Na July 9, 2020, MMahadum akarere, Schoollọ Akwụkwọ Ọrịa Ọha mere otu nnyocha nyocha banyere steeti EMS na nlekọta ahụike nnukwu na Uganda. Ha chọpụtara na n'ọkwa ala nke mba ahụ, enweghị akụrụngwa ụgbọ ihe mberede dị ka nke ụgbọ ala ambulance, bọọdụ azụ, yana enweghị ndị ọkachamara zụrụ azụ.

Naanị 16 (30.8%) nke ndị na-eweta ụlọ ọgwụ 52 tupu enwere ndị nwere ụgbọ ala mberede nwere ụgbọ ala chọrọ ngwá, ọgwụ, na ndị ọrụ iji meghachi omume na mberede ozugbo. Nke a bụ ihe Mahadum Makerere ghọtara mgbe ọ nyochachara nyocha niile na Uganda. Nke a pụtara na ọ fọrọ nke nta 70% nke ambulances na Uganda enweghị ikike maka nlekọta ahụike na ntọala ụlọ ọgwụ.

Na ndabere nke nyocha ahụ, ha kọrọ na Ministry of Health (MoH) ghọtara mkpa ọ dị ịkwalite ọrụ ụgbọ ihe mberede. Ọmụmụ ihe a nwere ebumnuche iji guzobe ọkwa nke ọrụ nlekọta ahụike mberede (EMS) yana nlekọta nlekọta ahụike nnukwu na Uganda. Ha duziri ntule ndị a ma na ọkwa mba na nke mpaghara, na-atụle ike EMS na ụlọ ọgwụ ụlọ ọgwụ na ọkwa dị iche iche jiri ngwá ọrụ nyocha ahụike ụwa (WHO) Ahụike Nlekọta Mberede (ECSSA).

Ọ bụ ezie na emeela nnyocha ole na ole iji nyochaa nlekọta ụlọ ọgwụ tupu ụlọ ọgwụ dị na Kampala [7,8,9], ọ dịghị nnyocha dị ka emego iji chọpụta ọnọdụ EMS na nlekọta ahụike ụlọ ọrụ na Uganda na ọkwa mba.

 

Ebumnuche nke ọmụmụ a na isi: ọrụ nke ndị ọkachamara na nke ụgbọ ihe mberede na Uganda EMS

Dịka usoro ọrụ nlekọta ahụike (EMS), yabụ ọrụ ambulance na Uganda kwesịrị ịhazi akụkụ niile nke nlekọta enyere ndị ọrịa nọ n'ụlọ ọgwụ tupu ụlọ ọgwụ ma ọ bụ n'ụlọ ọgwụ [1]. Paramedics na EMT (nke dịkwa na ọrụ ndị ọkwọ ụgbọ ala), kwesịrị ijikwa ndị ọrịa ambulance akọwapụtara. Ebumnuche kwesịrị ịbụ mmelite nke nsonaazụ na ndị ọrịa nwere ọnọdụ dị oke njọ, dịka nne ime, ọrịa mberede, nnukwu mmerụ ahụ, na ọrịa ndị ọzọ na-emetụta oge.

Nlekọta ụlọ ọgwụ tupu ụlọ ọgwụ abụghị ogige naanị na ngalaba ahụike, ebe ọ nwere ike ịgụnye akụkụ ndị ọzọ dịka ndị uweojii na ngalaba mgbanyụ ọkụ. Na mgbakwunye na nlekọta ụlọ ọgwụ tupu oge eruo, nsonaazụ ndị ọrịa na-enwe mmetụta dị ukwuu site na nnukwu nlekọta a na-enye na ụlọ ọrụ ahụ ike [4]. Ịlanarị onye ọrịa na mgbake dabere na ọnụnọ nke ndị ọrụ ahụike zụrụ azụ nke ọma, yana nnweta akụrụngwa ụgbọ ihe mberede dị mkpa, dị ka ihe ndọtị, spinal bọọdụ, sistemu oxygen na ihe ndị ọzọ, ọgwụ, na ihe enyemaka n'ime nkeji na awa na-eso ọbịbịa nke onye ọrịa siri ike na ebe nlekọta ahụike [5].

