Musi waChikunguru 9, 2020, Makerere University, Chikoro cheHutano hweHurumende yakaita ongororo chaiyo panharaunda yeEMS uye hutano hwekuchengetedza hutano nzvimbo muUganda. Vakaona kuti padanho repasi rose, pakanga paine kushomeka kwemishini yeAmbulensi, kunge ambulensi inotambanudza, spinal board, uye zvakare kushomeka kwevashandi vakadzidziswa.

Chete 16 (30.8%) yeiyo 52 pre-chipatara vanopa vakaongororwa vaive neyakajairwa mota dzekurumidzira nemaamburenzi anodikanwa midziyo, mishonga, uye vashandi kuti vapindure kune imwe nguva yechimbichimbi zvakanaka. Izvi ndizvo zvakanzwisiswa neMakerere University mushure mekuongororwa kwayo muUganda mose. Izvi zvinoreva kuti inoda kusvika 70% ye ambulances muUganda havana mukana wekurapwa muzvirongwa zvepamberi pechipatara.

Mumashure meongororo, vakashuma kuti Ministry of Health (MoH) yakaziva kukosha kwekuvandudza masevhisi eambulance. Ichi chidzidzo chine chinangwa chekumisikidza mamiriro ehutano hwekurapa (EMS) uye hutano hwehutano hwekuchengetedzwa kwehutano muUganda. Ivo vakaita zvinotevera ongororo ese pamazita uye epasi-yenyika mazinga, vachifunga EMS mukana kune pre-chipatara uye zvivakwa nzvimbo vachishandisa World Health Organisation (WHO) Emergency Care Systems Test (ECSSA) chishandiso.

Kunyange hazvo zvidzidzo zvishoma zvakaitwa kuti zviongorwe hutano hwepachipatara muKampala [7,8,9], hapana ongororo yakaratidza kunge yakaitwa yekuongorora mamiriro eEMS uye hutano hwekuchipatara hutano muUganda pamwero wenyika.

 

Chinangwa chekudzidza uye zvekutanga: basa revanyanzvi uye remamishini yeambulensi kuUU EMS

Seye emergency emergency service service (EMS) system, zvakare ma ambulensi masevhisi muUganda anofanirwa kuronga zvese zvikamu zvetariro zvinopihwa varwere vari pre-chipatara kana kunze kwechipatara marongero [1]. Paramedics uye EMTs (zvakare iri muchinzvimbo chevatyairi ambulensi), vanofanirwa kubata varwere vane chaiwo amburenzi midziyo. Chinangwa chinofanira kunge kuri kuvandudza kwezvirwere muvarwere vane mamiriro ezvinhu akaomarara, senge dzekudzivirira, zvekurapwa nekukuvara, kukuvara zvakanyanya, uye zvimwe zvikanganiso zvinotyisa nguva.

Pre-hospital care haisi munda unongogumira kune hutano, asi inogona kusanganisira mamwe masangano akadai semapurisa nedhipatimendi remoto. Mukuwedzera kune pre-hospital care, migumisiro yevarwere inokonzerwa zvikuru nekuchengetedzwa kwakanyanya kunounzwa panzvimbo yehutano inogamuchira [4]. Kupona kwemurwere uye kupora kunoenderana nekuvapo kwevashandi vekurapa vakanyatsodzidziswa, uye kuwanikwa kwemidziyo yeamburenzi inodiwa, senge machira, Musipinha mabhodhi, okisijeni system uye zvichingodaro, mishonga, uye zvekushandisa mumaminitsi nemaawa zvichitevera kusvika kwemurwere ari kurwara zvakanyanya panzvimbo yehutano [5].

 

EMS muUganda: ambulensi michina uye nyanzvi dzakadzidziswa dzinoshayikwa - Sampure size uye sampling nzira

IUganda yehutano hwehutano yakarongedzwa mumatanhatu makuru:

• zvipatara zvekuendesa nyika
• zvipatara zvinotumirwa kumatunhu
• general (district) zvipatara

Mukati wedunhu, mune nzvimbo dzehutano dzine hutano hwakasiyana:

Health Center I uye II: iyo inonyanya kukosha nzvimbo yekuchengetedza hutano. Haikodzeri mamiriro akakomba ekurapa [11];

Health Center II uye IV: yakanyanya kuzere kurapwa mabasa.

