Pa Julayi 9, 2020, MAkerere University, School of Public Health idachita kafukufuku wina wokhudza EMS ndi chisamaliro chaumoyo pachipatala ku Uganda. Adazindikira kuti kumayiko ocheperako, kudalibe zida zama ambulansi, monga ma ambulansi, ma spinal board, komanso kusowa kwa akatswiri ophunzitsidwa bwino.

16 (30.8%) yokha ya 52 omwe amapereka chithandizo chisanafike kuchipatala omwe adayesedwa anali ndi magalimoto azadzidzidzi omwe amafunikira ambulansi zida, mankhwala, ndi ogwira ntchito kuti athe kuthana ndi vuto ladzidzidzi moyenera. Izi ndi zomwe Makerere University idamvetsetsa pambuyo pofufuza ku Uganda konse. Izi zikutanthauza kuti pafupifupi 70% ya ambulansi ku Uganda alibe mwayi wothandizidwa kuchipatala asanamwalire.

Kumbuyo kwa kafukufukuyu, adanena kuti Unduna wa Zaumoyo (MoH) udazindikira kufunika kokweza ntchito za ambulansi. Kafukufukuyu ali ndi cholinga chokhazikitsa chithandizo chazachipatala chadzidzidzi (EMS) ndi chisamaliro chachipatala ku Uganda. Adachita zoyeserera izi konsekonse mmaiko ena komanso mdziko lonse, poganizira mphamvu ya EMS pachipatala choyambirira ndi malo othandizira pogwiritsa ntchito chida cha World Health Organisation (WHO) Emergency Care Systems Test (ECSSA).

Pomwe kafukufuku wochepa wachitika kuti ayesere chisamaliro cha chipatala ku Kampala [7,8,9], palibe kafukufuku yemwe akuwoneka kuti wachitika kuti athe kuzindikira za EMS ndi chisamaliro chachipatala ku Uganda pamlingo wadziko lonse.

 

Cholinga cha phunziroli ndi zoyambira: ntchito ya akatswiri ndi zida za ambulansi ku Uganda EMS

Monga dongosolo la chithandizo chamankhwala mwadzidzidzi (EMS), ma ambulensi ku Uganda akuyenera kukonza mbali zonse za chisamaliro choperekedwa kwa odwala omwe ali mchipatala chisanachitike kapena kuchipatala [1]. Ma Paramedics ndi EMTs (omwe amakhalanso oyendetsa ma ambulansi), amayenera kuyang'anira odwala omwe ali ndi zida za ambulansi. Cholinga chake ndikuyenera kukhala kusintha kwa zotsatira za odwala omwe ali ndi vutoli, monga zovuta kwambiri, zadzidzidzi zamankhwala, kuvulala koopsa, ndi matenda ena owopsa omwe amakhala ndi nthawi yayitali.

Chisamaliro chachipatala chisanachitike si gawo lazachipatala chokha, pomwe chitha kukhudza magawo ena monga apolisi ndi ozimitsa moto. Kuphatikiza pa chisamaliro chachipatala chisanachitike, zotsatira za odwala zimakhudzidwa kwambiri ndi chisamaliro chodzidzimutsa chomwe chimaperekedwa kuchipatala [4]. Kupulumuka ndi kuchira kwa odwala kumadalira kukhalapo kwa ogwira ntchito zachipatala ophunzitsidwa bwino, komanso kupezeka kwa zida zofunika za ambulansi, monga machira, Msana matabwa, dongosolo la okosijeni ndi zina zotero, mankhwala, ndi katundu mu mphindi ndi maola pambuyo pakufika kwa wodwala kwambiri kuchipatala [5].

 

EMS ku Uganda: zida za ambulansi ndi akatswiri ophunzirawa akusowa - Kukula kwachitsanzo ndi njira zazitsanzo

Dongosolo laumoyo wa ku Uganda lakhazikitsidwa m'magulu atatu:

• zipatala zothandizira dziko
• zipatala zothandizira zigawo
• zipatala zazikulu (zigawo)

Mchigawochi, muli malo azachipatala omwe ali ndi kuthekera kosiyanasiyana:

Health Center I ndi II: chipatala chofunikira kwambiri. Soyenera kuchipatala [11];

Health Center II ndi IV: chithandizo chokwanira kwambiri chachipatala.