 

EMS na Uganda: akụrụngwa ụgbọ ihe mberede na ndị ọzụzụ zụrụ azụ enweghị - Nlele nlele na usoro nlele

A haziri usoro ahụike Uganda na ọkwa atọ:

• ụlọ ọgwụ Ozi Ntuziaka maka mba
• ụlọ ọgwụ Ozi Ntuziaka
• ụlọ ọgwụ niile (mpaghara)

N'ime district, enwere ebe ahụike nwere ike dịgasị iche:

Health Center M na II: ụlọ ọrụ nlekọta ahụike kachasị. Adabaghị maka ọnọdụ ahụike siri ike [11];

Ahụike Ahụike II na IV: ọrụ ahụike kachasị ọnụ.

Mahadum Makerere nwetara ihe nlele maka ụlọ ọrụ ahụike niile dị na Uganda site na MoH wee wepụta ndepụta ahụ site na mpaghara ahụ ike. A kewara mpaghara ahụike ahụ n'ime mpaghara 4 na-achịkwa Yuganda [12] (ya bụ, North, East, West, na Central) iji hụ na ndị nnọchianya mpaghara mpaghara nọchiri anya mpaghara ahụ. N'ime mpaghara nhazi mpaghara ọ bụla, ndị otu nyocha ahụ họọrọ otu mpaghara ahụike na-ezighi ezi (Fig 1 - n'okpuru).

 

Ha kpachapụrụ anya tinye mpaghara mpaghara ahụ ike atọ ọzọ: mpaghara ahụ ike Arua na West Nile ebe ọ nwere nnukwu ndị gbara ọsọ ndụ, nke nwere ike imetụta nnweta na EMS. Ọzọ bụ Karamoja mpaghara ahụike ebe ọ bụ na o nwere akụkọ banyere ọgba aghara ma bụrụ nke akụkọ ya mere ka enwee nsogbu na enweghị ohere ịnweta ọrụ mmekọrịta niile. Nke atọ bụ mpaghara Kalangala nke mejupụtara agwaetiti 84 na ya mere nwere nsogbu pụrụ iche maka njem njem.

Ndi otu ndi oru nyocha nke Mahadum Makerere chikoro ihe nile nke HC na mpaghara ahu ahọtara site na ndi nwere ntinye (ya bu, ndi ochichi, nke onwe nke abughi nke ana enweta ego (PNFP / NGO), na ndi nzuzo HC). Maka mpaghara ahụike ọ bụla, ha họpụtara ụlọ ọrụ ahụike abụọ maka uru ego (dịka 2 HC IV na 1 HC III), ụlọọgwụ 1 PNFP / NGO (ya bụ, 4 HC IV na 2 HC III), yana gọọmentị 2 nwere gọọmentị. ebe nlekọta ahụike (ya bụ, 4 HC IV na 2 HC III). N'ebe onwere uru ma ọ bụ PNFP / NGO HC III ma ọ bụ HC IV na-anọghị na mpaghara ahụike ahọpụtara, ha mejupụtara oghere ndị ahụ site na HC III nke gọọmentị nwe.

Atụmatụ nlele ha gosipụtara n’omume nke nwere ụlọ ọgwụ ntụgharị mpaghara asaa, ụlọ ọgwụ iri abụọ na anọ (7), 24 HC IV na 30 HC III. Na mgbakwunye, a na-ahụta Obodo District dị ka mpaghara pụrụ iche n'ihi ọkwa ya dị ka isi obodo nke nwere nnukwu ahụike. N'ime n’ime RRH atọ (ya bụ, Rubaga, Nsambya, na Naguru) n’obodo, otu RRH (Naguru) ka etinyere n’omume ọmụmụ ahụ.

Na mgbakwunye, ha gụnyere ndị uwe ojii dịka ndị na-elekọta ụlọ ọgwụ tupu ha abụkarị ndị na-aza ajụjụ mbụ n'ihe nkiri mberede ma na-ebugara ndị ihe metụtara. Ihe omumu a bu nyocha nke ala nke gunyere mpaghara 7 ahuike, distrikti 38 (Fig 2) [13], ulo oru 111, na ndi 52 n’ilekota ulo ogwu. Site na mpaghara iri atọ na asatọ, ndị ọrụ nyochara otu onye isi kọmịshọn, ọkachasịkarị Kọmịshọna Ahụike District bụ onye na-eme mkpebi na ngalaba, yana ngụkọta ndị isi 38 so na EMS na nlekọta ahụike nnukwu.

