Kigali, Rwanda (September 2015) — The University of Rwanda College of Medicine and Health Sciences (UR/CMHS), in collaboration with the Ministry of Health and the Systems Improvement at District Hospitals and Regional Training of Emergency Care (sidHARTe) program at Columbia University Mailman School of Public Health, are pleased to announce the completion of the Post-Graduate Diploma (PGD) Course in Emergency and Critical Care Medicine.
An innovative program for Rwanda, the PGD in Emergency and Critical Care Medicine was launched in September of 2013 and set the PGD trainees on a revolutionary path. These pioneers boldly entered a new field of medicine for Rwanda as there was no Emergency Medicine training program in Rwanda before now. On Thursday, 30 July 2015, 8 PGD trainees celebrated the completion of the PGD requirements at a dinner event hosted at the Manor Hotel in Kigali, Rwanda.
The Ministry of Health, represented by the Medical Personnel Planning, Research and Capacity Building Specialist, Dr. Vincent Rusanganwa, thanked the University of Rwanda, College of Medicine and Health Sciences, in collaboration with sidHARTe, for their support and implementation of the Post-Graduate Diploma in Emergency and Critical Care Medicine. In addition, Dr. Rusanganwa recognised the District Hospital Medical Directors who supported the trainees to attend the two year part-time training while still fullfilling their duties as general physicians at their base hosptial.
“I expect that this first cohort of trainees has gained the knowledge to improve the organisation of the emergency system at the health facilities. The Ministry of Health has done much in controling the infectious desease burden, however, it is still in need of skilled physicians to respond to the emergency care need. The Ministry of Health needs skilled people at the National level, Provincial Hospitals, District Hospitals, Health Centers and even at the comminity level”, said Dr. Rusanganwa.
Dr. Rusanganwa concluded by emphasizing that Emergency Medicine is a priority of the Ministry of Health and that they will continue to support the Emergency Medicine program within Rwanda’s health sector.
The PGD program trained General Practitioners (GPs) from 5 district and 2 tertiary hospitals in the fundamentals of Emergency and Critical Care Medicine. In addition to participating in weekly lectures and simulations, students worked in the Emergency Department at Centre Hospitalier Universitaire de Kigali (CHUK) as a part of their training and rotated through other specialty services to increase the breadth of their education.
The one-year course was delivered on a part-time schedule over two years allowing the PGD trainees to work at their base hospital when the course was not in session. While at their hospitals, the PGD trainees worked to revise their hospital acute care systems , improve their Emergency Wards, train nursing staff and other GPs in the areas of triage, resusictation and other acute care specific skills and strengthened hospital administrator’s focus on the acute care delivery.
“Before the PGD training, many procedures were unclear to me and I feared how to manage cases at the District Hospital where over 70% of the deaths occur. Now, I have good training in emergency care and can perform many life saving procedures. I have even worked with my hospital administration to create an emergency room with fixed staff that I’ve helped to train and that do not rotate out” Dr. Chantal Uwamahoro, Emergency and Critical Care Resident, Gitwe District Hospital
Emergency Physician Dr. Rachel T. Moresky, Founding Director of the sidHARTe Program at Columbia University Mailman School of Public Health added that “Emergency Physicians, like a multivitamin, are a collection of all medical specialties in one physician. Emergency Physicians know how to manage the top emergencies of every medical specialization from Internal Medicine, Surgery, Anesthesia, Pediatrics, Orthopedics, Cardiology, Neurology, Ophthalmology and Toxicology… to name a few. Over the last two years there are impressive examples of the PGD students working at their home hospitals and taking lifesaving leadership roles in managing road traffic mass casualty incidents, setting up successful triage, and accurately diagnosing and successfully treating or referring severe trauma patients.”
One such example comes from Dr. Ezechiel Nteziryayo, a PGD trainee from Nemba District Hospital:
“I was at home when my colleague called me to come help him manage many severe cases after a bus crashed with an entire wedding party on it. The initial process was to set up mass casualty triage for the patients and determine the level of severity of their injuries. Three cases were identified as having the highest level of critical injuries, with one having severe head trauma. We worked as a team with the nurses to assess and stabilize the patients by providing necessary hydration and medicines, inserting breathing tubes and giving blood transfusions to those for which it was imperative.
Once the team stabilized the patients, they were transferred to CHUK for further treatment. During the PGD program, I learned how to perform proper triage whereas before I would only follow the order in which the patients arrived. I am thankful for the opportunity to study Emergency Medicine, “ Dr. Nteziryayo, Emergency and Critical Care Resident.
During his time in the PGD program, trainee Dr. Gabin Mbanjumucyo, in collaboration with his collegues, established the Rwanda Emergency Care Association (RECA). RECA is an association made up of Emergency Medicine Physicians, Emergency Medicine Residents, Nurses and Pre-hospital Care Providers both local and international with active involvement in emergency care in the country.
“RECA especially thanks the Ministry of Health, University of Rwanda and sidHARTe for introducing Emergency Medicine as a specialty in to Rwanda. With Emergency Medicine being in its infancy in Rwanda, there is a great need to consolidate every possible effort to provide better care for patients with acute illnesses or injuries that require immediate medical attention and to develop quality emergency care in the country.
This will only be achieved by working together. This is in line with RECA’s objectives that aim to promote and improve emergency care through teaching, research and education, to promote the specialty of emergency medicine and to advocate for emergency care in Rwanda,” Dr. Mbanjumucyo, RECA president and Emergency and Critical Care Resident.
Welcoming the Start of the First Masters of Medicine in Emergency and Critical Care Medicine
The University of Rwanda College of Medicine and Health Sciences (UR/CMHS), in collaboration with the Ministry of Health, the sidHARTe program at Columbia University Mailman School of Public Health, and Brown University Department of Emergency Medicine are also pleased to announce the start of the Masters in Medicine (MMed) in Emergency and Critical Care Medicine set to start 7 September 2015.
As the PGD served as year one of the four year Master of Medicine (MMed) in Emergency and Critical Care Medicine the PGD trainees had the opportunity to continue on to the MMed enabling them to serve as future faculty of Emergency and Critical Care Medicine for UR/CMHS should they choose. All 8 PGD trainees have applied and been accepted into the second year of the MMed and are excited to continue their training, as well as expand their leadership and advocacy efforts in the field of Emergency Medicine in Rwanda.
In addition, a new class of 8 students will their first year of training alongside their second-year peers in September. Many students in this new class were inspired to apply for the MMed in Emergency and Critical Care Medicine after witnessing their colleagues who had completed the PGD program successfully utilize their newly acquired skills in Emergency Medicine to save patient lives at their District Hospitals.
“The completion of the PGD course and integration of the PGD as year one of the four year MMed, represents an important milestone for the leadership of UR/CMHS and the Ministry of Health in supporting education and health systems processes for Emergency Care in Rwanda. We have been grateful for this opportunity to work with our colleagues in Rwanda, and look forward to what the future holds for this exciting endeavor,” says Dr. Moresky.