Iulai 9, 2020, MAkerere University, Aʻoga o le Soifua Maloloina o le Soifua Maloloina faia se suʻesuʻega faapitoa i le tulaga o le EMS ma le soifua maloloina togafitiga nofoaga i Uganda. Na latou mauaina e le lava le tulaga o le atunuʻu, sa i ai le leai o ni mea taʻavale masini, pei o taʻavale faʻamalosi uila, laupapa spinal, ma le leai foi o ni tagata aʻoaʻoina faʻapolofesa.

Naʻo le 16 (30.8%) o le 52 o loʻo faia falemaʻi falemaʻi na suʻesuʻeina na iai taʻavale faʻafuaseʻi faʻataʻavalevale ma le falemaʻi manaʻomia meafaigaluega, vailaʻau, ma tagata faigaluega e tali lelei i se faʻalavelave faʻafuaseʻi. Ole mea lea na malamalama iai le University of Makerere ina ua maeʻa ana suʻesuʻega ile Uganda atoa. Lona uiga e toeititi 70% o afifi i Uganda leai se agavaʻa mo togafitiga faʻafomaʻi i falemaʻi falemaʻi.

I tua atu o le suʻesuʻega, na latou lipotia mai o loʻo iloa e le Matagaluega o le Soifua Maloloina (MoH) le manaʻoga e faalelei auaunaga a le falemaʻi. O lenei suʻesuʻega ua i ai le mafuaʻaga ia faʻamautuina le tulaga o auaunaga faʻafomaʻi faʻafuaseʻi (EMS) ma tausi soifua maloloina lelei i Uganda. Na latou faia le suʻesuʻega o loʻo mulimuli mai, i le tulaga o loʻo i totonu o le atunuʻu faʻapea foi ma le tele o le atunuʻu, ma mafaufau ai i le EMS i le vaega o loʻo i ai i le falemaʻi ma le faʻaaogaina o mea faigaluega.

Aʻo faia ni nai suʻesuʻega e iloilo ai le tausiga o falemai i Kampala [7,8,9], e foliga mai e leai se suʻesuʻega na faia e iloiloina ai le tulaga o le EMS ma le malosi o le soifua maloloina nofoaga i Uganda i le tulaga lautele.

 

O le mafuaʻaga o le suʻesuʻega ma faʻavae: o le matafaioi a tagata atamamai ma falemaʻi masini i Uganda EMS

I le avea ai ma auaunaga faʻafuaseʻi (EMS), e tatau foʻi ona faʻatautaia e le falemaʻi i Uganda vaega uma o le tausiga i tagata mamaʻi i le falemaʻi poʻo fafo atu o le falemaʻi. Paramedics ma EMTs (faʻapea foi i le matafaioi a avetaavale taʻavale), e tatau ona puleaina tagata gasegase ma faʻapitoa masini falemaʻi. Ole faʻamoemoe ole tatau ona i ai le faʻaleleia atili o taunuʻuga i tagata gasegase o loʻo iai tulaga faigata, pei o le faʻafuaseʻi, faʻafuaseʻi fomaʻi, manuʻa matuia, ma isi maʻi ogaoga.

O le tausiga muamua ile falema'i e le'o na'o le vaega ole soifua maloloina, ae e ono a'afia ai isi vaega e pei o leoleo ma le matagaluega fuimu. I le faʻaopoopoga i le tausiga muamua ile falemaʻi, o taunuʻuga o tagata maʻi e matua aʻafia lava ile tausiga faʻapitoa e tuʻuina atu ile falemaʻi mauaina [4]. O le ola ma le toe faʻaleleia o maʻi e faʻalagolago i le i ai o tagata fomaʻi ua aʻoaʻoina lelei, ma le maua o mea manaʻomia a le falemaʻi, e pei o fata, vaʻa laupapa, faiga okesene ma isi mea, vailaʻau, ma sapalai i minute ma itula pe a maeʻa le taunuʻu mai o se maʻi maʻi tigaina i le falemaʻi [5].

 

EMS i Uganda: falemaʻi masini ma mea faʻapolofesa leai ni tomai - Faʻataʻitaʻiga tele ma faʻataʻitaʻiga metotia

O le Uganda soifua maloloina polokalama ua faʻatulagaina i tolu vaega autu:

• atunuu referal falemai
• itumalo faaitulagi falemai
• lautele (Itumalo) falemaʻi

I totonu o le itumalo, o loʻo iai nofoaga soifua maloloina e eseese a latou agavaʻa:

Soifua Maloloina I ma II: o le sili falemaʻi falemaʻi falemaʻi. Le agavaʻa mo tulaga ogaoga faʻafomaʻi [11];

Soifua Maloloina Center II ma IV: sili ona lautele tautua faafomaʻi.

