right of every Kenyan to get emergency treatment. We will establish the necessary laws and structures to provide for this,” Dr Kibias said at a symposium on the state of emergency care in the country in Nairobi last week.

However, even as the government moves to make universal access to emergency care a reality, it has emerged that Kenya lacks the infrastructure, human resources and technological innovations to handle emergency cases.

Kenyans only have two emergency physicians to handle emergency cases, and none of medical universities or colleges have emergency medicine as a training programme.

The problem is particularly dire in counties, and this has led to the need to map access to emergency care, which is critical in the achievement of universal healthcare.

According to Dr Benjamin Wachira, an assistant professor of emergency medicine at the Aga Khan University Hospital that is currently building up faculty to initiate emergency medicine as a specialisation in the country, most emergency units in the counties are manned by clinical officers without specialised training to provide urgent care to largely rural populations.

Another problem that emerged is that the Kenya Medical and Dentists Board, does not seem to recognise emergency medicine as a speciality, such that even foreign-trained emergency physicians are not registered as such. Moreover, the country has no code for Kenyans to dial for help during emergencies.

“The first point of emergency care is the place where the victim or survivor of an accident, disease or robbery is picked from, yet there are no structures in place to ensure that the victim is rushed to hospital for intervention,” said Dr Wachira.


However, things are bound to change as Emergency Medicine Kenya Foundation (EMKF) and the Ministry of Health in partnership with World Health Organisation (WHO) start mapping emergency care in all 47 counties.

This will involve assessing emergency departments in the counties to identify gaps and set priority action plans for each county, to enhance the capability of the emergency care network. So far, 10 counties have signed up.

Using WHO requirements, the project implementers will look at the type of facility, size of population served, infrastructure, human resource capacity and the number of referrals they make.

“With this in place we will be able to know, which county needs which specialists and the infrastructure needed depending on the emergency cases rampant in the region,” said Emily Nyagaki, the chief operating officer of EMKF, which is implementing the mapping dubbed Project 47.

Dr Kibias noted that the mapping of facilities that can provide emergency care and especially surgical intervention, will go a long way in strengthening the referral system and increase access to emergency care as a right.

Executive Director of EMKF Dr Jeremiah Gitau, noted that an estimated 54 per cent of all deaths in Kenya occur before the patient accesses emergency care.

“Kenya cannot achieve universal health coverage without rethinking the status of its emergency healthcare services,” he observed.