 

Akụrụngwa ụgbọ ihe mberede na ndị ọkachamara zụrụ azụ enweghị na Uganda: nnakọta data

Ndị nyocha ahụ sitere na Mahadum Makerere nwetara ihe nyocha nke Ahụike Ahụike Ahụike Ahụike WHO [14] nke Teri Reynolds na ndị ọzọ [10] mepụtara. Nke a nyeere ha aka ịnakọta data na EMS n'ụlọ ọgwụ tupu ụlọ ọgwụ yana ọkwa ụlọ ọrụ ahụike. Ngwá ọrụ mejupụtara ndị na-enyocha enyocha ya na ajụjụ a haziri ahazi, nke nyochara ogidi usoro isii ahụike: ochichi na ochichi; ego; ozi; ọrụ ahụike; ọgwụ ọgwụ; na nnyefe ọrụ. Ha tụleghachikwara akụkọ sitere n'ọmụmụ EMS ndị gara aga na Uganda [7,8,9] na ohere dị na ozi sitere na isi onye mgbazi ihu na ihu na otu onye isi MOH.

 

 

EMS na Uganda: Nsonaazụ nyocha dị na ngwa ụgbọ ihe mberede na ndị ọkachamara amụrụ ọzụzụ enweghị

Tebụl na-esote chịkọtara nsonaazụ ndị a hụrụ n'usoro dị iche iche na mba na mba. Nsonaazụ nkọwa zuru ezu na njikọ ndị dị na njedebe nke isiokwu.

 

Data na EMS na Uganda: mkparịta ụka

Uganda tụgharịrị enweghị ụkọ nke iwu mba, ụkpụrụ na ụkpụrụ dị na ngalaba ahụike mberede. A na-echebara ụkọ a n'akụkụ mpaghara ahụike ahụike: ego; ọgwụ ọgwụ, na nhazi.

Mpaghara ebe mberede na akụrụngwa ahụike akaghị akụrụngwa ọgwụ na ọgwụ kacha mkpa iji lelee ma gwọọ ọnọdụ ọnọdụ ahụike mberede dị iche iche. A hụrụ enweghị akụrụngwa na ọgwụ na ọkwa niile nke ahụike. Agbanyeghị, akụrụngwa ahụike na ụlọ ambulances dị mma karịa nke gọọmentị. Enweghi oke ọrụ na akụrụngwa akụrụngwa maka ịzaghachi ọnọdụ ahụike mberede ọsịsọ pụtara na ndị ọrịa na-enwetacha nlekọta ahụike na ngalaba ụlọ ọgwụ, ma na-ebuga ya n'ụlọ ọrụ ahụike nke agbachasịsịsịsịsịsịsịsịsị ihe dị mma iji jikwaa ihe mberede ha.

Ihe ọghọm, nnakọta na nkwukọrịta juputara n'ụlọ ọrụ ambulanị. Ọ dịkarịa ala, 50% nke ndị na-enye EMS gbara ajụjụ ọnụ kọrọ na ọ dịghị mgbe ha gwara ụlọ ọrụ ahụike tupu ibuga ọnọdụ mberede. Hospitalslọ ọgwụ ndị ahụ, gụnyere ụlọ ọgwụ maka mpaghara, enweghị EMS dị ụbọchị iri abụọ na anọ. N'ezie, ndị na-ahụ ya na ndị ikwu na-abụkarị naanị ndị na-enyere ndị ọrịa aka. Vehiclesgbọ ndị uwe ojii na-echekwa ebe ndị mmadụ (maka mmadụ 24 n'ime ndị 36) na-ebuga ndị ọrịa chọrọ nlekọta mberede.

Ọmụmụ ihe ahụ akọwaala ụgbọ ihe mberede dị ka ụgbọ ihe mberede na-enye ma njem mberede na nlekọta mberede mgbe ọ nọ ohere ụlọ ọgwụ tupu oge ụlọ ọgwụ, ọ pụtara na imirikiti ndị na - eweta ụlọ ọgwụ enweghị ambulances, kama ha bụ ndị na - ebugharị ụgbọ njem mberede. Ọzọkwa, na ọkwa ọ bụla, enwere ihe akaebe na ego ezughi oke maka EMS.

Uzo nke ihe omumu a bu ihe omuma site na ntukwasi obi na akuko nke onwe gi banyere ufodu ihe si na ya puta (dika iji data mee ihe). Ka osi di, otutu ihe si na ihe putara ihe (nnweta na oru nke ihe ogwu di) n’ime ihe omumu a bu ihe nlebara anya. Nchoputa ndi nyocha a choputara ndi sitere na ihe omumu ndi ozo site na iji usoro ozo gosiputara enweghi ochichi, iwu na ntinye ego dika ihe isi ike na mmepe nke EMS na obodo ndi na etoolite etolite [16].

