The state of emergency care in the Republic of the Sudan

Sudan is one of the largest African countries; covering an area of 1.9million km2-approximately one fifth of the geographic area of the United States. The population is 30million people; the majority of whom (68) live in rural areas; as compared with the sub-Saharan African average of approximately 62. Sudan is considered a lower-middle income country-with 47 of the population living below the poverty line and a gross domestic product (GDP) of US $62billion in 2010. In addition to excessive burden of communicable diseases such as malaria; tuberculosis; and schistosomiasis; Sudan is particularly susceptible to both natural and manmade disasters. Drought and flood are quite common due to Sudan's proximity to and dependency on the Nile; and throughout history Sudan has also been plagued with internal conflicts and outbreaks of violence; which bring about a burden of traumatic disease and demand high quality emergency care. The purpose of this paper is to describe the state of emergency care and Emergency Medicine education; and their context within the Sudanese health care system. As is the case in most African countries; emergency care is delivered by junior staff: new graduates from medical schools and unsupervised medical officers who handle all types of case presentations. In 2001; increased mortality and morbidity among unsorted patients prompted the Ministry of Health to introduce a new triage-based emergency care system. In late 2005; twenty-one Emergency physicians delivered these new Emergency Services. In 2011; following a curriculum workshop in November 2010; the Emergency Medicine residency program was started in Khartoum. Currently there are 27 rotating registrars; the first class of whom is expected to graduate in 2015

Development of emergency medicine in Rwanda

"Rwanda; known as the ""Land of a Thousand Hills;"" is a small; East African country that was the site of the devastating 1994 genocide. In the past 18years; this post-conflict country has made tremendous progress in rebuilding itself and its health infrastructure. The country has recovered or surpassed many of its pre-1994 health levels; including reduction in HIV/AIDS prevalence; under-five mortality and road traffic accidents. Nevertheless; Rwanda continues to face a high burden of disease. The leading causes of mortality in Rwanda include complications of HIV/AIDS and related opportunistic infections; severe malaria; pulmonary infections; and trauma; and are best managed with emergency and acute care services. However; health care personal resources remain significantly lacking; and there is currently no emergency medicine-trained workforce. The Rwandan government; partnering with international organizations; has launched a campaign to improve human resources for health; and as a part of that effort the creation of training programs in emergency medicine is now underway. The Rwandan Human Resources for Health program can serve as a guide to the development of similar programs within other African countries. The emergency medicine component of this program includes two tracks: a 2-year postgraduate diploma course; followed by a 3-year Masters of Medicine in Emergency Medicine. The program is slated to graduate its first cohort of trained Emergency Physicians in 2017."