Trauma Care: Stakeholders highlight ways to improve emergency response services

Former Minister of Health, Prince Juli Adelusi Adeluyi, flanked by other dignitaries at Trauma Conference 2019 held in Lagos, Nigeria

By Taiwo Okanlawon

‘Trauma Care: The Way Forward’ was the theme of Trauma Conference 2019 organized by Trauma Care International Foundation where policymakers, senior government officials, the academics, media practitioners, corporate organizations, professional associations and scholars from various health and trauma-related disciplines had discussions on trauma care and emergency response management.

The conference, held at Radission Blu, Ikeja, Lagos, Nigeria on Tuesday, was aimed at improving the state of trauma care and emergency response services in Nigeria through discussions among the delegates.

In her welcome address, the Chairperson of Trauma Care International Foundation, Dr. Deola Philips disclosed that trauma has become a global public health problem with Nigeria recording over 4 million injuries and more than 200,000 deaths annually from road crashes, “a major cause of traumatic injuries in our environment.”

She said TCIF has been actively involved in mass health and safety education and advocacy campaigns, voluntary blood donation initiatives, hospital endowment, and MEDICAID programmes.

“These programmes targeted at increasing the pool of skilled first responders, strengthening of existing health care systems and facilities with significant successes recorded.”

Philips further said the focus of the conference was to define the way forward for trauma care and emergency response services in Nigeria and in the sub-continent, against the antecedent which portrayed the fundamental challenges of poor planning and lack of sustainability.

In her words, “It is a solution- based convention to emphasize the possibility of an absolutely adequate system for trauma care and emergency response in Nigeria and West Africa. To generate answers innovatively which can be tailored to every level in the health care system.

“To accelerate support for the existing health care structures in a robust, comprehensive and enduring fashion. To fast-track education and advocacy for these in a sustainable manner. To reawaken in health care providers, the essence of stakeholdership in Trauma Care and Emergency Response which remains saving lives every day.”

She, however, boasted that these solutions would bring viable principles that will improve stakeholder responsiveness, education of the populace and health care providers, the execution of innovative, indigenous and globally-accepted solutions as well as the provision of a veritable networking platform for trauma care.

She said, “Not only are these possible; TCIF through collaboration and galvanized engagement of relevant stakeholders is committed to supporting the achievement of the sustainable development goals concerned for a healthier nation.”

“It is our hope that the inputs from this conference will proffer a real and actionable framework to be designed and agreed upon which will impact health care delivery especially in the management of trauma cases. It is our desire that health care services for traumatic injuries become more cohesive, affordable and in compliance with global best practices.

“I trust that our speakers and panelists will help to enlighten all of us and stimulate us to action towards sustainable trauma care in Nigeria,” she said.

The Chairman of the occasion and former Minister of Health, Prince Juli Adelusi Adeluyi, in his opening remarks advised the participants at the conference to put their thoughts together to see what needed to be done to make the Trauma Care International Foundation become relevant and impactful in order to advance trauma care in Nigeria.

“It is also important to focus on a few things. You can’t solve all the problems in just one seminar, this is only a signal. Trauma itself is a big deal all over the world, it is not necessarily such a big deal here because we have other big deals; you don’t know who is going to win politically, you never know who will knock you down, even you never know when you report to the police station whether you are going to be the accused or the one reporting, too many things.

“Trauma is not a new thing if you look at it, trauma has been in the English dictionary since 1693, all these will come into folds when we are developing.  I know some of the faces that I am seeing here, you have better brains, use them. In fact, some of them want to use them. And I hope that the area of education will be visited during your discussion, we need it,” he said.

He also urged them to follow whatever they were doing with passion, perseverance, using networking and not to give up.

Delegates and dignitaries at Trauma Conference 2019 held in Lagos, Nigeria

In his Keynote Address, the Chairman, Senate Committee on Health, Senator Ibrahim Yahaya Oloriegbe commended TCIF’s efforts in contributing to focusing the attention of key stakeholders in the health care delivery system on a crucial aspect of health care service delivery in Nigeria.

He added that their efforts had the potential to positively alter the mortality statistics and improve the quality of care in “our hospitals and service delivery points.”

“I am always delighted to be associated with gatherings like this and to speak on what we can do together to improve and better the healthcare sector of Nigeria.”

Oloriegbe, who was represented by Mr. Mike Egboh, the Country Director, USAID GHSC-PSM while delivering his speech, titled, “National Health Act and its Provisions for Emergency Care” said appropriate and timely care given early could significantly improve outcome from trauma care.

