GW physicians, students aid Ethiopian emergency medical services

When someone in the United States experiences medical distress, the first response of those at the emergency scene is typically to call 911.

But this amenity of emergency medical service is not afforded to the people of Addis Ababa, Ethiopia, where no paramedics or ambulances exist. A group of GW doctors and students hopes to change that.

Last month a team of professionals and students visited Addis Ababa on a needs-assessment trip the Ronald Reagan Institute of Emergency Medicine and Students for International Medical Action planned.

About a dozen volunteers assessed the severity of the country’s emergency medical services, helped treat patients and brainstormed ideas specific to Ethiopia about how to implement needed services.

“Emergency health care … is an important part of any healthcare system,” said Tenagne Haile-Mariam, an assistant emergency medicine professor and an Ethiopian native who led the risk assessment trip. “Countries such as Ethiopia that are in the process of building up national healthcare systems should strive to include provisions for emergency care. This will help insure good allocation of resources and health security.”

Maria Smeby, executive coordinator of the Ronald Reagan Institute of Emergency Medicine, said the Institute’s primary goal is helping developing countries start or expand their emergency medical service departments. According to the institute’s Web site, in addition to working in Ethiopia, the group has worked to implement emergency medical services in 12 countries around the world.

“Everyone has the right to efficient treatment and emergency medicine,” Smeby said. “We can teach that system to places that don’t have them.”

Two 4th-year medical students at GW, Jeremy Berman and Zach Steinberg, founded SIMA. The organization allows other medical students to spend some of the six-week rotations required of fourth-year medical students in Ethiopia.

Elizabeth Fihe, a participant of the trip and an International Emergency Medicine Fellow at the Ronald Reagan Institute of Emergency Medicine, said the biggest issue for Ethiopia is the country’s lack of resources for acquiring medical equipment.

“The hospital may have two cat scans machines, but they’re broken and probably won’t be fixed in the foreseeable future,” Fihe said. “However, the physicians are intelligent and much better than we are at clinical diagnosis because they can’t rely as much on tests.”

James Marinucci, another trip participant and the director of wound management programs at the GW Medical Center, said hospitals in Addis Ababa are “totally under-funded and overstretched.” Marinucci helped lead the wound management component of SIMA participants’ six-week rotation in Ethiopia.

Marinucci added that the main local hospital in Addis Ababa, Black Lion, has about 700 to 800 beds, which is considerably larger than GW hospital’s 500 beds.

“Now if you picture a hospital that size having very little equipment … they (lack) not just funding, but the people to (fix and operate the equipment),” he said.

Marinucci said the trip’s participants were not only shocked at the state of emergency medical care in Ethiopia, but they were also shocked at the severity of the wounds and illnesses needing treatment.

Medical conditions considered rare in D.C. such as malaria, tuberculosis or grotesquely healing wounds, are seen constantly in Ethiopia’s hospitals.

“There are a lot of limbs that are lost over there that would never be lost back in D.C.,” Marinucci said.

Steinberg, a SIMA co-founder said, “We met 30 to 40 people with the most disgusting, festering wounds you’ve ever seen.”

Although the group was not able to install world-class emergency medical care in one trip, many participants said they felt the success of their experience on a smaller level.

“The problems (in Ethiopia) are huge, and the accomplishments are all due to the hard work and perseverance of our colleagues in Ethiopia,” Haile-Mariam said. “Our greatest sense of accomplishment has come from the great professional relationships that we have established with healthcare professionals in Ethiopia.”

Haile-Mariam added, “We know these relationships will lead to academic and clinical collaborations that will benefit all of us.”

For Steinberg, the personal relationships with patients were especially satisfying. He said, “I felt gratification from patients because we were doing something when no one else was.”

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