Ua maua e le Iunivesite o Makerere se faʻataʻitaʻiga o soʻo se nofoaga o le soifua maloloina i Uganda mai le MoH ma faʻavasegaina le lisi e itu o le soifua maloloina. O isi vaega o le soifua maloloina na toe tuufaʻatasia i vaega e 4 o le pulega o Uganda [12] (o lea, Matu, Sasaʻe, Sisifo, ma Tutotonu) ina ia mautinoa o loʻo fai ma sui o faʻataʻitaʻiga a le itulagi o faʻataʻitaʻiga. I totonu o geo-pulega itulagi, o le vaega suʻesuʻe filifilia soʻo se tasi itulagi soifua maloloina (Fig. 1 - lalo).

 

Na latou aofia ai ma le lotoʻa ni vaega se tolu o le soifua maloloina: Arua soifua maloloina faʻaitulagi i West Nile talu ai o loʻo talimalo i le tele o tagata sulufaʻi, lea e ono aʻafia ai le avanoa ma le avanoa o le EMS. O le isi o le Karamoja health region talu ai o loʻo i ai se talaʻaga o feteʻenaʻiga ma na faʻaleagaina lava i le leai o se avanoa i soʻotaga lautele. Lona tolu o le itumalo Kalangala lea e aofia ai 84 atumotu ma o lea e faʻapitoa ai tulaga faʻafitauli feʻaveaʻi.

O le vaega o tagata suʻesuʻe a le Iunivesite o Makerere faʻaputuputu uma HC i vaega filifilia o le soifua maloloina e ala i le pule (ie, malo, faʻalilolilo, tumaʻoti-mo-polofiti / faʻalapotopotoga tumaoti (PNFP / NGO), ma le HC mo tumaoti. Mo vaipanoa o le soifua maloloina, na latou filifilia soʻo se 2 nofoaga tutoʻatasi mo polofiti-polofesa (ie, 1 HC IV ma 1 HC III), 4 PNFP / NGO nofoaga soifua maloloina (ie, 2 HC IV ma 2 HC III), ma 4 malo-umia soifua maloloina nofoaga (o lona uiga, 2 HC IV ma 2 HC III). A leai se pisinisi-faʻamanuiaga poʻo PNFP / NGO HC III poʻo le HC IV i le vaega filifilia o le soifua maloloina, na latou faʻatumu avanoa i le HC III poʻo le HC IV a le malo.

La latou faʻataʻitaʻiga fuafuaga na mafua ai le tele o faʻataʻitaʻiga o loʻo iai 7 falemaʻi faʻaitulagi, 24 falemaʻi lautele (itumalo), 30 HC IV ma le 30 HC III. E le gata i lea, o Kampala District e taua o se itulagi faʻapitoa ona o lona tulaga o le laumua, ma le tele o mea e maua mo le soifua maloloina. Mai i totonu o le tolu RRH (o, Rubaga, Nsambya, ma Naguru) i totonu o le taulaga, o le tasi RRH (Naguru) na faʻaopopo i le suʻesuʻega.

E le gata i lea, sa latou aofia ai leoleo o loʻo avea ma fomaʻi i le falemaʻi aua e masani ona avea i latou ma tagata muamua tali ile vaʻaiga faʻalavelave ma tuʻuina atu felauaiga i tagata afaina. O lenei suʻesuʻega o se suʻesuʻega o vaega lautele e aofia ai le 7 o le itu o le soifua maloloina, 38 itu (Fig. 2) [13], 111 fale mo le soifua maloloina, ma le 52 au Mai le 38 itu, na faʻatalatalanoa e tagata suʻesuʻe se tasi ofisa sinia, o le toʻatele lava o le Ofisa o le Soifua Maloloina o se tasi e faia faʻaiuga fai, ae o le aofaʻi e 202 tagata taua na aʻafia i le EMS ma le maʻi o tausiga o le soifua maloloina.

