The ICRC, working in partnership with the Kenyan Ministry of Health, recently conducted a training course in emergency room trauma, the first of its kind to be held in Nairobi. The three-day workshop brought together 21 participants, mostly medical doctors, clinical officers and a few nurses from Voi, Makindu, Naivasha, Nakuru, Kisumu, Thika and Eldoret districts, where the ministry is establishing more emergency response centres.

Two ICRC surgeons, Harald Veen and Mauro Dalla Torre, facilitated the course, whose aim was to refresh the participants’ knowledge of the ABCs of treating trauma patients. ''The ABC approach is a safe and reliable method of evaluating and treating an injured patient. Ideally, the most gravely injured patient should be attended to first,'' Harald Veen explains. ''In any emergency, the first step in handling trauma situations is to establish a safe airway for the patient, restore the mechanics of breathing and maintain circulation to the body. The nature of the injuries may vary, but the basics remain the same”. These, and triage, the setting of priorities in handling multiple casualties, were some of the issues discussed during the course.

He stated that it was not always important to give a definitive diagnosis. ''Time is of the essence if further damage is to be prevented.'' He noted that while all cases were considered equal under the ABC approach, doctors were expected to pay particular attention to women, especially expectant mothers, and children.

At a practical session, participants simulate the treatment of trauma to limbs, the head and spine, something they have faced in numerous real-life situations while dealing with road traffic accident victims in Kenya. Practical sessions concentrated on the treatment of acute emergencies and on how to spot life-threatening situations and others requiring immediate attention. Central to the exercises was the reminder that in an emergency room a doctor must remain calm, even under pressure.

The rationale behind the workshop

The deputy director of medical services, John Masasabi Wekesa, said the course was instrumental for the health ministry, which is in the process of setting up emergency response centres in nearly all the hospitals in Kenya. ''As a ministry, we have realized the need to set up emergency response centres in our main hospitals to deal with the influx of severely injured patients. In 2008, we set up pilot centres in Voi and Naivasha, and are expanding to the rest of the country,'' he explained. ''Our aim is to equip 10 doctors in each of the 202 hospitals in Kenya to be part of emergency response teams,'' he added. He believes the lack of follow-up for doctors who have been trained so far in the programme poses a major challenge.

The ICRC has previously worked with the Ministry of Health in boosting the capacity of local doctors. In times of armed conflicts and other situations of violence the ICRC has a mandate to protect and assist the victims. In 2008, following post-election violence, two workshops were held in Nyanza and Eastern provinces on emergency preparedness and the treatment of weapon wounds. Those attending the Nairobi course already had practical experience in handling trauma patients, having dealt with the influx of casualties of the violence. The course complemented their experience with theory.

They found it useful and felt that the practical aspect of it would help them improve their handling of the emergencies they encounter at work. As John Simiyu from Moi University, in Eldoret, put it, “The medical profession is changing daily and this workshop has helped us to keep abreast of new advances in the field.'' He added that the course had also provided the opportunity to exchange knowledge and experience with peers.