- Emergency medicine is an integral part of medical care, but many regions in the world don’t have access to the right facilities
- New healthcare financing models are helping Tanzania’s national hospital to continue providing best-in-class emergency medical care for all
The recent floods that wreaked havoc in East Africa have underscored the critical need for access to emergency medicine. Lives are lost or forever altered without swift and effective medical responses to such natural disasters.
This situation highlights the vital importance of strong healthcare systems and emergency medical services. Tanzania was one of the most affected countries in the region, the floods stretching the country’s infrastructure to the core.
However, the country was able to manage emergencies effectively thanks to the presence of comprehensive emergency care throughout its healthcare system – from local dispensaries to the national level.
This has not always been the case.
Just 14 years ago, Tanzania did not have a single hospital with well-equipped emergency medicine facilities, and had a national hospital mortality rate of nearly 14%. Patients who needed critical and often lifesaving care sometimes had to wait hours to see specialists who didn’t always have the expertise needed to provide emergency care.
Abbott’s philanthropic foundation, Abbott Fund, began collaborating with the Government of Tanzania in 2000 to strengthen the country’s healthcare system through a $160+ million public-private partnership that includes broader initiatives to help children and families access education and build livelihoods across the country.
Building on this decade-long partnership with the government, in 2010, Abbott Fund helped establish the Emergency Medicine Department (EMD) at Muhimbili National Hospital, and the first Emergency Medicine Residency Program at Muhimbili University of Health and Allied Sciences – both being the first in East Africa. These efforts saw immediate results, with nearly 40% decrease in the mortality rate at Muhimbili National Hospital in the first two years, and the first class of emergency medicine residents graduating in 2013.
Pioneering Emergency Medicine Model
The EMD at Muhimbili National Hospital went from being donor-funded to self-sustaining in less than five years – now illustrating a new impactful operational model of delivery of emergency medicine services in public health. Since the establishment of the EMD Business unit in 2013, which has helped the department to reduce its dependence on donors and to be able to serve Tanzanians sustainably without losing standards in service delivery.
Today, patients visiting Muhimbili National Hospital receive quality care in a state-of-the-art facility that provides care for up to 50,000 people each year.
Expanding the Emergency Care Ecosystem
Based on resounding success and sustainability of the Muhimbili EMD, beginning in 2017, the Abbott Fund established emergency medicine facilities at 8 more locations across Tanzania, including Mbeya, Arusha, Dodoma, Tanga, and Pwani.
Abbott Fund has provided more than $15 million of support to establish and advance emergency medicine in Tanzania. The life-saving impact has only expanded since then: more than 1.2 million people have received emergency care since 2010 at emergency care facilities supported by Abbott Fund, and the residency program has trained more than 6,000 healthcare providers.
The Government of Tanzania is now rolling out the largest expansion of emergency medicine in sub-Saharan Africa, setting up more than 100 new EMDs at district and regional-level hospitals across the country.
This public-private partnership is expanding the reach of emergency medicine to millions of people in previously underserved areas. The Abbott Fund is supporting this expansion by providing technical assistance on design and systems at the facilities, and training staff at new EMD, through support of the Emergency Medicine Association of Tanzania (EMAT).
Building Staff Capacity for Emergency Care
The emergency medicine revolution has been driven by a young team of Tanzanian doctors who were willing to take a chance on a new medical specialty – and then lead the way on saving lives and transforming healthcare in their country.
2023 marked the 10-year anniversary of the first class of eight emergency medicine specialists in Tanzania; this first class included the Executive Director of Abbott Fund Tanzania, Prof. Hendry Sawe and the Head of the EMD at Muhimbili, Dr. Juma Mfinanga, Dr. Philip Koka, Dr. Faith Ringo, Dr. Sifael Mgalula, Dr. Shaina Yusuf, Dr. Esmail Sangey, and the Late Dr. Upendo George. Together with other health care providers they founded the Emergency Medicine Association of Tanzania (EMAT), that is training the next generation of emergency medicine leaders to advance emergency care through research, advocacy and collaboration.
Through the Emergency Medicine Residency program, to date, 88 emergency physicians and 6,000+ healthcare providers have graduated from the program. Today, majority of physicians are still leading the way in emergency care in Tanzania.
While Abbott’s efforts are focused on scaling up emergency medicine in Tanzania, the EMD is serving as a model for emergency medicine in other countries. Physicians, nurses and other healthcare workers from Democratic Republic of Congo, Ethiopia, Malawi, Uganda, Kenya, Mozambique have been trained at the EMD in Tanzania.
The residency training curriculum was used as a model for the African Federation of Emergency Medicine and replicated in Ethiopia and Haiti. The EMD and residency also contribute to advancing the research and understanding of emergency medicine – the EMD is one of four organizations that piloted a World Health Organization (WHO) trauma registry that is currently informing care around the world.