 

Le au taʻavale a le falemaʻi ma le au aʻoaʻoga faʻapitoa leai i Uganda: aoina faʻamaumauga

O le au suʻesuʻe mai le Iunivesite o Makerere na faʻafetaui le meafaigaluega suʻesuʻe a le WHO Emergency Care Systems [14] na faia e Teri Reynolds ma isi [10]. Na fesoasoani lea ia i latou e aoina faʻamatalaga i luga o le EMS i le falemaʻi ma le nofoaga o le soifua maloloina. O le mea faigaluega e aofia ai lisi faʻataʻitaʻi ma faufaʻatasia fesili, na iloiloina ni pou soifua maloloina se ono: faʻataʻitaʻiga ma le pulega; faatupeina; faʻamatalaga; aufaigaluega soifua maloloina; fomai oloa; ma le faʻaooina atu o tautua. Na latou iloiloina foi lipoti mai suesuega EMS talu ai i Uganda [7,8,9] ma faatumuina avanoa i faamatalaga faafetai i se tagata autu o le faailoa atu faafesootaiga ma se ofisa sinia o le MOH.

 

 

EMS i Uganda: Suʻesuʻega iuga i luga o masini falemaʻi ma leai ni polofesa ua aʻoaʻoina

O loʻo tuʻuina mai i lalo le siata o iʻuga na maua mai i matata eseese i le atunuʻu ma le atunuʻu. Faʻamatalaga sili atu i le fesoʻotaʻiga i le iʻuga o le tusitusiga.

 

Faʻamatalaga i EMS i Uganda: talanoaga

Uganda na i ai sa i ai le loloto le le maua o tulafono a le atunuu, taiala, ma tulaga i le faalavelave faafomai tulaga. Ole leai o se mea e atagia mai i soo se vaega o le vaega ole soifua maloloina: faatupeina; vailaau oloa, ma le faamaopoopoina.

Nofoaga o faʻalavelave faʻafuaseʻi i nofoaga o le soifua maloloina leai se mea sili ona taua masini falemaʻi ma vailaʻau e mataʻitu uma ma togafitia tulaga faʻafuaseʻi faʻafomaʻi tulaga. Na matauina vaega uma o le soifua maloloina. E ui lava, o falemai tumaoti nofoaga ma falemaʻi na sili atu ona lelei faʻaaogaina nai lo malo. Le faʻatapulaʻa o le avanoa ma le faʻaaogaina o masini falemaʻi mo le tali atu i faʻalavelave tulaga faʻafuaseʻi o lona uiga o tagata mamaʻi maua le tele o tausiga i le muamua-falemai vaega, ma ona aveina lea i nofoaga o le soifua maloloina o mea na o le sili atu ona lelei faʻaoga e faʻatautaia ai a latou mea ogaoga.

O taʻavale faʻalavelave o loʻo faʻalavelave i masini leaga, fesoʻotaʻiga ma fesoʻotaʻiga. Le itiiti ifo o le 50% o le kamupani EMS o loʻo faʻatalanoaina na lipotia mai latou te leʻi logoina ni nofoaga faʻale soifua maloloina aʻo leʻi siʻitia faʻalavelave tutupu iina. O loʻo iai falemai, e aofia ai falemaʻi faʻaitulagi, e leʻi mauaina le EMS ile 24 ha. O le mea moni, tagata uma ona o aiga ma aiga e naʻo latou lava o loʻo fesoasoani faʻafomaʻi i maʻi. Ma leoleo leoleo leoleo taʻavale o se masani sili lea (mo 36 o 52 faʻalapotopotoga) auala o feʻaveaʻi o tagata o loʻo manaʻomia le tausiga faʻafuaseʻi.

O le suʻesuʻega sa faʻamatalaina ai se falemaʻi o se taʻavale faʻafuaseʻi e maua uma ai femalagaiga faʻafuaseʻi ma tausiga aʻo i ai i le tuʻuga falemai, o lona uiga o le tele o tagata e leʻi faia falemai e leai ni taʻavale, ae o i latou o loʻo avea ma tautua faʻalavelave faʻafuaseʻi. E le gata i lea, i tulaga uma, e i ai faʻamaoniga e le lava le faʻatupeina mo EMS.

O faʻatapulaʻaina o lenei suʻesuʻega o fua o mea sese mai le faʻalagolago i latou lava-lipoti mo nisi o taunuʻuga (eg, faʻaaogaina o faʻamatalaga mo fuafuaga). Peitai, o le tele o le taua taunuʻuga (avanoa ma le faʻaaogaina o fomaʻi oloa) i le suʻesuʻega na fuaina e ala i vaʻaiga tuusaʻo. O mea na maua mai i suʻesuʻega e faʻamautu ai i latou mai isi suʻesuʻega e faʻaaoga ai se metotia tutusa lea na maua ai le le lava o le taʻitaʻi, tulafono ma le faʻatupeina o ni pa pupuni i le atinaʻe o le EMS i atunuʻu atinaʻe [16].

