Pre-Hospital Care UK Projects
Paediatric Transfer Ambulance
In November 2007 I visited Dar es Salaam in Tanzania, East Africa to look at the Pre-Hospital Care Services available and form links with health initiatives in Tanzania. It was an extremely interesting and successful visit.
In Dar es Salaam there is no National Ambulance Service so injured members of the public have to make there own way to the hospital or pay for a private ambulance. Most people get to the hospitals in pick-up trucks or basic ambulance vehicles attached to dispensaries. The more affluent people are able to afford private ambulances, which although well equiped, can take over an hour to respond to emergencies.
Whilst in Dar es Salaam I visited a Regional Hospital and was shown round their Paediatric Ward. It contained 28 beds, which were all occupied and the ward was packed with mothers and siblings. The ward was divided into two halves, one for children with infectious diseases, the other for non-infectious.
The vast majority of children on the infectious side were suffering from vomiting & diarrhoea and other related illnesses. On ther other side of the ward were children with burns, malaria and pneumonia. There was one area allocated for the resuscitation. There was a wooden table, oxygen cylinder and suction kit, but unfortunately no surrounding curtains. Due to lack of funding the ambu bags were broken and only partially worked.
Whilst visiting the hospital there was one child that stuck in my mind. A twelve year old boy who had been brought in unconscious from a local orphanage. He was lying in his bed, in the recovery position, being treated for possible meningitis. He was being looked after by one of the carers from the home but had no oxygen or intravenous access at the time. I found this difficult as in the U.K the Paediatric Crash team would have been called and 4-5 doctors would have attended and likely intubated him and taken him to the Paediatric Intensive Care Unit or transfered. Thankfully I was with a Senior Paediatrician from another hospital who arranged urgent transfer of the child.
At the end of this particular day I asked how this child was transferred, and I was informed that he was taken in the hospital ambulance. This was very basic and are often driven by non-medical staff. Below is a picture of the ambulance this child was transferred in.
As a result of this visit, Pre-Hospital Care UK is working with JEMA, a non-governmental organisation to provide the first Paediatric Transfer Ambulance in Dar es Salaam. Exciting times !!
Written by: Dr. Nic Sparrow
If you are interested in helping with the projects and making a difference
please e-mail:
info@pre-hospitalcare.co.uk
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