One of the most important challenges faced by governments throughout the world is how to respond to the ever growing need for prompt, appropriate medical care in emergency situations. The Sudan is no exception where Emergency Medical Service (EMS) networks are disjointed and somewhat limited in scope. Emphasis is put on a few components rather than treating them as an integrated coordinated system. The overall goal of an EMS programme is to reduce avoidable death and disability from accidents or sudden illness by providing timely, efficient and appropriate medical services.
Obviously, governments need to have a comprehensive programme to address EMS system development over a definite time period, and address EMS manpower training capability to ensure the availability of an adequate manpower pool to meet the EMS needs.
Life saving resuscitation skills are poor among Sudanese health care providers and laypersons. Almost all medical and paramedical personnel are deficient in organized certified knowledge of resuscitation. Emergency services are poorly operatedwith high level of failure rates, and limited achievements. Health care organizations lack basic infrastructure, organization, and trained personnel.
The solid knowledge base that is available worldwide is strikingly absent in Sudan.The Tigani El Mahi Medical Skills Laboratory in Educational Development Centre in the Faculty of Medicine, University of Khartoum has pioneered efforts in this field at the level of schools of medicine. This centre remains by definition limited in scope and the range and extent of services provided.Similar work is carried out at Soba University andAhfad College of Medicine where basic life support training is given as part of undergraduate basic skills training. Several resuscitation courseswere conducted in Continuing Professional Development Centre (CPD)of the Federal Ministry of Health. As its name implies, training here includes all fields of medicine.
Yet, there is no organisation specialized in training BLS, ACLS/ALS for all age groups and ATLS and related skills. Schools of medicine offer limited help and guidance in this field.Medical schools curricula are silent and, hence they do not offer proper training on how to resuscitate the critically ill person. Theyprovide students with basic didactic knowledge but no more.
There are no channels of formal or informal coaching ofhealth care providers in the different levels of resuscitation training. In short, there are no means of improving one’s knowledge or practice as an individual or an organization in the face of handling the critically-ill patient.These problems have to be resolved; deficiencies corrected, and needs met.
Maharat presumes that health care providers would like to achieve higher skills and knowledge in this field, but they do not have the right training programme or facility. In addition, and as a prerequisite to patient safety in modern societies, and the increasing costs of litigation, health care providers recruited to work in ICU, ER, OR or in any other section within the health care delivery system, are expected to have proven knowledge and skill in these fields.