Building Trauma Care Capacity in Burkina Faso
Dr. Shailvi Gupta
School of Medicine
A person in the world dies every 5 seconds after injury, accounting for over 5.8 million victims annually and causes 10% of the world’s deaths. Despite this, comprehensive, systematic trauma care is not commonplace in many parts of the world, particularly in conflict zones and low resource settings. Our overarching goal for this proposal is to build trauma care capacity in Burkina Faso.
We aim to build trauma capacity in Burkina Faso in three different capacities: creating a bidirectional educational exchange, developing a local Burkinabe expertise conference on “Damage Control Resuscitation in Austere Environments”, and building global trauma community partnerships.
The Shock Trauma Center is developing a Masters in Trauma Sciences, the first of its kind, housed in the School of Graduate Studies at UMB. Within this Masters Program will be an elective on Global Humanitarian Surgery. Shock Trauma Center is one of the most internationally recognized trauma facilities in the world and hails as being incredibly progressive and innovative with regards to trauma care. As a collaborative educational approach, we would like to develop the Global Humanitarian Surgery Course alongside our Burkinabe colleagues, led by Dr. Yves Sanou. As faculty from STC, we are well versed in data driven, progressive trauma care. With Dr. Sanou’s extensive experience in war surgery in low resource settings, we aim to work collaboratively to help develop an effective and accurate global humanitarian surgery course. Creating this course fulfills a few goals. Currently in Burkina Faso, the insecurity and conflict has not allowed surgeons to travel to receive proper surgical training. Furthermore, the previously offered course on war surgery by the International Committee of the Red Cross (ICRC) was discontinued. ICRC previously offered its war surgery course in Burkina Faso as well as other conflict-affected countries in Sub-Saharan Africa. Over the past several years, ICRC made a decision to centralize these activities in the Democratic Republic of Congo, making this course inaccessible to surgeons in Burkina Faso and other locations. Meanwhile, the need for war surgery training is steadily increasing. To meet this need, we will adapt elements of the Masters in Trauma Sciences curriculum to the local context as well. Instructors will be predominantly Burkinabe, with Shock Trauma faculty identifying subject matter experts to fill in any gaps of local expertise identified by Burkinabe partners. The development of this curriculum will help lay the foundation for future funding proposals to support
the creation of a surgical training center in Ouagadougou, Burkina Faso, with STC as a key partner. In addition to the concrete modules within the Masters in Trauma Sciences and in Burkina Faso, this will be a productive bi-directional educational system. STC surgeons can learn about the reality of war surgery from Dr. Sanou, and Dr. Sanou and his colleagues can take innovative trauma care ideas back to Burkina Faso.
This funding would also allow Burkinabe surgeons to participate in the STC Observership Program. The program will provide Burkinabe surgeons with the opportunity to participate in a high-volume trauma service with high resources. They will be exposed to diagnostic modalities and treatment
algorithms that may be less familiar to them based on resource limitations in their practice settings. This program will also create an opportunity for our Burkinabe partners to become part of a broader trauma surgery community, facilitating research and educational collaboration. While in Baltimore,
the modules for the Masters in Trauma Sciences would be recorded at the School of Graduate Studies by STC faculty and our Burkinabe colleagues.
One of the most intractable barriers facing attempts to reduce preventable death and disability among conflict casualties in Burkina Faso are the delays to care. Prehospital transport is ad hoc outside of the capital. Significant barriers are faced including lack of means, lack of telecommunications infrastructure and major security restraints. In areas facing prolonged prehospital times, one of the most significant opportunities to improve survival is by increasing damage control resuscitation capabilities and strengthening blood transfusion infrastructure. This grant will support new collaborations to conduct exploratory research to define an approach to strengthening emergency blood transfusion capabilities in rural and conflict-affected regions of
Burkina Faso. We envision that these activities will begin with a contextual analysis including key informant interviews and health facility surveys to examine existing capabilities and gaps as well as sociocultural perceptions that may impact implementation strategies for interventions such as
walking blood banks. To establish this agenda, we anticipate engaging key stakeholders in Ouagadougou, Burkina Faso such as national partners within the Ministry of Health, the Centre national de transfusion sanguine (CNTS) and Centre des Operations aux urgences sanitaire (CORUS). Through these discussions and a focused stakeholder workshop, we will establish the necessary stakeholder engagement to create a “roadmap” for advancing damage control resuscitation in Burkina Faso. One of our goals is to develop a local conference on “Resuscitation in Austere Environments” in Burkina Faso. This would help spread awareness and engage conversation regarding this topic. In conjunction with the clinical observership in Baltimore, Dr. Yves Sanou would be able to join the Committee of Trauma’s Point CounterPoint Conference held in Baltimore, discussing hot topics in trauma. We would welcome him as a guest speaker regarding Resuscitation in Austere Environments. This would also garner interest from the US side, to help our Burkinabe colleagues in their endeavor.