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Most people working in Kenya’s healthcare system would readily acknowledge that emergency medical care is lacking and must be improved.  Unfortunately, the problem is so big and complicated that it cannot easily be fixed, and this deters many from trying.  Also, for many in the system, their single focus is providing direct care to patients, and they cannot see what is happening across the healthcare system.  

Early in his career, a Kenyan doctor, Dr Benjamin Wachira witnessed how many patients experienced medical emergencies and died because they could not access an ambulance or presented to healthcare facilities that were inadequately resourced to provide lifesaving emergency medical care. He went to South Africa to study Emergency Medicine and experienced how a functioning emergency medical care system worked to save lives. Ben returned to Kenya in 2012 and was the first Kenyan Emergency Physician based in Kenya. Together with his colleague Dr Jeremiah Gitau, they realised that to improve Kenya’s emergency medical care system, they had to increase the focus on emergency medical care within the existing healthcare system and gradually, over time, integrate it so that emergency medical care is delivered seamlessly inside and outside the hospital system to save lives. They established the Emergency Medicine Kenya Foundation (EMKF) in 2015. 

The Foundation had one pressing objective: to improve Kenya’s emergency healthcare system. To do this, they had to encourage everybody involved in Kenya’s healthcare system to change how they saw emergency medical care. First, everybody needed to be convinced that emergency medical care had to be provided as quickly as possible to be of maximum benefit. 

When an emergency occurs, some patients need immediate lifesaving treatment. This means an adequately equipped ambulance with qualified EMTs/Paramedics should be sent to the patient as quickly as possible so that the EMTs/Paramedics can diagnose and provide this initial treatment. Once the patient is stabilised, the ambulance takes them to the most appropriate emergency department to receive additional lifesaving care and be admitted for more specialised treatment.  One of EMKF’s challenges is to increase the number and availability of adequately equipped ambulances with trained EMTs/Paramedics throughout Kenya because ambulances play a critical role in saving lives and providing early notification to emergency departments so that they are prepared when the patient arrives.

Delivering a patient to a hospital quickly is critical, but it is just the first stage of treatment.  Until recently, once a patient arrived at a hospital in an emergency, the hospital’s response was chaotic as the facilities were not appropriately designed or equipped to handle emergencies, and the healthcare providers had no specific training or guidelines on emergency medical care.  While most of the hospitals in Kenya are accustomed to handling regular patients in a planned way based on experience, emergency medical care is unique. It requires innovative approaches, specialised equipment and resources, sequencing different treatments and working with colleagues across different specialities while managing multiple patients simultaneously.

It was clear to EMKF that to be successful, it had to promote a new approach (evidenced by a new national policy). This approach needed to be adopted by the national government and county governments, and various stakeholders and partners. Ben and Jeremy’s specialised knowledge, expertise, experience and vision for a better emergency medical care system gave them credibility. Their willingness to volunteer their time to achieve this vision earned them respect.  As a result of this work, EMKF was instrumental in positively influencing the development of Kenya’s first Emergency Medical Care Policy by the Ministry of Health (the Policy) in 2020.  The Ministry of Health clearly values their advice and input, and Ben has been appointed to the National Emergency Medical Care Steering Committee to support the government to operationalise the Policy and provide oversight of emergency medical care in Kenya as guided by the Policy. 

Over the years, the stewardship of the Board of Directors has seen EMKF experience significant growth and establish itself as the trusted partner in developing emergency medical care services in Kenya.  EMKF has benefitted enormously by having a talented, almost all-female team totally committed to improving emergency medical care in Kenya because they understand the massive, positive impact an improved emergency medical care system that values and respects human life can have on society. They have enormously contributed to a unique synergy of purpose shared throughout the organisation, encouraging ownership and pride in everything EMKF does.  Together, they are building an emergency medical care system in Kenya that will save lives, make Kenya a better place and provide a model for other countries wanting to improve emergency medical care.

Now that we have Kenya Emergency Medical Care Policy 2020-2030, the next step is to disseminate this across the country in all 47 Counties and directly support its implementation. However, the barrier to this is funding. If we want to change the status quo, funding has to come from external sources to get the work moving, which in turn will motivate the National and County governments to prioritise the development of an emergency medical care system within Kenya’s healthcare system to save lives.