Yunivesite ya Makerere idapeza zolemba zawozipatala zonse za ku Uganda kuchokera ku MoH ndikusintha mndandandawu ndi zigawo zaumoyo. Madera azachipatala adagawidwanso m'zigawo zinayi zadziko la Uganda [4] (mwachitsanzo, Kumpoto, Kummawa, West, ndi Central) kuwonetsetsa kuti dera lililonse loyang'anira likuperekedwa. M'gawo lililonse la geo-admin, gulu lochita kafukufuku linasankha dera limodzi laumoyo (mkuyu. 12 - pansipa).

 

Adaphatikizanso madera ena atatu azaumoyo: Chigawo cha Arua kumadzulo kwa West Nile chifukwa kumakhala anthu ambiri othawa kwawo, zomwe zitha kukhudza kupezeka ndi kupezeka kwa EMS. China ndi dera lachipatala la Karamoja popeza ili ndi mbiri ya nkhondo ndipo kale lidasokonekera chifukwa chokana kupeza ntchito zothandiza anthu onse. Lachitatu ndi chigawo cha Kalangala chomwe chimapangidwa ndi zilumba 84 ndipo chifukwa chake chimakhala ndi zovuta zapanjira zoyendera.

Gulu la ofufuza a Makerere University linaika magulu onse a ma HC m'zigawo zosankhidwa ndi umwini (mwachitsanzo, maboma, mabungwe osagwiritsa ntchito phindu / osagwirizana ndi boma (PNFP / NGO), ndi ma HCs omwe sanapange ndalama). Kudera lirilonse laumoyo, adasankha mosamala malo awiri azaumoyo (mwachitsanzo 2 HC IV ndi 1 HC III), 1 PNFP / NGO health (ie, 4 HC IV ndi 2 HC III), ndi 2 omwe ali ndi boma malo azachipatala (mwachitsanzo, 4 HC IV ndi 2 HC III). Pomwe payokha-yopanga phindu kapena PNFP / NGO HC III kapena HC IV sipezeka m'magulu azaumoyo omwe adasankhidwa, adadzaza ma slot ndi HC III ya Boma kapena HC IV.

Njira zawo zoyeserera zinapangitsa kuti pasakhale zitsanzo za zipatala 7 zothandizidwa, zipatala 24 (zigawo), 30 HC IV ndi 30 HC III. Kuphatikiza apo, District District ya Kampala idawonedwa ngati dera lapadera chifukwa cha likulu lawo ngati likulu lokhala ndi zothandizira zambiri zathanzi. Mwa ma RRH atatu (mwachitsanzo, Rubaga, Nsambya, ndi Naguru) mu mzindawu, RRH (Naguru) inaonjezedwa pa kafukufukuyu.

Kuphatikiza apo, adaphatikizaponso apolisi monga oyang'anira chisamaliro cha chipatala chifukwa nthawi zambiri amakhala oyankha pamachitidwe ovulala komanso amapereka mayendedwe kwa omwe akhudzidwa. Kafukufukuyu ndi kafukufuku wokhudzana ndi dziko lomwe limaphatikizapo zigawo 7 zaumoyo, zigawo 38 (mkuyu. 2) [13], zipatala za 111, komanso othandizira othandizira odwala asanachitike kuchipatala. Kudera lirilonse la 52, ofufuza adafunsa mkulu m'modzi mwa oyang'anira chigawo, nthawi zambiri Woyang'anira District Health Wopanga zigawo, komanso anthu 38 ofunika kwambiri mu EMS ndi kuchipatala.

