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Designing, Implementing, and Managing a National Emergency Medical Service in Sierra Leone

Published online by Cambridge University Press:  01 December 2020

Luca Ragazzoni ,
Marta Caviglia Open the ORCID record for Marta Caviglia [Opens in a new window] ,
Paolo Rosi ,
Riccardo Buson ,
Sara Pini ,
Federico Merlo ,
Francesco Della Corte ,
Matthew Jusu Vandy ,
Amara Jambai  and
Giovanni Putoto
Luca Ragazzoni*
Affiliation:
CRIMEDIM - Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Novara, Italy
Marta Caviglia
Affiliation:
CRIMEDIM - Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Novara, Italy
Paolo Rosi
Affiliation:
SUEM 118, Veneto Region, Venice, Italy
Riccardo Buson
Affiliation:
Doctors with Africa CUAMM, Padua, Italy
Sara Pini
Affiliation:
Doctors with Africa CUAMM, Padua, Italy
Federico Merlo
Affiliation:
CRIMEDIM - Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Novara, Italy
Francesco Della Corte
Affiliation:
CRIMEDIM - Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Novara, Italy
Matthew Jusu Vandy
Affiliation:
Ministry of Health and Sanitation, Freetown, Western Area, Sierra Leone
Amara Jambai
Affiliation:
Ministry of Health and Sanitation, Freetown, Western Area, Sierra Leone
Giovanni Putoto
Affiliation:
Doctors with Africa CUAMM, Padua, Italy
*
Correspondence: Luca Ragazzoni CRIMEDIM – Research Center in   Emergency and Disaster Medicine Università del Piemonte Orientale,   Novara, Italy E-mail: luca.ragazzoni@med.uniupo.it
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Abstract

Sierra Leone is one of the least developed low-income countries (LICs), slowly recovering from the effects of a devastating civil war and an Ebola outbreak. The health care system is characterized by chronic shortage of skilled human resources, equipment, and essential medicines. The referral system is weak and vulnerable, with 75% of the country having insufficient access to essential health care. Consequently, Sierra Leone has the highest maternal and child mortality rates in the world. This manuscript describes the implementation of a National Emergency Medical Service (NEMS), a project aiming to create the first prehospital emergency medical system in the country. In 2017, a joint venture of Doctors with Africa (CUAMM), Veneto Region, and Research Center in Emergency and Disaster Medicine (CRIMEDIM) was developed to support the Ministry of Health and Sanitation (MOHS) in designing and managing the NEMS system, one of the very few structured, fully equipped, and free-of-charge prehospital service in the African continent. The NEMS design was the result of an in-depth research phase that included a preliminary assessment, literature review, and consultations with key stakeholders and managers of similar systems in other African countries. From May 27, 2019, after a timeframe of six months in which all the districts have been progressively trained and made operational, the NEMS became operative at national level. By the end of March 2020, the NEMS operation center (OC) and the 81 ambulances dispatched on the ground handled a total number of 36,814 emergency calls, 35,493 missions, and 31,036 referrals.

Keywords

developing countriesEmergency Medical Servicesprehospital carereferral system
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 1 , February 2021 , pp. 115 - 120
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Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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Footnotes

Note: Luca Ragazzoni and Marta Caviglia equally contributed to the present paper.

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