Interview: Egypt needs to do more for trauma care
Nourhan Magdi (TCP) : At least 3,675 people died in Egypt in 2015 as a result of injuries caused by road accidents, burns, poisoning and other reasons that are considered largely preventable.
Statistics provided by the Central Administration for Critical and Urgent Care, although not comprehensive, showed that violence-related accidents like: fights, fire shooting, explosion of strange bodies and shells account for around 21 percent of the total 7,053 accidents cited last year.
According to the World Health Organization (WHO,) injuries and violence are among the most prominent public health problems globally, and a leading cause of mortality; many of the non-fatal injuries result in health consequences and life-long disabilities.
On the top of a list containing 29 types of accidents in Egypt, traffic crashes account for 53.3 percent of the total accidents. Around 3 percent of the road injuries suffer disability, Dr. Khaled el-Khateeb, head of Central Administration for Critical and Urgent Care said in an interview with The Cairo Post.
Cairo has witnessed the highest number of accidents amounting to 850, while the restive area of North Sinai saw 279 last year, according to the administration’s report that did not detail types of accidents in each governorate.
The emergency sector in Egypt has faced many challenges since 2011 Revolution, said El-Khateeb, adding that doctors dealt with new kinds of violence-related injuries in huge numbers, “it was like an exam to us at this time.”
Now, Sinai is facing a “war” that results in many fatal injuries, according to El-Khateeb. “As trauma doctors are afraid to be assigned there, we mostly depend on Sinai-based doctors, and volunteering rapid deployment teams.”
“Egypt should pay utmost attention to trauma care and services,” said Dr. El-Khateeb, as he cites citizens’ complaints over lack of beds at intensive care (ICU) and burns treatment units.
The administration, which is part of the health ministry, was officially launched in 2010, where it was tasked with operating emergency and ambulance departments only. Other departments like burns, poisons and pre-term birth care were not working efficiently or even been monitored then.
“That’s why we chose the toughest task, which is bringing all these departments to work under the administration,” continued El-Khateeb.
Where does Egypt stand in trauma care?
“Talking about trauma care mainly means swift ambulance service, and good emergency care,” said El-Khateeb, adding that the administration in the beginning focused on assessing the status-quo of the emergency departments after former health ministers raised efficiency of the ambulance sector with fully equipped vehicles.
First of all, he said that the emergency sector suffers a big problem, which is lack of staff; he cited students’ reluctance to register at medicine faculties, attributing the reason to low salaries and incentives allocated to trauma doctors.
Egypt has currently around 10,300 intensive care beds in both public and private hospitals; the figure is “very low” compared to other countries, said El-Khateeb.
“Egypt’s rate is equal to one bed for each 9,000 citizens; in some neighboring states, it is one bed for 7,000 citizens, while in the U.S., the rate is one bed for each 5,000 citizens,” he added.
According to El-Khateeb, at least 3,000 additional intensive care beds are needed so that the country can meet people’s need for urgent services, “but both public and private hospitals should share responsibility to provide them.”
The head of the administration added that “around 1,300 incubators are also needed at pre-term birth care units.”
“We do not ignore the fact that there are deficiencies in the emergency care units; however, we have short and long term plans to eliminate such deficiencies because maintaining people’s health is our mission,” El-Khateeb added.
Egypt’s to-do-list for injury prevention
According to a 2014 WHO report on injury prevention, more than 5 million people die each year as a result of injuries, making 9% of the world’s deaths, nearly 1.7 times the number of fatalities that result from HIV/AIDS, tuberculosis and malaria combined.
The report said that low and middle income countries have higher rates of fatal and non-fatal injuries than wealthier ones; however, it stressed that successful adoption of preventable measures has significantly reduced injuries in some countries.
El-Khateeb explained to The Cairo Post that a plan to prevent injuries has been designed by the administration, in cooperation with WHO, based on two axes: therapeutic and preventive measures.
The therapeutic care measures includes: raising efficiency of hospitals by classifying them into three categories of A, B and C, and providing them with emergency devices according to their proximity to highways and the number of trauma patients checking in.
The Ministry of Health has cooperated with WHO in conducting training sessions to 300-400 doctors and 200-300 nurses in emergency, burns and intensive care services, El-Khateeb added.
As part of the ministry’s short-term development plan for emergency departments, El-Khateeb mentioned that 300 new intensive care beds, 500 incubators and 28 burns treatment units will be added by the financial year 2016/2017. The total cost of the plan for the same FY is around 150 million EGP.
An awareness campaign, funded by WHO, is among preventive measures, with TV ads and printed flyers aiming at raising people’s and students’ awareness against all types of injuries.
Road injuries: pre-hospital care
Despite road accidents being on the top of Egypt’s agenda with new established roads, renewed bridges and drug screening carried out to drivers, annual death toll as a result of traffic injuries is still on the rise.
In 2015, Egypt’s road accidents recorded an increase, reaching 14,548 resulting in 6,203 deaths, 19,325 injured and 19,116 damaged vehicles, according to a latest report by the Central Agency for Public Mobilization and Statistics (CAPMAS.)
By 2030, road traffic injuries are predicted to become the 7th leading cause of death, according to WHO report.
“Unfortunately, victims of traffic injuries are mostly youth,” El-Khateeb said, adding that one of the main long-term projects he seeks to adopt is establishing trauma centers on highways.
He explained “instead of waiting until the injured is transferred to an internal hospital inside a governorate in order to receive the necessary care, which would cost him his life, trauma centers will be built to provide urgent pre-hospital care to stabilize the patient’s condition.”
Egypt is among 10 states enrolled in the UN Decade of Action program for road safety that aims to halve the rate of traffic deaths by 2020.
Nourhan Magdi, The Cairo Post