South Africa 2015

African Federation for Emergency Medicine: South Africa

By Crystal Bae

Crystal Bae South Africa internship with colleaguesEmergencies happen everywhere. “All healthcare facilities will be faced with acutely ill patients, whether they are prepared or not.” (1) Any person at any time is susceptible to needing access to quality emergent health care. Specifically, this may entail the care of acutely ill and injured patients with initial resuscitation, stabilization, and treatment and the provision of definitive care for appropriate patients, regardless of financial status. (2) However, a formal structure for emergency care in many low resource settings, including in Africa, has not been fully established and is only in the beginning stages of development. (3)

In 2014, I moved to Cape Town, South Africa to work for the African Federation for Emergency Medicine (AFEM), an organization dedicated to the development of emergency care systems in Sub-Saharan Africa. While there, I learned about the progress of developing emergency care across the continent and met with physicians, nurses, and other health providers dedicated to improve the current status.

Through AFEM, I helped organize conferences, including the 2014 African Conference on Emergency Medicine (AfCEM) in Addis Ababa, Ethiopia, the 2015 World Congress on Disaster and Emergency Medicine in Cape Town, South Africa, and the 2015 AFEM Consensus Conference. At these conferences, I learned about the work being done across the continent and assisted in the collaboration of local and international healthcare workers. These meetings were essential in determining what research projects have been completed or are in progress. It exposed young local researchers to scientific processes and gave them an opportunity to share their work on a wider platform. It also helped countries with well-developed emergency care systems to understand how to assist colleagues from countries with less-developed systems.

At these conferences, we learned that one of the most sustainable ways to develop emergency care is through advocacy - if we convince people that emergency care is important, then governments, schools, and hospitals are more likely to prioritize emergency care development, such as through funding, the formation of residency or medical school training programs, or a change in hospital-wide protocols to include triage and emergency care. One such way was through the creation of national societies such as the Rwandan Emergency Care Association (RECA) and the Botswana Society for Emergency Care (BSEC), allowing like-minded health professionals to partner and have a voice for their specialty. I had the opportunity to work at the government level to advocate for emergency care systems development. I was fortunate to assist the Ugandan Ministry of Health in developing a proposal for a formal national ambulance system, the Ugandan National Ambulance Service. The most valuable experiences I had was meeting and working with some of the most dedicated people in emergency care and global health. I even had the opportunity to interview leaders in emergency care in Uganda, Tanzania, Egypt, Ethiopia, and Malawi, published in the journal, Emergency Physicians International.

I pursued this opportunity by taking the year off in between my second and third year of medical school at University of Maryland, Baltimore immediately after taking Step 1 of my board examinations. I was the president of the Global Health Interest Group and was always interested in emergency medicine, but just did not have much exposure in my pre-clinical years as a first and second year student. When I found this opportunity (mostly through chance and knowing the right people like Dr. Emilie Calvello), I thought it was a natural combination of my interests. I was fortunate to have the support from my family and friends and from the medical school administration; they believed this to be a valuable opportunity for my career. My decision to accept the position was solidified when I met with Dr. Calvello and learned more about AFEM and the role that I would take on there.

I am now a fourth year medical student, applying for residency in emergency medicine and look forward to pursuing a career in global health. I am indebted to AFEM and all of its members, especially my mentor, Professor Lee Wallis, for the incredible experience and the impact it has made on my career. I will continue my involvement with AFEM through their affiliate journal, the African Journal for Emergency Medicine (AfJEM) as a production editor. 

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  1. Calvello EJB, Tenner AG, Broccoli MC, Skog AP, Muck AE, Tupesis JP, et al. Operationalising emergency care delivery in sub-Saharan Africa: consensus-based recommendations for healthcare facilities. Emerg Med J EMJ. 2015 Jul 22;
  2. Calvello E, Reynolds T, Hirshon JM, Buckle C, Moresky R, O’Neill J, et al. Emergency care in sub-Saharan Africa: Results of a consensus conference. Afr J Emerg Med. 2013 Mar;3(1):42–8.
  3. Mock C. WHA resolution on trauma and emergency care services. Inj Prev. 2007 Aug;13(4):285–6.
  4. Salmon M, Landes M, Hunchak C, Paluku J, Malemo Kalisya L, Salmon C, et al. Getting It Right the First Time: Defining Regionally Relevant Training Curricula and Provider Core Competencies for Point-of-Care Ultrasound Education on the African Continent. Ann Emerg Med. 2017 Feb;69(2):218–26.