 

Zida za ambulansi ndi akatswiri ophunzitsidwa bwino akusowa ku Uganda: kusonkhanitsa deta

Ofufuzawo ochokera ku Makerere University adasinthitsa chida chofufuzira cha WHO Emergency Care Systems [14] chopangidwa ndi Teri Reynolds ndi ena [10]. Izi zidawathandiza kuti azitha kupeza zidziwitso pa EMS pachipatala chachipatala komanso pachipatala. Chipangizochi chinali chophatikiza ndi mafunso ofunikira, omwe amayesa mizati isanu ndi umodzi yaumoyo: utsogoleri ndi utsogoleri; ndalama; zambiri; ogwira ntchito yazaumoyo; mankhwala azachipatala; ndi kaperekedwe ka ntchito. Adawunikiranso malipoti ochokera ku maphunziro am'mbuyomu a EMS ku Uganda [7,8,9] ndikudzaza mipata yazidziwitso chifukwa cha wofunsa wamkulu kuti ayang'ane ndi wamkulu wa MOH.

 

 

EMS ku Uganda: Zowunikira kwambiri pazida za ambulansi ndi akatswiri ophunzitsidwa bwino akusowa

Tebulo lotsatirali likuwunika mwachidule zotsatira zomwe zimapezeka m'magawo osiyanasiyana pamitundu yadziko. Zotsatira zatsatanetsatane kumapeto kumapeto kwa nkhaniyo.

 

Zambiri pa EMS ku Uganda: zokambirana

Uganda idasowa kwambiri ndale, zitsogozo, ndi zofunikira pantchito zachipatala zadzidzidzi. Kuperewera uku kumawonetsera gawo lililonse laumoyo: ndalama; mankhwala azachipatala, komanso mgwirizano.

Madera azachipatala omwe ali ndi zithandizo zadzidzidzi adasowa zida zoyambira ma ambulansi ndi mankhwala onse kuti azitha kuyang'anira ndi kuchiza matenda osiyanasiyana azadzidzidzi. Kuperewera kwakukulu kwa zida ndi mankhwala uku kumawonedwa m'magawo onse azachipatala. Ngakhale, malo azaumoyo wamba ndi ma ambulansi anali ndi zida zambiri kuposa za boma. Kupezeka kochepa komanso kagwiritsidwe ntchito ka zida za ambulansi poyankhira zithandizo zadzidzidzi zamankhwala kumatanthauza kuti odwala anali kupeza chisamaliro chochepa kwambiri gawo loyambirira la chipatala, kenako ndikumawatumizira kumalo azaumoyo omwe anali okonzekera bwino machitidwe awo pang'ono.

Ntchito zama ambulansi zinkasokonezeka ndi zida zopanda ntchito, mgwirizano komanso kulumikizana. Osachepera 50% ya othandizira a EMS omwe adafunsidwa adanenanso kuti sanadziwitse zaumoyo asanasamuke ngozi zadzidzidzi kumeneko. Kuti zipatala, kuphatikiza zipatala zokomera zigawo, zinalibe EMS 24 tsiku lililonse. Inde, anthu okhala pafupi ndi abale nthawi zambiri ndi okhawo omwe angathandize odwala. Ndipo magalimoto owongolera apolisi anali njira wamba (yama 36 mwa opereka 52) yonyamula odwala omwe akufunika thandizo mwadzidzidzi.

Kafukufukuyu adafotokoza ambulasi ngati galimoto yodzidzimutsa yomwe imaperekera mayendedwe onse mwadzidzidzi komanso chisamaliro pomwe ili pamalo oyambira chipatala, zimatanthawuza kuti ambiri omwe amaperekera kuchipatala asanakhale ndi ma ambulansi, koma anali othandizira mayendedwe achuma. Kuphatikiza apo, pamlingo uliwonse, panali umboni wopeza ndalama zokwanira EMS.

Malire a phunziroli ndi zolakwika zoyezera kuchokera pakudzidalira pazotsatira zanu zina (mwachitsanzo, kugwiritsa ntchito deta pokonzekera). Komabe, ambiri pazotsatira zazikulu (kupezeka ndi magwiridwe antchito azachipatala) mu kafukufukuyu anayeza mwa kuwunika mwachindunji. Zomwe ofufuzawo apeza zimachokera ku maphunziro ena pogwiritsa ntchito njira yofananira yomwe idapeza utsogoleri, malamulo komanso ndalama ngati zotchinga zazikulu pakukula kwa EMS m'maiko otukuka [16].