He said trauma, which is the leading cause of death in the first four decades of life, was also identified as one of the major causes of death on a daily basis in Nigeria.

“Majority of Nigeria’s highways are without plans for emergency rescue operations either by state or non-state actors.

“Moreover, when such emergencies happen and evacuation takes place through help of individuals close to the scene of the accident or the emergency situation, the bureaucracy at the reception of most hospitals and health institutions may pose an obstacle to saving the endangered lives- as it used to be the practice that persons with gunshot wounds are required to provide police reports before health care providers can attend to the victims, and failure to provide the report may lead to the victims bleeding to death or dying of other complications!

“The Goal of Emergency Care for Trauma is appropriate and timely care, this can significantly improve outcome from trauma. This should be one of the key messages every health care professional in this conference should go home with and strive to implement and live with.”

Egboh, however, disclosed that the National Health Act (2014) was enacted by the 8th National Assembly of the Federal Republic of Nigeria on the 31st of October, 2014, and the Section 20 (1) of the Act provides that a health care provider, health worker or health establishment shall not refuse a person emergency medical treatment for any reason.

He further said anyone who contravened this section committed an offence and is liable on conviction to a fine of N100, 000.00 or to imprisonment for a period not exceeding six months or to both.

“By prohibiting the refusal of emergency care and penalizing the refusal to provide emergency care, the National Assembly underscored the seriousness which it attaches to emergency treatment considering that it is about saving lives through taking steps to fulfill the right to life,” he said.

Some special dignitaries at Trauma Conference 2019 held in Lagos, Nigeria

In his address, Commissioner for Health, Prof. Akin Abayomi enjoined all Health care workers to do whatever they could to save people during emergencies despite the unfavorable circumstances they might find themselves.

Abayomi highlighted government’s actions on trauma care in Lagos State, lamenting the state of public transit drivers who were not in the right mental health or under the influence of alcohol while driving sometimes, which needed to be managed.

“We are now experiencing a very high number of cases ascribe to trauma either due to road traffic accident or physical violence and we are now gearing up to do something about mental health because mega cities are known to be risk factors associated with increased mental health distress that we feel under the pressure of living in a crowded buzzing environment where nobody seems to care for anybody else and of course mental health can’t be responsible for physical violent.

“Lagos has taken the bull by the horn according to the Health Act and the issue around the subject of what we do with trauma cases as they present to our health facilities or what we do to trauma cases at the scene, our major issues of concern. As doctors, we are supposed to render help at all times irrespective of the individual.”

Abayomi also said it was sad that health care workers were being trained and lost in Nigeria to developed countries, urging government bodies to value their workers.

“It takes a lot of time, effort and money to build and train a doctor, a specialist and therefore they must be valued,” he said.

Minister of Health, Dr. Osaghie E. Ehanire, who was represented by the Medical Director of the National Orthopaedic Hospital, Igbobi, Lagos, Dr. Mustapha Alimi highlighted the scourge of trauma in Nigeria, saying the factoring in the huge cost of mainly out-of-pocket treatment of victims, left many a family bankrupt, hugely indebted and often destitute.

He, however, disclosed that the Federal Ministry of Health was in collaboration with other Ministries, Departments, and Agencies of government and the private sector, to support Federal Road Safety Commission and other responding entities, to further push down the statistics of casualties from road traffic and other accidents.

The minister also said the ministry would develop a robust all-embracing response mechanism to mitigate the damaging impact of trauma from accidents on citizens and the economy.

In her goodwill message, the First Lady of Lagos State, Mrs. Ibijoke Sanwoolu, represented by Dr. Abiola Mafe said Governor Babajide Sanwo-Olu was fully committed to addressing trauma care in Lagos State.

Corps Marshal of the Federal Roads Safety Corps, Mr Boboye Oyeyemi, who was also represented by Corps Commander, Hyginus Omeje in his goodwill message commended Trauma Care International Foundation for training FRSC officials. He also commended the Lagos State Government’s efforts in addressing trauma care in the State.

Omeje, however, appealed to the healthcare workers to render service to critical emergency victims. He also appealed to hospitals to stop closing their doors on crash victims, especially for lack of bed space.

The representative of the Nigerian Red Cross, Elder Anani in his goodwill message said Red cross was currently in 20 states in Nigeria, doing well in managing trauma care and that they have trained a lot of private and public agencies.

Dr. Chris Otabo, Consultant Orthopaedic Surgeon, Asokoro District Hospital in his presentation titled, “Transforming Health Care in Nigeria through trauma Network,” said the number of people that died in road accidents in Nigeria was alarming.