O le tasi na lipotia i lenei tusitusiga o se sailiiliga a le atunuʻu ma o le mea lea o mea na maua e mafai ona lautele i uma Uganda. O faʻaiʻuga e mafai foʻi ona faʻalauaʻitele atu i isi atunuʻu maualalo ma ogatotonu-tupe maua i totonu o Aferika e leai ni EMS polokalama [1] ma, o le mea lea, e mafai ona faʻaogaina e taʻitaʻia ai taumafaiga e faʻatatau i le faʻaleleia o le EMS i totonu o nei nofoaga.

 

I le faaiuga ...

E iai le tele o vaega o le soifua maloloina e iai Uganda ia e mafai ai e tagata mamai ona o atu mo togafitiga Peitai, mai i sailiiliga i luga e toatele e ono fesili 'E iai Uganda i le EMS?'. Ua matou maitauina o lenei suʻesuʻega na faia i le taimi na leai ai se tulafono a le EMS, leai ni tulaga faʻataʻitaʻi, ma le leaga le faʻatulagaina i le atunuʻu ma le atunuʻu.

E tusa ai ma suʻesuʻega a Makerere Iunivesite, o lea, e foliga mai e talafeagai le faʻaiʻu e leai se EMS, ae o le tele o vaega taua na mafai ona toe faʻaleleia o se amataga o le faʻavaeina o le faiga. O lenei e faʻamatalaina le mafuaʻaga mo le falemaʻi masini ma le aʻoaʻoina lelei tagata le lava. Peitaʻi, o loʻo iai se faʻagasologa o loʻo faʻagasolo e atiaʻe ai faiga faʻavae ma taʻiala mo le faʻavaeina o le EMS.

 

FUAFUAGA

1. Mistovich JJ, Hafen BQ, Karren KJ, Werman HA, Hafen B. Falemaʻi muamua le tausiga faafomaʻi: Brady prentice hall soifua maloloina; 2004.
2. Suia-Millman NK, Dixon JM, Sefa N, Yancey A, Hollong BG, Hagahmed M, et al. O le setete o faʻalavelave faʻafomaʻi auaunaga tau tautua (EMS) i Aferika. Muai Falemai Med. 2017; 32 (3): 273–83.
3. Plummer V, Boyle M. EMS polokalama i le maualalo-ogatotonu tupe maua atunuu: o se tusitusiga toe iloilo. Muai Falemai Med. 2017; 32 (1): 64–70.
4. Hirshon JM, Risko N, Calvello EJ, SSd R, Narayan M, Theodosis C, et al. Soifua Maloloina polokalama ma auaunaga: o le matafaioi a le matua tausi. O le Organ Health Health Organ. 2013; 91: 386–8.
5. Mock C, Lormand JD, Goosen J, Joshipura M, Peden M. Taiala mo le taua o le tausiga. Sineva: Lalolagi Soifua Maloloina Faalapotopotoga; 2004.
6. Kobusingye OC, Hyder AA, Bishai D, Joshipura M, Hicks ER, Mock C. O fesoasoani faafomaʻi. Dis Control Faʻamuamua Dev Count. 2006; 2 (68): 626–8.
7. Bayiga Zziwa E, Muhumuza C, Muni KM, Atuyambe L, Bachani AM, Kobusingye OC. Ala i auala i Uganda: muamua taimi i le falemaʻi tausiga taimi mai le faalavelave i le falemai ma mea taua e leoleo Uganda. Int J Inj Contr Saf Faʻalauiloa. 2019; 26 (2): 170–5.
8. Mahmood A, Paichadze N, Bayiga E, et al. 594 Atinaʻe ma faʻataʻitaʻi-faʻataʻitaʻi o vave suʻesuʻega mea faigaluega mo le falemaʻi muamua i Kampala, Uganda. Puipuiga o manua. 2016; 22: A213.
9. Balikuddembe JK, Ardalan A, Khorasani-Zavareh D, Nejati A. BMC Emerg Med. 2017; 17 (1): 29.
10. Reynolds TA, Sawe H, Rubiano AM, Do Shin S, Wallis L, Mock CN. Faʻamalosia soifua maloloina e tuʻuina atu faʻalavelave faʻafuaseʻi. Faʻataʻitaʻiga Pulea mo Faʻamaʻi: Faʻaleleia o le Soifua Maloloina ma Faʻaititia le Mativa Lomiga faʻapitoa: Le Faletupe Faavaomalo mo Toe Fuataina ma Atinae / Le Faletupe o le Lalolagi; 3.
11. Acup C, Bardosh KL, Picozzi K, Waiswa C, Welburn SC. O mea na aʻafia ai le pasiaina o le mataʻitaga mo T. rhodesiense tagata aferika trypanosomiasis i Uganda. Galue Trop. 2017; 165: 230–9.
12. Wang H, Kilmartin L. Faʻatusatusa nuu ma taulaga i agafesootai ma tamaoaiga amio i Uganda: malamalamaaga mai faʻaaogaina telefoni feʻaveaʻi auaunaga. J Urban Technol. 2014; 21 (2): 61–89.
13. QGIS Atinaʻe 'au. QGIS Geographic Information System 2018. Avanoa mai: http://qgis.osgeo.org.
14. WHO. Togafitiga mai faalavelave faafuasei ma le tausiga 2018. Avanoa mai: https://www.who.int/emergencycare/activities/en/.
15. Hartung C, Lerer A, Anokwa Y, Tseng C, Brunette W, Borriello G. Tatala faʻamatalaga pusa: mea faigaluega e fausia ai faʻamatalaga tautua mo le atiaʻe o itulagi. I: Taualumaga o le 4th ACM / IEEE International Conference on Information and Communication Technologies and Development. Lonetona: ACM; 2010. i. 1–12.
16. Nielsen K, Mock C, Joshipura M, Rubiano AM, Zakariah A, Rivara F. Iloiloga o le tulaga o fomaʻi i totonu o falemaʻi ile 13 atunuu maualalo ma le-vaʻa. Prehosp Emerg Tausiga. 2012; 16 (3): 381–9.

