Nge-9 kaJulayi, 2020, MIYunivesithi yase-akerere, iSikolo seMpilo kaRhulumente yaqhuba uphando oluthile malunga nemeko ye-EMS kunye nonakekelo lwezempilo e-Uganda. Bafumanise ukuba kwinqanaba lesizwe elingezantsi, ubukhulu becala kukho ukunqongophala kwezixhobo zeenqwelo zezigulana, ezinjenge-ambulensi, ii-spinal board, kunye nokusilela kwabaqeqeshi abaqeqeshiweyo.

Kuphela li-16 (30.8%) lababoneleli bangaphambi kwesibhedlele abangama-52 abavavanyiweyo abaneemoto zikaxakeka ezisemgangathweni ezine-ambulensi efunekayo izixhobo, amayeza, kunye nabasebenzi ukuba baphendule kwimeko engxamisekileyo ngokufanelekileyo. Yile nto yayiqondwa yiYunivesithi iMakerere emva kovavanyo lwayo kuyo yonke i-Uganda. Oku kuthetha ukuba phantse iipesenti ezingama-70 ze ii-ambulensi eUganda abanaso isibonelelo sokhathalelo lonyango kwimo yangaphambi kwesibhedlele.

Ngasemva kophando, banike ingxelo yokuba iSebe lezeMpilo (MoH) liyayibona imfuneko yokuphucula iinkonzo zeenqwelo zezigulana. Olu phononongo luneenjongo zokumisela imeko yeenkonzo zonyango ezingxamisekileyo (EMS) kunye nonyango lwezempilo eUganda. Baqhube olu vavanyo lulandelayo bobabini kwinqanaba lesizwe nelikazwelonke, bethathela ingqalelo ubungakanani be-EMS kwizibhedlele zakwangaphambi kwesibhedlele kunye namaziko enkonzo kusetyenziswa isixhobo seWorld Health Organisation (WHO).

Ngelixa izifundo ezimbalwa zenziwe ukuvavanya ukhathalelo lwe-pre-hospital eKampala [7,8,9], akukho sifundo kubonakala ngathi senziwe ukuhlola imeko ye-EMS kunye noncedo lwempilo olugcweleyo e-Uganda kwinqanaba likazwelonke.

 

Injongo yesifundo kunye neziseko: indima yeengcali kunye nezixhobo zeAmbulensi e-Uganda EMS

Njengenkonzo yonyango olungxamisekileyo (EMS), kunye neenkonzo zeenqwelo zeziguli eUganda kufuneka zilungelelanise zonke iinkalo zononophelo ezinikezwe abaguli kwizibhedlele zangaphambi kwesibhedlele okanye ngaphandle kwesibhedlele [1]. Ii-Paramedics kunye nee-EMTs (zikwindawo yokudlala i-ambulensi), kufuneka zilawule izigulana ngezixhobo zeenqwelo zezigulana. Injongo kufuneka ibe kukuphuculwa kweziphumo kwizigulana ezineemeko ezinzima, ezinje nge-thintelo, imeko kaxakeka kwezonyango, ukonzakala okunzima, kunye nezinye isigulo esinexesha elinobuzaza.

Ukhathalelo lwangaphambi kwesibhedlele alukho intsimi kuphela kwicandelo lezempilo, ngelixa linokubandakanya amanye amacandelo afana namapolisa kunye nesebe lomlilo. Ukongeza kukhathalelo lwangaphambi kwesibhedlele, iziphumo zesigulana zichaphazeleka kakhulu lukhathalelo oluqatha olunikezelwa kwiziko lezempilo elifumanayo [4]. Ukusinda kwesigulane kunye nokuchacha kuxhomekeke kubukho babasebenzi bezonyango abaqeqeshwe ngokufanelekileyo, kunye nokufumaneka kwezixhobo eziyimfuneko ze-ambulensi, njengezolula, Umgudu iibhodi, inkqubo yeoksijini njalo njalo, amayeza, kunye nezibonelelo kwimizuzu kunye neeyure ezilandela ukufika kwesigulana esigula kakhulu kwiziko lezempilo [5].

