“Has anyone done resuscitation on a real patient?” A few hands go up in a room of doctors, nurses and medical students. “Has anyone seen a situation where resuscitation should have been started but nobody was there who knew how to do it?” The room erupts with cries of “Papa Wemba!”
Papa Wemba, 66, the flamboyant King of Rhumba, collapsed and died on stage during a concert in Côte d’Ivoire on April 24, 2016. Videos of the incident went viral. It was clear that not even those wearing Red Cross bibs knew how to perform cardiopulmonary resuscitation (CPR). The Congolese singer and musician received a state funeral. Kinshasa was plastered with banners and murals of grief and commemoration.
This was the backdrop to our mission bringing emergency medicine education to the Democratic Republic of Congo (DRC). I am a specialist emergency physician based in Sydney with an interest in developing emergency medicine in low resource settings. My team member Lucy Hobgood-Brown grew up in the Congo where her parents had lived and worked. Her father was Rector of the Université Protestante au Congo (UPC). She is a co-founder of the NGO HandUp Congo through which she has been doing community development projects since 2005. She is also a member of ICA Australia, which has been a generous supporter of HandUp Congo’s capacity building projects in Equateur Province – see for example ICA Australia supports the Congo Canoe Challenge. We met at a development sector social function in Sydney in October 2013 shortly after I returned to Australia from working with the International Committee of the Red Cross in Geneva.
Despite a clear need for, and growing interest in, developing emergency medicine in the DRC, the discipline does not exist as a specialty. There is currently no postgraduate training program for doctors and nurses. There is no functional public pre-hospital system of ambulances and paramedics, although some private hospitals provide an ambulance service. Basic and advanced life support are not a standard part of medical training. Few Congolese medical institutions have the capacity to train recognized specialists of any kind. Most doctors must seek this outside the country. UPC is the only university in the Congo able to train family medicine specialists.
After an initial assessment of the potential to deliver emergency medicine education through the UPC infrastructure last year, we returned this year to develop the initiative further. We started our six-week trip in Cape Town at the International Conference on Emergency Medicine. UPC members gathered there with representatives from the African Federation for Emergency Medicine (AFEM) and the WHO Emergency, Trauma and Acute Care program, among others, to help shape the project.
After that, we travelled with two Congolese doctors specialising in emergency medicine outside the Congo, Dr Müller Mundenga and Dr Ken Diango, and Australian nurse Maureen Hurley, to deliver a three-day emergency medicine training course at five locations across the country where UPC has clinical sites for their family medicine trainees. These included Goma in the east, and Tshikaji, Vanga, Kinshasa and Kimpese in the west.
The program included didactic and practical modules on resuscitation, paediatric rehydration, trauma management, ECG interpretation and intravenous access. Over 220 healthcare providers participated. They were each given certificates of attendance and a USB containing the training material in electronic form (donated by Blu Gibbon).
A core principle of the project is the involvement of Congolese doctors, especially those trained as emergency medicine specialists outside the DRC, in the shaping and leadership of this initiative. The project also aims to establish a component of visiting physicians from overseas to help in on-site teaching.
Back in Kinshasa, our team held further meetings, including with the Ministry of Health. We conducted hospital site visits to assess them for suitability as a pilot site for emergency medicine training. Together with UPC, we aim to develop a one-year emergency medicine certificate for Congolese doctors already trained in another specialty, based on an African-centric curriculum developed by AFEM. A longer-term ambition is to train emergency medicine specialists in the Congo based on AFEM’s three-year curriculum.
Lucy and I are most grateful for the support of Rotary Australia World Community Service and many individual donors. We are constantly on the lookout for potential donors or suitable collaborators. For more information or to share your comments and ideas, please e-mail handupcongo@gmail.com. For tax deductible donations (in Australia), please visit http://rawcs.org.au; Project No. 47, Year Registered 2015-16, “Building a Healthy Congo”.
Dr Vera Sistenich, a specialist emergency physician based in Sydney, contributed this article following her recent visit to the DRC with ICA Australia member Lucy Hobgood-Brown. This post was first published in Winds and Waves, November 2016. For past issues, please visit our Winds and Waves archive.