Iyo Makerere University yakawana chimiro chemuenzaniso chekunze kwese hutano muUganda kubva kuMoH ndokugadzirisa zvinyorwa nematunhu ehutano. Matunhu ehutano akaiswa zvakare mudunhu reUganda mana ehurumende-4 Mukati mega yega yega-yedunhu rekutonga, timu yekudzidza yakasarudzika nharaunda imwe yehutano (12. 1 - pazasi).

 

Ivo nemaune vakasanganisira matatu matatu hutano hwekuwedzera: hutano hweArua nzvimbo muWest Nile sezvo iine huwandu hwakawanda hwevapoteri, zvinogona kukanganisa kuwana uye kuwanikwa kweEMS. Rimwewo dunhu rehutano reKaramoja sezvo iine nhoroondo yekunetsana uye yagara ichikanganisirwa nekusawanikwa zvakanaka kumabasa ese munharaunda. Yechitatu idunhu reKalangala iro rinoumbwa nezvitsuwa makumi masere nesere uye nekudaro rine matambudziko akasiyana ekufambisa.

Chikwata che Makerere University chevaongorori chakaisa ma HCs ese kumatunhu akasarudzika hutano (semuhurumende, yevaridzi, yakazvimiririra kwete-yekuita-mari / isiri yehurumende (PNFP / NGO), uye yakazvimiririra yeiyo inobatsira. Kune dunhu rega rega rezvehutano, vakasarudza napo kaviri nzvimbo dzakazvivakira dzehutano (semuenzaniso, 2 HC IV uye 1 HC III), 1 PNFP / NGO nzvimbo dzehutano (kureva. nzvimbo dzehutano (kureva, 4 HC IV uye 2 HC III). Iko kwakavanzika-kwe-purofiti kana PNFP / NGO HC III kana HC IV pakanga pasina matunhu akasarudzwa ehutano, ivo vakazadza ma slot nehurumende-yevaridzi HC III kana HC IV.

Danho ravo rekuenzanisira rakaguma raita saizi yakakura ine zvipatara zvinomwe zvekutakurisa, makumi maviri nematatu (zvipatara), 7 HC IV uye makumi matatu neHC III. Pamusoro pezvo, Kamara yeKampala yakaonekwa sedunhu rakakosha nekuda kwechimiro chavo seguta guru rine huwandu hwehupfumi hwehutano. Kunze kweRRH matatu (kureva, Rubaga, Nsambya, uye Naguru) muguta, imwe RRH (Naguru) yakawedzerwa kumuenzaniso wekudzidza.

Pamusoro pezvo, vaisanganisira mapurisa sevachengeti vechipatara nekuti vanowanzove vanopindura pazviitiko uye vanopa zvifambiso kune vakawirwa nenjodzi. Kuongororwa uku kuyambuka-chikamu chenyika kuongorora uko kunosanganisira kumatunhu manomwe ehutano, makumi matatu nematanhatu (Fig. 7) [38], 2 zvivakwa zvehutano, uye makumi mashanu nevaviri pre-chipatara vanotarisira varwere. Kubva kumatunhu ese makumi matatu nemasere, vaongorori vakabvunzurudza mumwe mukuru wedunhu, kazhinji Gavhuna weHurumende anotora matanho ekutora matunhu, uye vashandi vanosvika makumi maviri nevaviri vakabata EMS nehutano hwekuchengetedzwa kwenzvimbo.

 

Mishini yeAmbulensi uye nyanzvi dzakadzidziswa dzinoshayikwa muUganda: kuunganidza data

Vatsvaguri vepaMakerere University vakachinjisa iyo yeEU Emergency Care Systems test tool [14] yakagadzirwa naTeri Reynolds nevamwe [10]. Izvi zvakavabatsira kuti vatore data paEMS pachipatara chepamberi nepamamiriro ehutano. Chishandiso ichi chaisanganisira chechinyorwa uye chakabvunzwa mibvunzo, iyo yakaongorora hutanhatu sisitimu yehutano: hutungamiriri uye hutongi; mari; ruzivo; vashandi vehutano; zvigadzirwa zvekurapa; uye kusvitswa kwebasa. Ivo vakaongororawo mishumo kubva kune yakapfuura EMS zvidzidzo muUganda [7,8,9] uye vakazadza mapundu mune ruzivo nekutenda kune akakosha azviso kumeso kutarisana nemutungamiriri mukuru MOH mukuru.