Onye a kọrọ na ederede bụ nyocha nke mba na ya mere enwere ike ibughari nyocha ya na Uganda dum. Ihe nchoputa a nwekwara ike ibufe nye obodo ndi ozo pere mpe na nke etiti n’ime Africa n’enweghi usoro EMS [1], ya mere, enwere ike iji ya duzie mgbali aka imeziwanye usoro EMS n’ime saiti a.

 

Na ngwụcha…

Uganda nwere ọtụtụ usoro ụlọ ọrụ ahụ ike mmadụ nwere ike iji gaa maka nlekọta ahụike. Agbanyeghị, site na nchoputa dị n’elu ọtụtụ nwere ike jụọ ‘Mba Uganda nwere EMS?’. Anyị kwesiri ịkọwapụta na a duziri ọmụmụ a n'oge enweghị iwu EMS, enweghị ụkpụrụ, yana nhazi dị oke ala na ọkwa mba na nke dị n'okpuru ala.

Dabere na nchọpụta Mahadum Makerere, ya mere, ọ dị ka ihe amamihe dị na ya ikwubi na, n'eziokwu, enweghị EMS, mana ọtụtụ akụkụ dị mkpa nke enwere ike idozigharị dị ka mmalite mmalite nke usoro ahụ. Nke a ga - akọwa ihe kpatara akụrụngwa ụgbọ ihe mberede na ndị ọrụ amụrụ nke ọma. Agbanyeghị, enwere usoro iji wee mepụta atumatu na ụkpụrụ maka ịtọlite ​​EMS.

 

References

1. Mistovich JJ, Hafen BQ, Karren KJ, Werman HA, Hafen B. Nlekọta mberede ọnọdụ mberede: Brady prentice hall hall; 2004.
2. Ete-Millman NK, Dixon JM, Sefa N, Yancey A, Hollong BG, Hagahmed M, et al. Ọnọdụ usoro nlekọta ahụike mberede (EMS) na Africa. Prehosp Ọdachi Med. 2017; 32 (3): 273–83.
3. Plummer V, Boyle M. EMS n'ime mba ndị nwere obere ọkara: nyocha akwụkwọ. Prehosp Ọdachi Med. 2017; 32 (1): 64-70.
4. Hirshon JM, Risko N, Calvello EJ, SSd R, Narayan M, Theodosis C, et al. Usoro ahụike na ọrụ ahụike: ọrụ nke nlekọta oke. Bull World Health Organ. 2013; 91: 386–8.
5. Mock C, Lormand JD, Goosen J, Joshipura M, Peden M. Iwu maka nlekọta trauma dị mkpa. Geneva: Healthtù Ahụ Ike Worldwa; 2004.
6. Kobusingye OC, Hyder AA, Bishai D, Joshipura M, Hicks ER, Mock C. ndị ọrụ ahụike mberede. Kọwaa Ihe Nleba Anya Mba Dev. 2006; 2 (68): 626–8.
7. Bayiga Zziwa E, Muhumuza C, Muni KM, Atuyambe L, Bachani AM, Kobusingye OC. Ihe ọghọm okporo ụzọ n'okporo ụzọ na Uganda: oge ​​nlekọta ụlọ tupu oge ụlọ ọgwụ site na ọnọdụ mberede wee ruo ụlọ ọgwụ na ihe ndị ọzọ metụtara ndị uwe ojii Uganda. Int J Inj Contr Njem Ndota. 2019; 26 (2): 170–5.
8. Mehmood A, Paichadze N, Bayiga E, et al. Ihe ngosi 594 na nnwale nke ngwa nyocha ngwa ngwa maka nlekọta ụlọ ọgwụ na Kampala, Uganda. Mgbochi Ọrịa. 2016; 22: A213.
9. Balikuddembe JK, Ardalan A, Khorasani-Zavareh D, Nejati A, Raza O. Adịghị ike na ike na-emetụta nlekọta mberede nke Prehospital maka ndị ihe ọghọm okporo ụzọ n'okporo ụzọ dị na mpaghara obodo ukwu nke Kampala: ọmụmụ nke ngalaba. BMC Emerg Med. 2017; 17 (1): 29.
10. Reynolds TA, Sawe H, Rubiano AM, Do Shin S, Wallis L, Mock CN. Systemsme ka usoro ahụike dị ike iji nye nlekọta mberede. Ihe Ndị Na-ebute Ọrịa Ọrịa: Imeziwanye Ahụike na Mbelata vertyda Ogbenye Nke atọ: Banklọ akụ nke mba ụwa maka iwughari na mmepe / Bank World; 3.
11. Acup C, Bardosh KL, Picozzi K, Waiswa C, Welburn SC. Ihe ndi n’eme ka nchekwube n’uche maka T. b. rhodesiense mmadu african trypanosomiasis na Uganda. Acta Trop. 2017; 165: 230–9.
12. Wang H, Kilmartin L. Tụnyere omume ime obodo na obodo mepere emepe na akụnụba na Uganda: nghọta site na iji olu olu ekwentị. J Urban Technol. 2014; 21 (2): 61–89.
13. Otu Mmepe QGIS. Usoro QGIS Geographic Information 2018. O si na: http://qgis.osgeo.org.
14. World Health Organization. Nlekọta mberede na trauma Geneva, Switzerland. 2018. Sitere na: https://www.who.int/emergencycare/activities/en/.
15. Hartung C, Lerer A, Anokwa Y, Tseng C, Brunette W, Borriello G. Mepee ngwa data: ngwaọrụ iji wuo ọrụ ozi maka mpaghara na-emepe emepe. Na: Usoro nke 4 nke ACM / IEEE International Conference na Ozi na Teknụzụ Nkwukọrịta na Mmepe. London: ACM; 2010. p. 1–12.
16. Nielsen K, Mock C, Joshipura M, Rubiano AM, Zakariah A, Rivara F. Ntụle ọnọdụ nke nlekọta prehospital na mba iri na ụma na ọkara. Nlekọta Pregsp Emerg. 13; 2012 (16): 3–381.