 

AUTU

Albert Ningwa: Matagaluega o Faʻamaʻi ma Faʻamaʻi o le Siʻosiʻomaga, Makerere University School of Public Health, Kampala, Uganda

Kennedy Muni: Matagaluega o Epidemiology, Iunivesite o Washington, Seattle, WA, ISA

Feterika Oporia: Matagaluega o Faʻamaʻi ma Faʻamaʻi o le Siʻosiʻomaga, Makerere University School of Public Health, Kampala, Uganda

Iosefa Kalanzi: Matagaluega o Faalavelave Tutupu Faafuasei Fomai Auaunaga, Matagaluega o le Soifua Maloloina, Kampala, Uganda

Eseta Bayiga Zziwa: Matagaluega o Faʻamaʻi ma Faʻamaʻi o le Siʻosiʻomaga, Makerere University School of Public Health, Kampala, Uganda

Claire Biribawa: Matagaluega o Faʻamaʻi o Faʻamaʻi ma le Soifua Maloloina Siosiomaga, Makerere University Aʻoga o le Soifua Maloloina, Kampala, Uganda

olive Kobusingye: Matagaluega o Faʻamaʻi ma Faʻamaʻi o le Siʻosiʻomaga, Makerere University School of Public Health, Kampala, Uganda

 

 

FAITAU ALO

EMS I Uganda - Uganda Ambulance Auaunaga: Pe a Feiloaʻi Puapuaga ma Taulaga

Uganda Mo maʻitaga Ma Boda-Boda, Moli Taʻavale Loli Faʻaaogaina O ni Taʻavalevale o Taʻavalevale

Uganda: 38 New Ambulans Mo Le Asiasiga a Pope Francis

 

 

SOURCES

BMS: BioMed Central - O le setete o faalavelave faafuaseʻi auaunaga faafomaʻi ma matuia nofoaga o le soifua maloloina tausiga i Uganda: sailiiliga mai le National Cross-Sectional Survey

Iloiloga a Tagata: O le tulaga o faalavelave faafomaʻi auaunaga faafomaʻi ma matuia nofoaga o le soifua maloloina tausiga i Uganda: sailiiliga mai le National Cross-Sectional Survey

Aoga a le Public Health Kolisi o le Soifua Maloloina Saienisi, Makerere University

 

O le WHO: faʻalavelave faʻafuaseʻi