 

 

EMS muUganda: Zvizhinji zvinowonekwa pamusoro pemishini yeambulensi uye nyanzvi dzakadzidziswa dzinoshaya

Iyi tafura inotevera inopfupisa zvawanikwa zvinowanikwa muminda dzakasiyana siyana zviri zviviri pamatunhu epasi uye epasi. Mamwe mhinduro dzakawanikwa pamatanho ekupedzisira kwechinyorwa.

 

Data pa EMS muUganda: nhaurirano

Uganda yakazove nekushomeka kwakadzika kwemitemo yenyika, nhungamiro, uye zviyero mune zvekurapa zvekurapa. Uku kushayikwa kunoratidzira pane chero chikamu chemunda wehutano: mari; zvigadzirwa zvekurapa, uye kudyidzana.

Nzvimbo dzekurumidzira munzvimbo dzehutano dzakashaiwa zvakanyanya zvekushandisa ambulensi nemishonga zvese zvekutarisa nekurapa mamiriro akasiyana siyana ekukurumidzira. Uku kushomeka kwakakomba kwemidziyo nemishonga zvakaonekwa pamatanho ese ehurongwa hwehutano. Kunyange hazvo, zvivakwa zvehutano zvakazvimirira uye maamburenzi aive akagadzirirwa zvirinani pane ehurumende. Kuwanikwa kushoma uye mashandisirwo emishini yeambulensi yekupindura mamiriro ekukurumidzira ekurapa zvaireva kuti varwere vaiwana hutano hushoma muchipatara chepamberi, vozotakurwa kuenda kunzvimbo dzehutano izvo zvaive zvakaringana zvirinani kubata zviitiko zvavo zvakanyanya.

Ma ambulensi masevhisi akatambudzwa nemidziyo isiriyo, kubatana uye kutaurirana. Anosvika makumi mashanu muzana evatsigiri veEMS vakabvunzurudzwa vakashuma kuti havana kumbozivisa nzvimbo dzehutano vasati vaendesa emergency ipapo. Kuti zvipatara, kusanganisira zvekumaruwa zvinotakurirwa zvipatara, hazvina EMS kuwanikwa 50 ha zuva. Chokwadi, vanhu vanoona uye nehama kazhinji ndivo chete vanobatsira varwere pakurapa. Uye mota dzekufambisa dzemapurisa ndidzo dzaive dzakajairika (yevarwere makumi maviri nemasere nemakumi mashanu neshanu) maitiro ekutakura varwere anoda kuchengetedzwa kwekukurumidzira.

Chidzidzo ichi chakatsanangura ambulensi sekumotokari yekumhanya-mhanya inopa vaviri pekufambisa nekutarisira vachiri kuchipatara nzvimbo, zvaireva kuti vazhinji vevanotangira chipatara havana maamburenzi, asi vaive vanopa pekufambisa. Zvakare, pamatanho ese, pakanga paine humbowo hwemari isina kukwana yeEMS.

Iyo miganhu yekudzidza iyi kuyerwa zvikanganiso kubva pakuvimba kune wega-mishumo kune zvimwe zvezvabuda (semuenzaniso, kushandiswa kwedata kuronga). Nekudaro, iyo yakawanda yezvakakosha zvabuda (kuwanikwa uye mashandiro ezvigadzirwa zvekurapa) mukuongororwa akayerwa kuburikidza nekutarisa kwakananga. Zvakawanikwa nevatsvaguri zvinogadzirisa izvo kubva kune zvimwe zvidzidzo vachishandisa nzira yakafanana iyo yakawana kushomeka kwehutungamiriri, mutemo uye mari sezvipinganidzo zvakakosha mukusimudzirwa kweEMS munyika dzichiri kusimukira [16].

