January 29, 2018
This morning Jane and I returned to Central University Hospital of Kigali (CHUK) for Rounds and then to give lectures on Event Medicine, MCI and START triage. Here in Kigali SAMU is often called upon to staff everything from high profile international business meetings to football matches with 50,000 fans. They are challenged by short notice for the events, which sometimes leaves little time for planning. Fortunately everyone seems to recognize that Rwanda is growing and becoming more high profile, and with that the need for Event Medicine management increasing.
The lectures were well received, probably because we started by passing out Toblerone chocolate bars Dr. Sudha bought in the Amsterdam airport. Free food at a meeting or lecture is universally well received.
After lectures at the hospital, Jane and I rejoined Dr. Sudha and Basil at the SAMU Trauma Course. Last week we taught this course to 25 of SAMU’s brightest providers with high potential to be great educators. Friday, Basil taught them fundamentals of medical education in the adult learner. Today and tomorrow, those 25 are now teaching the same course to 25 more SAMU staff from district hospitals all over Rwanda.
The change can be felt already. Yes, the test scores were significantly improved last week, but more importantly, the SAMU staff have already incorporated their trauma training into their regular practice. While at CHUK this morning, the residents told us that SAMU was no longer performing reductions on extremities with intact pulses. The residents asked for clarification so that everyone would be on the same page. The change in practice was apparent to the hospital staff.
Sitting back and watching these instructors teach was quite inspiring. Just a few days ago, they too were uncertain and had only a fragile confidence. The preparation they invested over the weekend was obvious. Switching between three languages to ensure they are meeting the needs of all students, they delivered the content with enthusiasm and grace.
It’s a good thing these new instructors are strong, because I can barely follow what they are saying in French or Kinyarwanda. Every few sentences I recognize words or phrases like “stay and play” or “scoop and run.” It’s amusing to discover that some of these expressions are universal no matter where you practice EMS.
One thing I’ve been asking myself is “how important is creating a culture of EMS?” What does a star of life patch signify? How do awards and recognition of heroic calls help motivate providers? In a line of duty death, the traditional funeral exercise that follows…
Are these traditions specific to EMS in the US, or are they something universally necessary to growing and sustaining a productive EMS system? Would SAMU of Rwanda benefit from connecting with other International EMS agencies? How can we help SAMU grow without imposing too many of our own values that may not be what’s right for SAMU. It will be interesting to watch the SAMU staff grow and develop over the next few years. I’ve seen them grow so much just this short week.
Explore more days in Rwanda: