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First Responders and Prehospital Care for Road Traffic Injuries in Malawi

Published online by Cambridge University Press:  07 December 2016

Linda Chokotho
Affiliation:
Beit Cure Hospital, Blantyre, Malawi
Wakisa Mulwafu
Affiliation:
Department of Surgery, College of Medicine, University of Malawi, Blantyre, Malawi
Isaac Singini
Affiliation:
John Hopkins Project, Blantyre, Malawi
Yasin Njalale
Affiliation:
Blantyre Adventist Hospital, Blantyre, Malawi
Limbika Maliwichi-Senganimalunje
Affiliation:
Department of Psychology, Chancellor College, Zomba, Malawi
Kathryn H. Jacobsen*
Affiliation:
Department of Global & Community Health, George Mason University, Fairfax, Virginia, USA
*
Correspondence: Kathryn H. Jacobsen 4400 University Drive 5B7 George Mason University Fairfax, Virginia 22030, USA E-mail: [email protected]

Abstract

Introduction

Road traffic collisions are a common cause of injuries and injury-related deaths in sub-Saharan Africa (SSA). Basic prehospital care can be the difference between life and death for injured drivers, passengers, and pedestrians.

Problem

This study examined the challenges associated with current first response practices in Malawi.

Methods

In April 2014, focus groups were conducted in two areas of Malawi: Karonga (in the Northern Region) and Blantyre (in the Southern Region; both are along the M1 highway), and a qualitative synthesis approach was used to identify themes. All governmental and nongovernmental first response organizations identified by key informants were contacted, and a checklist was used to identify the services they offer.

Results

Access to professional prehospital care in Malawi is almost nonexistent, aside from a few city fire departments and private ambulance services. Rapid transportation to a hospital is usually the primary goal of roadside care because of limited first aid knowledge and a lack of access to basic safety equipment. The key informants recommended: expanding community-based first aid training; emphasizing umunthu (shared humanity) to inspire bystander involvement in roadside care; empowering local leaders to coordinate on-site responses; improving emergency communication systems; equipping traffic police with road safety gear; and expanding access to ambulance services.

Conclusion

Prehospital care in Malawi would be improved by the creation of a formal network of community leaders, police, commercial drivers, and other lay volunteers who are trained in basic first aid and are equipped to respond to crash sites to provide roadside care to trauma patients and prepare them for safe transport to hospitals.

ChokothoL, MulwafuW, SinginiI, NjalaleY, Maliwichi-SenganimalunjeL, JacobsenKH. First Responders and Prehospital Care for Road Traffic Injuries in Malawi. Prehosp Disaster Med. 2017;32(1):14–19.

Type
Original Research
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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References