Omwe adanenedwa m'nkhaniyi anali kafukufuku wapadziko lonse lapansi kotero zomwe zapezazi zingathe kufalikira ku Uganda yonse. Zomwe zapezekazi zitha kuphatikizidwanso kumayiko ena otsika ndi ochepa pakati mu Africa omwe alibe njira za EMS [1] ndipo motero, angagwiritsidwe ntchito kuwongolera zoyesayesa kukonza mabungwe a EMS mkati mwa makonzedwe awa.

 

Pomaliza…

Uganda ili ndi njira zosiyanasiyana zothandizira odwala kuti azikalandira chithandizo chamankhwala. Komabe, kuchokera pazomwe zapezeka pamwambapa ambiri amafunsa kuti 'Kodi Uganda ili ndi EMS?'. Tikuyenera kunena kuti kafukufukuyu anachitika panthawi yomwe kunalibe mfundo za EMS, popanda miyezo, komanso kulumikizana koperewera kwambiri pamabungwe azikunja ndi mayiko.

Malinga ndi zomwe apeza pa Yunivesite ya Makerere,, zikuwoneka kuti ndizanzeru kunena kuti, palibe, EMS, koma zofunikira zingapo m'malo mwake zomwe zitha kukonzedwanso monga poyambira kukhazikitsa dongosololi. Izi zikufotokozera chifukwa chomwe zida za ambulansi zilili komanso kusowa kwa anthu ophunzitsidwa bwino. Komabe, panali njira yomwe ikupangidwa yopanga mfundo ndi malangizo a kukhazikitsidwa kwa EMS.

 

ZOKHUDZA

1. Mistovich JJ, Hafen BQ, Karren KJ, Werman HA, Hafen B. Prehospital chisamaliro chodzidzimutsa: thanzi la holo ya Brady; 2004.
2. Mold-Millman NK, Dixon JM, Sefa N, Yancey A, Hollong BG, Hagahmed M, et al. Mkhalidwe wamachitidwe azachipatala azithandizo zadzidzidzi (EMS) ku Africa. Zowopsa Prehosp Med. 2017; 32 (3): 273-83.
3. Makina a Plummer V, a Boyle M. EMS omwe ali ndi ndalama zotsika ndi zapakati: kuwunikira mabuku. Zowopsa Prehosp Med. 2017; 32 (1): 64-70.
4. Hirshon JM, Risko N, Calvello EJ, SSd R, Narayan M, Theodosis C, et al. Makina azantchito ndi ntchito: udindo wa chisamaliro chovuta. Bull World Health Organ. 2013; 91: 386-8.
5. Mock C, Lormand JD, Goosen J, Joshipura M, Malangizo a Peden M. Geneva: World Health Organisation; 2004.
6. Kobusingye OC, Hyder AA, Bishai D, Joshipura M, Hicks ER, Mock C. ntchito zachipatala zadzidzidzi. Dis Control zofunika Kuchita Mayiko. 2006; 2 (68): 626-8.
7. Bayiga Zziwa E, Muhumuza C, Muni KM, Atuyambe L, Bachani AM, Kobusingye OC. Kuvulala pamsewu ku Uganda: Nthawi yayitali chisamaliro cha chipatala imachitika kuyambira ngozi kupita kuchipatala komanso zinthu zina zofananira ndi apolisi aku Uganda. Int J Inj Contr Saf Promot. 2019; 26 (2): 170-5.
8. Mehmood A, Paichadze N, Bayiga E, et al. Kupititsa patsogolo ndi kuyesa kwa chida chakuchipatala mwachangu ku Kampala, Uganda. Kupewa Kwambiri. 594; 2016: A22.
9. Balikuddembe JK, Ardalan A, Khorasani-Zavareh D, Nejati A, Raza O. Zofooka ndi maluso okhudzana ndi chisamaliro chadzidzidzi cha Prehospital kwa omwe akhudzidwa ndi ngozi zapamsewu mumzinda waukulu wa Kampala: kafukufuku wapaulendo. BMC Emerg Med. 2017; 17 (1): 29.
10. Reynolds TA, Sawe H, Rubiano AM, Do Shin S, Wallis L, Mock CN. Kulimbikitsa machitidwe azaumoyo kuti apereke chithandizo chadzidzidzi. Kuwona Zoyang'anira Matenda: Kupititsa patsogolo Zaumoyo ndi Kuchepetsa Umphawi 3: Banki Yapadziko Lonse Yokonzanso Ntchito Zachitukuko ndi Development / The World Bank; 2017.
11. Acup C, Bardosh KL, Picozzi K, Waiswa C, Welburn SC. Zinthu zomwe zimalimbikitsa kuyendera kwa T. b. Rhodesiense human african trypanosomiasis ku Uganda. Acta Trop. 2017; 165: 230-9.
12. Wang H, Kilmartin L. Poyerekeza zochitika zakumidzi komanso zakumizinda komanso zachuma ku Uganda: nzeru zakugwiritsa ntchito mawu. J Urban Technol. 2014; 21 (2): 61-89.
13. Gulu la Development la QGIS. QGIS Geographic Information System 2018. Ipezeka kuchokera kwa: http://qgis.osgeo.org.
14. Bungwe Loyanganira Thanzi Padziko Lonse la Pansi. Mavuto azadzidzidzi ndi a zoopsa Geneva, Switzerland. 2018. Ipezeka kuchokera kwa: https://www.who.int/emergencycare/activities/en/.
15. Hartung C, Lerer A, Anokwa Y, Tseng C, Brunette W, Borriello G. Tsegulani zida zapa data: zida zomangira zidziwitso zamagawo omwe akutukuka. Mu: Kafukufuku wa Msonkhano wa 4 wa ACM / IEEE wa Misonkhano Yadziko Lonse pa Chidziwitso ndi Ma Technologies ndi Development. London: ACM; 2010. tsa. 1-12.
16. Nielsen K, Mock C, Joshipura M, Rubiano AM, Zakariya A, Rivara F. Kuwunika kwa oyang'anira prehospital m'maiko 13 otsika ndi apakati. Chisamaliro cha Prehosp Emerg. 2012; 16 (3): 381-9.

