Sundaymail Editor
Leroy Dzenga
Senior Reporter
A comprehensive reorganisation of the country’s emergency and trauma health services is in the works.
This will see nurses undergoing specialist emergency services training and the introduction of new fully equipped ambulances for rapid response to disasters.
The Ministry of Health and Child Care is undertaking a multi-pronged restructuring exercise of the emergency and trauma services, which is anticipated to upgrade emergency and disaster management in the country.
A fortnight ago, Zimbabwe opened the doors to the country’s first-ever Accident and Emergency School at Chivhu General Hospital, Mashonaland East Province.
It provides specialised nurse training for handling emergency situations, including accidents and natural disasters. Only South Africa and Egypt have similar specialist institutions in Africa.
In addition, the Government has procured a fleet of 100 new fully equipped ambulances that are set to be deployed to healthcare facilities throughout the country, with the first batch of 50 expected by August.
The extensive revamp of the country’s disaster response and management services is expected to help drastically reduce loss of life during what is termed in medical parlance as the “Golden Hour”.
The Golden Hour is the time in which a person who has suffered trauma needs immediate emergency assistance in order to enhance their chances of survival.
Deputy Minister of Health and Child Care Dr John Mangwiro told The Sunday Mail that the new school was one of the ways authorities were revamping the sub-sector.
“The Accident and Emergency School will be the first of its kind in Zimbabwe and probably second to South Africa in Southern Africa. There is a need to expand the infrastructure at the school with appropriate equipment . . . laboratory services at the hospital will be expected to improve drastically.”
The school was purposely set up along the Harare-Masvingo Highway, which is notorious for road traffic accidents.
Milestone
National co-ordinator for the Accident and Emergency Nurse Training Dr Pisirayi Ndarukwa, who will manage the school, said Zimbabwe becomes only the third African country to have such a facility.
“Only South Africa and Egypt have such training programmes in their countries,” he said. “It is a critical element of modern health delivery systems and I am happy we are taking this route.
“The nurses we are going to produce will have competencies in dealing with trauma and accident cases.
“We realised there was an unacceptable rate of mortalities caused by the lack of ambulances and skilled personnel.
“Now that the Government is buying the vehicles and investing in specialised nurses, we should see some positive changes.”
The first group of trainees from the school will be attached to casualty wards at hospitals countrywide starting next semester, towards the end of the year.
A study on emergency and ambulance service commissioned by the Government in 2018, established that owing to the shortage of ambulances, nearly 30 percent of road traffic accident victims die before reaching a healthcare facility.
The study established that transit time for patients in ambulances ranges between four to five hours, leading to unnecessary loss of life.
All Government ambulances, the study revealed, lacked basic equipment including oxygen, delivery packs for pregnant women in transit, resuscitation equipment, masks, intravenous lines for drips, intravenous stands and trolleys.
It recommended that all 63 districts in the country’s health system should have at least two functional ambulances and qualified personnel. The City of Harare, which is home to an estimated two million people, had only two serviceable public ambulances in April, leaving emergency and trauma response in the hands of private players. Zimbabwe currently has a fleet of 134 functional ambulances and 148 which are non-runners.
The country requires a ground fleet of at least 200 fully equipped ambulances and a handful of air ambulances for medical emergencies where the distance does not allow for use of a road ambulance.
According to the Zimbabwe National Statistics Agency’s Quarterly Digest of Statistics Second Quarter 2018, 1 793 people died on Zimbabwe’s roads in 2017 and 8 213 were injured. ZimStat figures show that 7 787 people were killed in road accidents in the four years to December 2017. Last year, 138 people died in 1 518 road accidents during the festive season holidays.
The right path
Zimbabwe Nurses Association secretary-general Mr Enock Dongo said upskilling nurses will enhance efficiency and save lives.
He said the Government should expedite decentralisation of the training programme.
“It is a welcome development. It was long overdue as other countries like South Africa have already started the programme. They even have an Advanced Diploma and Degree programme in emergency services,” said Mr Dongo. Some of the deaths which happen following road accidents, he added, can be attributed to lack critical skills.
“During trauma emergencies, we lose people that are supposed to survive. We commend the Government for this intervention.
“Our suggestion is that there should be further training to include ambulance drivers to ensure that the skills are abundantly available at any given time.
The Government should not stop at Chivhu Centre; they have to open similar centres across the country, especially along highways.” Doctors believe that skilled emergency services nurses will help reduce unnecessary loss of life following disasters.
President of the Medical and Dental Private Practitioners Association of Zimbabwe Dr Johannes Marisa said: “We commend the Government for the idea, which will result in better care being rendered to patients who may find themselves in need of emergency services. It would be regrettable if they invest money in training nurses, giving them skills only for them to leave for other countries immediately after training.”The country, he added, has one of the best nurse training programmes in the world and locally trained nurses are the envy of many health sectors globally.
“Zimbabwe has some of the best nurse training programmes in the world, which sees many countries trying to recruit skilled nurses from here. “There is need for the Government to put in place measures for retaining the nurses because it costs money to train nurses and there should be a return on that investment,” he said.
Zimbabwe has over the years suffered the bane of brain drain in the medical sector.
The situation has been compounded by the Covid-19 pandemic.
Swaziland-based Zimbabwean medical practitioner Dr Ben Mudiwa said: “This is something that can work, considering they have the basic knowledge of emergencies, even practicing nurses should be upskilled.”
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