Iyo yakashumwa muchinyorwa ichi yaive ongororo yenyika uye nekudaro izvo zvakawanikwa zvinogona kuve zvakaganhurirwa kune yose yeUganda. Izvo zviwanikwa zvinogone kunge zvakaganhurirwa kune dzimwe nyika dzine mari yepakati uye yepakati-mukati meAfrica dzisina EMS system [1] uye inogona, saka, kushandiswa kutungamira kuedza kwakanangana nekuvandudza EMS masisitimu mukati meaya marongero.

 

Mukupedzisa ...

Uganda ine chirongwa chakawanda-chakawanda chezvivakwa zvehutano izvo varwere vanogona kuenda kunorapwa. Nekudaro, kubva pane zvakawanikwa pamusoro vazhinji vanogona kubvunza 'Ko iyo Uganda ine EMS?'. Isu tinofanirwa kutaura kuti iyi ongororo yakaitwa panguva iyo pakange pasina mutemo weEMS, pakanga pasina mwero, uye kurongeka kwakashata pamazinga epasi uye epasi rose.

Sekureva kwe Makerere University akawana, saka, zvinoita senge zvine hungwaru kugumisa kuti kwaive, hapana, EMS, asi huwandu hwezvakakosha munzvimbo izvo zvinogona kugadziridzwa sosi yekutanga kwekugadzwa kwehurongwa. Izvi zvaigona kutsanangura chikonzero chemishini yeamburenzi uye nekudzidziswa vashandi zvakanaka. Nekudaro, pakanga paine maitiro ari kuitika ekuvandudza marongero uye nhungamiro dzekugadzwa kweEMS.

 

References

1. Mistovich JJ, Hafen BQ, Karren KJ, Werman HA, Hafen B. Prehospital emergency emergency: Brady prentice holo hutano; 2004.
2. Mold-Millman NK, Dixon JM, Sefa N, Yancey A, Hollong BG, Hagahmed M, et al. Iyo mamiriro e emergency emergency medical services (EMS) masisitimu mu Africa. Prehosp Njodzi Med. 2017; 32 (3): 273-83.
3. Plummer V, Boyle M. EMS masisitimu ari munzvimbo yepasi-yepakati mari: ongororo yezvinyorwa. Prehosp Njodzi Med. 2017; 32 (1): 64-70.
4. Hirshon JM, Risko N, Calvello EJ, SSd R, Narayan M, Theodosis C, et al. Hutano masisitimu nemasevhisi: iro basa rekuchengetedza zvakanyanya. Bull World Hutano Organ. 2013; 91: 386–8.
5. Mock C, Lormand JD, Goosen J, Joshipura M, Peden M. Nhungamiro dzekutarisira kwakakosha kwenjodzi. Geneva: World Health Organization; 2004.
6. Kobusingye OC, Hyder AA, Bishai D, Joshipura M, Hicks ER, Mock C. Emergency medical services. Dis Dzikoshesa Zvinotangira Kukora Nyika Nyika. 2006; 2 (68): 626-8.
7. Bayiga Zziwa E, Muhumuza C, Muni KM, Atuyambe L, Bachani AM, Kobusingye OC. Kukuvara kwemigwagwa muUganda: pre-chipatara chengetedzo nguva inopindirana kubva pakaitika tsaona kuenda kuchipatara uye zvimwe zvinhu zvinoenderana nemapurisa eUganda. Int J Inj Contr Safa Yekukurudzira. 2019; 26 (2): 170–5.
8. Mehmood A, Paichadze N, Bayiga E, et al. 594 Budiriro uye kuyedzwa-kwekuedzwa kwekukurumidza kwekushandisa kwekutarisira kwepachipatara muKampala, Uganda. Kudzivirira Kwekuvadza. 2016; 22: A213.
9. Balikuddembe JK, Ardalan A, Khorasani-Zavareh D, Nejati A, Raza O. Kuneta uye huchenjeri hunobata prehospital yekutarisira varwere vezviitiko zvemumigwagwa munharaunda yeKampala yakakura yedunhu: kudzidza-muchikamu. BMC Emerg Med. 2017; 17 (1): 29.
10. Reynolds TA, Sawe H, Rubiano AM, Ita Shin S, Wallis L, Mock CN. Kusimbisa hutano masisitimu kuti ape kuchengetedzwa kwekukurumidzira. Zvinotarisirwa Kudzivirira Zvirwere: Kuvandudza Hutano uye Kuderedza Urombo 3rd edition: Iyo Bhangi repasi rese rekuvakazve uye kuvandudza / iyo World Bank; 2017.
11. Acup C, Bardosh KL, Picozzi K, Waiswa C, Welburn SC. Zvinhu zvinopesvedzera kungoongorora kuongorora kweB b. Rhodesiense human african trypanosomiasis muUganda. Acta Trop. 2017; 165: 230-9.
12. Wang H, Kilmartin L. Kuenzanisa maitiro ekumaruwa nemadhorobha nemagariro ehupfumi muUganda: ruzivo kubva mukushandiswa kweshoko renzwi rekushandisa. J Urban Technol. 2014; 21 (2): 61-89.
13. QGIS Development Team. QGIS Geographic Information System 2018. Inowanikwa kubva: http://qgis.osgeo.org.
14. Sangano Rinoona nezve Utano Pasi pose. Zvekukurumidzira uye zvekushungurudzika kutarisira Geneva, Switzerland. 2018. Inowanikwa kubva: https://www.who.int/emergencycare/activities/en/.
15. Hartung C, Lerer A, Anokwa Y, Tseng C, Brunette W, Borriello G. Vhura data kit: zvishandiso zvekuvaka ruzivo rwemabasa ekuvandudza matunhu. Mu: Kuenderera mberi kweiyo 4th ACM / IEEE International Musangano paRuzivo uye Ruzivo rwekukurukurirana Technologies uye Development. London: ACM; 2010. p. 1–12.
16. Nielsen K, Mock C, Joshipura M, Rubiano AM, Zakariya A, Rivara F. Kuongorora mamiriro ekuchengetedza prehospital munyika 13 dzakaderera-nepakati-mari yepakati. Prehosp Emerg Kuchengeta. 2012; 16 (3): 381–9.