1. Peden, M, Surfield, R, Sleet, D, et al. World Report on Road Traffic Injury Prevention. Geneva, Switzerland: World Health Organization; 2004.Google Scholar
2. Beuran, M, Paun, S, Gaspar, B, et al. Prehospital trauma care: a clinical review. Chirurgia. 2012;107(5):564-570.Google Scholar
3. Sasser, S, Varghese, M, Kellerman, A, Lormand, JD. Prehospital Trauma Care Systems. Geneva, Switzerland: World Health Organization; 2005.Google Scholar
4. World Health Organization. Global Status on Road Traffic Safety: Time for Action. Geneva, Switzerland: World Health Organization; 2013.Google Scholar
5. Chen, G. Road traffic safety in African countries: status, trend, contributing factors, countermeasures, and challenges. Int J Inj Contr Saf Promot. 2010;17(4):247-255.Google Scholar
6. World Health Organization. World Health Statistics 2016: Monitoring Health for the SDGs. Geneva, Switzerland: World Health Organization; 2016.Google Scholar
7. Sivak, M, Schoettle, B. Mortality from Road Crashes in 193 Countries: A Comparison with Other Leading Causes of Death. Ann Arbor, Michigan USA: University of Michigan Transportation Research Institute; 2014.Google Scholar
8. Chokotho, L, Mulwafu, W, Jacobsen, KH, Pandit, H, Lavy, C. The burden of trauma in four rural district hospitals in Malawi: a retrospective review of medical records. Injury. 2014;45(12):1065-1070.Google Scholar
9. Chasimpha, S, McLean, E, Chihana, M, et al. Patterns and risk factors for deaths from external causes in rural Malawi over 10 years: a prospective population-based study. BMC Public Health. 2015;15:1036.Google Scholar
10. World Health Organization. Global Status Report on Road Safety 2015. Geneva, Switzerland: World Health Organization; 2015.Google Scholar
11. Olukoga, A. Trends in road traffic crashes, casualties, and fatalities in Malawi. Trop Doct. 2007;37(1):24-28.CrossRefGoogle ScholarPubMed
12. Lagarde, E. Road traffic injury is an escalating burden in Africa and deserves proportionate research efforts. PLoS Med. 2007;4(6):e170.CrossRefGoogle ScholarPubMed
13. Lincoln, YS, Guba, EG. Naturalistic Inquiry. Newbury Park, California USA: Sage Publications; 1985.Google Scholar
14. Adeloye, D. Prehospital trauma care systems: potential role toward reducing morbidities and mortalities from road traffic injuries in Nigeria. Prehosp Disaster Med. 2012;27(6):536-542.Google Scholar
15. Mock, CN, Jurkovich, GJ, nii-Ammon-Kotei, D, Arreola-Risa, C, Maier, RV. Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. J Trauma. 1998;44(5):804-814.Google Scholar
16. Khorasani-Zavareh, D, Khankeh, HR, Mohammadi, R, Laflamme, L, Bikmoradi, A, Haglund, BJA. Post-crash management of road traffic injury victims in Iran: stakeholders’ views on current barriers and potential facilitators. BMC Emerg Med. 2009;9:8.CrossRefGoogle ScholarPubMed
17. Pallavisarji, U, Gururaj, G, Girish, RN. Practice and perception of first aid among lay first responders in a southern district of India. Arch Trauma Res. 2013;1(4):155-160.Google Scholar
18. Pitt, E, Pusponegoro, A. Prehospital care in Indonesia. Emerg Med J. 2005;22(2):144-147.Google Scholar
19. Jayaraman, S, Mabweijano, JR, Lipnick, MS, et al. First things first: effectiveness and scalability of a basic prehospital trauma care program for lay first-responders in Kampala, Uganda. PLoS One. 2009;4(9):e6955.Google Scholar
20. Sun, JH, Wallis, LA. The emergency first aid responder systems model: using community members to assist life-threatening emergencies in violent, developing areas of need. Emerg Med J. 2012;29(8):673-678.Google Scholar
21. Mock, CN, Tiska, M, Adu-Ampofo, M, Boakye, G. Improvements in prehospital trauma care in an African country with no formal Emergency Medical Services. J Trauma. 2002;53(1):90-97.Google Scholar
22. Sangowawa, AO, Owoaje, ET. Building capacity of drivers in Nigeria to provide first aid for road crash victims. Inj Prev. 2012;18(1):62-65.Google Scholar
23. Tiska, MA, Adu-Ampofo, M, Boakye, G, Tuuli, L, Mock, CN. A model of prehospital trauma training for lay persons devised in Africa. Emerg Med J. 2004;21(2):237-239.Google Scholar
24. Oluwadiya, KS, Olakulehin, AO, Olatoke, SA, et al. Prehospital care of the injured in south western Nigeria: a hospital-based study of four tertiary level hospitals in three states. Annu Proc Assoc Adv Automot Med. 2005;49:93-100.Google ScholarPubMed
25. Solagberu, BA, Ofoegbu, CKP, Abdur-Rahman, LO, Adekanye, AO, Udoffa, US, Taiwo, J. Prehospital care in Nigeria: a country without Emergency Medical Services. Niger J Clin Pract. 2009;12(1):29-33.Google Scholar
26. Hofman, JJ, Dzimadzi, C, Lungu, K, Ratsma, EY, Hussein, J. Motorcycle ambulances for referral of obstetric emergencies in rural Malawi: do they reduce delay and what do they cost? Int J Gynaecol Obstet. 2008;102(2):191-197.Google Scholar
27. Martel, J, Oteng, R, Mould-Millman, NK, et al. The development of sustainable emergency care in Ghana: physician, nursing, and prehospital care training initiatives. J Emerg Med. 2014;47(4):462-468.Google Scholar
28. Adewole, OA, Fadeyibi, IO, Kayode, MO, et al. Ambulance services of Lagos state, Nigeria: a six-year (2001-2006) audit. West Afr J Med. 2012;31(1):3-7.Google Scholar
29. Stewart, BT, Gyedu, A, Quansah, R, et al. District-level hospital trauma care audit filters: Delphi technique for defining context-appropriate indicators for quality improvement initiative evaluation in developing countries. Injury. 2016;47(1):211-219.Google Scholar