Emergency health education in a conflict stricken environment: A situational analysis

Abstract

IntroductionBosasso General Hospital is located in Puntland Somalia, an area affected by prolonged civil conflict, terrorism, clan fighting and piracy. International evidence highlights that staff skills and competence may have a significant impact on patient outcomes however there has been little research on emergency education in such an austere and volatile environment. The purpose of this study therefore was to identify current practices and gaps in delivering emergency medicine education in this resource-deprived environment.MethodsA mixed methods approach was adopted to inform convergent parallel data collection techniques including questionnaire (n = 16), key informant (n = 5) and focus group interviews (n = 16). Data analysis, following data triangulation, produced descriptive quantitative statistics of themes such as emergency care, educational provision, enablers and barriers.ResultsThe research showed that among health care staff at the hospital, 19% of the nurses felt that visiting nurses offer some knowledge on emergency care, while 38% of knowledge was gained from visiting doctors. Regarding knowledge of emergency medicine, 88.9% of the nurses felt that emergency medicine is basically first aid.DiscussionEmergency care was perceived by the majority as essentially ‘first aid’. Many indicated that they received little or no regular or formal training on emergency care and related essential topics. In terms of challenges faced in delivering emergency care education demonstrated a common factor in the limited resources available which included lack of teaching materials, reading materials, online resources, health care professionals, equipment and mentors. Conclusions drawn suggest that the knowledge of emergency medicine by front line professionals is limited. Therefore, the development of field curricula, practical and theoretical training by visiting practitioners, provision of additional teaching aids, tools and equipment, integration of multiple disciplines in training and financial resource mobilisation would be beneficial in improving knowledge, attitudes and practices of emergency care.

Maintaining health professional education during war: A scoping review

“…The overarching themes described were similar despite the type of health professional trainee, diversity in conflicts, duration of conflicts, countries involved, and time periods, suggesting they might provide a useful framework for future research. Such a framework can also enable faculty, school administrators, governmental and nongovernmental organisations, researchers, and policymakers to share common understandings of indicators in assessing health care education and to more strategically address educational needs during times of conflict 52 . The targeted interventions identified in this review have the potential for both positive and negative impacts if replicated in the future.…”

“…Such a framework can also enable faculty, school administrators, governmental and nongovernmental organisations, researchers, and policymakers to share common understandings of indicators in assessing health care education and to more strategically address educational needs during times of conflict. 52 The targeted interventions identified in this review have the potential for both positive and negative impacts if replicated in the future. Decreased length of training and increased training in critical care and war time topics increase the health care workforce in the short-term, addressing emergent needs.…”

Interprofessional Education in Critical Care: A Consensus Statement

“…During curriculum development, the following factors should be considered: the local patient case mix (consideration to be given to both high-volume patient presentations and low-volume, high-risk patient presentations); developing situational awareness across the continuum of critical care (Bekkink et al,2018;Herath et al,2017;Muya et al2018). It is also important to consider routine procedures and care including points of care transitions (handover, discharge planning, and specific situations such as end of life care); availability of local human resources and clinical/educational supplies must also be considered with curriculum designed to incorporate local needs and resources (Bekkink et al,2018;Herath et al, 2017;Muya et al, 2018).…”

The Epidemiology and Management of Maxillofacial Fractures at a Tertiary Care Hospital in a Conflict-Torn Region in Somalia

“…20,21 In Somalia, where life expectancy at birth is as low as 52 years 22 ; ongoing civil unrest, terrorist attacks, and conflicts constitute (4.1%) of deaths. 23 In epidemiological studies, it has been stated that age and gender are the most common elements affecting the incidence of maxillofacial trauma and most common in males between the ages of 21 and 29. 3,5,9,11,14,16,24 The distribution of MFFs varies depending on facial anatomy, impact vector, and the amount of energy absorbed 14,25 and mandible fractures were most common in many studies.…”