 

NDỊ aka

Albert Ninwa: Ngalaba Na-ahụ Maka Ọrịa na Ahụike Gburugburu Ebe obibi, Makelọ Akwụkwọ Mahadum Makerere nke Ahụike Ọha, Kampala, Uganda

Kennedy Muni: Ngalaba Epidemiology, Mahadum Washington, Seattle, WA, USA

Frederick Oporia: Ngalaba Na-ahụ Maka Ọrịa na Ahụike Gburugburu Ebe obibi, Makelọ Akwụkwọ Mahadum Makerere nke Ahụike Ọha, Kampala, Uganda

Joseph Kalanzi: Ngalaba nke Ọrụ Ahụike Mberede, Ministry of Health, Kampala, Uganda

Esther Bayiga Zziwa: Ngalaba Na-ahụ Maka Ọrịa na Ahụike Gburugburu Ebe obibi, Makelọ Akwụkwọ Mahadum Makerere nke Ahụike Ọha, Kampala, Uganda

Claire Biribawa: Ngalaba Na-ahụ Maka Ọrịa na Ahụike Gburugburu Ebe Obibi, Universitylọ Akwụkwọ Mahadum Makerere nke Ahụike Ọha, Kampala, Uganda

Olive Kobusingye: Ngalaba Na-ahụ Maka Ọrịa na Ahụike Gburugburu Ebe obibi, Makelọ Akwụkwọ Mahadum Makerere nke Ahụike Ọha, Kampala, Uganda

 

 

GỤRỤ AHỤ

EMS na Uganda - Amlọ Ọrụ Ambulance Uganda: Mgbe Passion Na-achụta Àjà

Uganda Maka ime ime na Boda-Boda, Taxis moto eji eme dika Ambulances moto

Uganda: 38 Ambulances ọhụrụ maka nleta Pope Francis

 

 

SOURCES

BMS: BioMed Central - Ọnọdụ ndị ọrụ nlekọta ahụike mberede na nlekọta ahụike ụlọ ọrụ dị ukwuu na Uganda: nchoputa sitere na Nnyocha Nlekọta nke Mba Cross.

Nyocha ndị ọgbọ: Ọnọdụ ndị ọrụ nlekọta ahụike mberede na nlekọta ahụike nnukwu na Uganda: nchoputa sitere na Nnyocha Nnyocha nke Mba Cross

School of Public Health College of Health Sciences, Mahadum Makerere

 

WHO: nlekọta mberede