 

VANHU

Albert Ningwa: Dhipatimendi reChirwere Chokudzivirira Zvirwere uye Nezvakatipoteredza Utano, Makerere University Chikoro cheHutano hweHurumende, Kampala, Uganda

Kennedy Muni: Dhipatimendi reEpidemiology, University of Washington, Seattle, WA, USA

Frederick Oporia: Dhipatimendi reChirwere Chokudzivirira Zvirwere uye Nezvakatipoteredza Utano, Makerere University Chikoro cheHutano hweHurumende, Kampala, Uganda

Joseph Kalanzi: Dhipatimendi reEmergency Medical Services, Ministry of Health, Kampala, Uganda

Esther Bhayiga Zziwa: Dhipatimendi reChirwere Chokudzivirira Zvirwere uye Nezvakatipoteredza Utano, Makerere University Chikoro cheHutano hweHurumende, Kampala, Uganda

Claire Biribawa: Dhipatimendi reChirwere Chokudzivirira Nehutano hwezvakatipoteredza, Makerere University Chikoro cheHutano hweHuzhinji, Kampala, Uganda

Olive Kobusingye: Dhipatimendi reChirwere Chokudzivirira Zvirwere uye Nezvakatipoteredza Utano, Makerere University Chikoro cheHutano hweHurumende, Kampala, Uganda

 

 

VERENGA ZVIMWE

EMS muUganda - Uganda reAmbulensi rekuUganda: When Passion Meets Sacrifice

Uganda Yepamuviri NeBoda-Boda, Pikipiki Tekisi Dzinoshandiswa SaMota Dzemagetsi

Uganda: 38 Ambulensi Itsva Yekushanya KwaPapa Francis

 

 

SOURCES

BMS: BioMed Central - Iyo nzvimbo yekukurumidzira yekurapa uye hutano hwehutano hwekuchengetedza hutano muUganda: zvakawanikwa kubva kuNational Cross-Chikamu Kuongororwa.

Peer Reviews: Iyo mamiriro ekukurumidzira ekurapa ekushandira uye akanyanya hutano nzvimbo yekuchengetedza hutano muUganda: zvakawanikwa kubva kuNational Cross-Chikamu Kuongorora

Chikoro cheParuzhinji Utano Koreji yehutano Sayenzi, Makerere University

 

IYO: kurapwa nekukurumidzira