 

AUTHORS

Albert Ndingwa: Dipatimenti Yoyang'anira Matenda ndi Zaumoyo, Makerere University School of Public Health, Kampala, Uganda

Kennedy Muni: Dipatimenti ya Epidemiology, University of Washington, Seattle, WA, USA

Frederick Oporia: Dipatimenti Yoyang'anira Matenda ndi Zaumoyo, Makerere University School of Public Health, Kampala, Uganda

Joseph Kalanzi: Dipatimenti ya Emergency Medical Services, Unduna wa Zaumoyo, Kampala, Uganda

Esther Bayiga Zziwa: Dipatimenti Yoyang'anira Matenda ndi Zaumoyo, Makerere University School of Public Health, Kampala, Uganda

Claire Biribawa: Dipatimenti Yoyang'anira Matenda ndi Zaumoyo, Makerere University School of Public Health, Kampala, Uganda

Olive Kobusingye: Dipatimenti Yoyang'anira Matenda ndi Zaumoyo, Makerere University School of Public Health, Kampala, Uganda

 

 

WERENGANI ZINA

EMS Ku Uganda - Ntchito ya Ambulansi ya ku Uganda: Passion Atakumana Nsembe

Uganda Yokhala Ndi Mimba Ndi Boda-Boda, Ma Tekisi Athuthu Amangogwiritsidwa Ntchito Ngati Ma ambulansi Amayendedwe Osewera

Uganda: Ambulansi 38 Zatsopano Za Ulendo Wa Papa Francis

 

 

SOURCES

BMS: BioMed Central - Dera la zithandizo zadzidzidzi ku chipatala ku Uganda: zomwe zapezeka ku kafukufuku wa National Cross-Partal Survey

Zotsatira za anzanga: Boma la chithandizo chamankhwala chodzidzimutsa ndi chisamaliro chachipatala ku Uganda: zopezeka ku National Cross-Partal Survey

School of Public Health College of Health Science, Makerere University

 

The WHO: chisamaliro chodzidzimutsa