 

I-EMS e-Uganda: izixhobo zeenqwelo zezigulana kunye neengcali eziqeqeshiweyo ukuswela-ubungakanani beSampulu kunye neendlela zokwenza iisampulu

Inkqubo yezempilo e-Uganda ihlelwe yangamanqanaba amathathu aphambili:

• Izibhedlele ezithunyelwa kuzwelonke
• izibhedlele zokudluliselwa kwengingqi
• izibhedlele ngokubanzi (zesithili)

Kwisithili, kukho amaziko ezempilo anamandla ahlukeneyo:

IZiko lezeMpilo mna no-II: elona ziko lisisiseko lonyango. Ayizilungelanga iimeko zonyango ezinzulu [11];

IZiko lezeMpilo II kunye ne-IV: ezona zinkonzo zibanzi zibanzi.

IYunivesithi yase Makerere yafumana isampulu yazo zonke izibonelelo zempilo eUganda kwi-MoH yaze yahlaziya uluhlu lwemimandla yezempilo. Imimandla yezempilo iphinde yadityaniswa yaba yimimandla emi-4 yolawulo lwe-geo-Uganda [12] (okt, emantla, eMpuma, eNtshona, naseMbindini) ukuqinisekisa ummandla ngamnye wolawulo lwe-geo umelwe kwisampula. Kwingingqi nganye yolawulo lwe-geo, iqela elifundayo likhethe indawo yempilo (umzobo 1 - ngezantsi).

 

Babandakanye imimandla emithathu yezempilo eyongeziweyo: Ingingqi yezempilo yeArua eNtshona yeNayile ekubeni ibambe indawo enkulu yababaleki, enokuthi ichaphazele ukufikelela kunye nokufumaneka kwe-EMS. Omnye ngommandla wezempilo waseKaramoja kuba unembali yongquzulwano kwaye ngaphambili wayefudula efikelwa kukungafikeleli kuzo zonke iinkonzo zentlalo. Okwesithathu sisithili saseKalangala esenziwe iziqithi ezingama-84 kwaye ke ngoko sinemingeni eyahlukileyo yokufikelela kwezothutho.

Iqela leYunivesithi yase Makerere labaphandi lafaka zonke ii-HCs kwimimandla yezempilo ekhethiweyo ngobunini (okt, urhulumente ephethwe ngurhulumente, imibutho engekho phantsi korhulumente / yabucala (i-PNFP / NGO), kunye nee-HCs zabucala ezizimeleyo. Kwingingqi nganye yezempilo, bakhetha ngokungacwangciswanga amaziko ama-2 abucala azenzela inzuzo (okt. 1 HC IV kunye ne-1 HC III), amaziko ezempilo e-4 PNFP / NGO (okt, i-2 HC IV kunye ne-2 HC III), kunye ne-4 ephethwe ngurhulumente. amaziko ezempilo (okt, i-2 HC IV kunye ne-2 HC III). Apho ingeniso yabucala okanye yenzuzo okanye ye-PNFP / ye-HC III okanye ye-HC IV ingakhange ibekho kwimimandla yezempilo ekhethiweyo, bazalisa ii-slot nge-HC III okanye i-HC IV kaRhulumente.

Isicwangciso sabo sokufaka isampulu sikhokelele kubungakanani besampula equkethe izibhedlele ezisi-7 zokudluliselwa, izibhedlele ezingama-24 (zesithili), ezingama-30 ze-HC IV kunye ne-30 HC III Ukongeza, iSithili saseKampala sathatyathwa njengommandla okhethekileyo ngenxa yesimo saso njengedolophu enkulu enezixhobo ezininzi zempilo. Ngaphandle kwe-RRHs ezintathu (okt, iRubaga, iNsambya, neNaguru) esixekweni, enye iRRH (Naguru) yongezwa kwisampula yokufunda.

Ukongeza, babandakanya amapolisa njengababonelela ngononophelo lwangaphambi kwesibhedlele kuba bahlala bengabaphenduli bokwenzakala kwiindawo ezinobungozi kwaye babonelela ngezinto zokuhamba kumaxhoba. Olu phononongo luvavanyo lukazwelonke oluquka imimandla yezempilo esi-7, izithili ezingama-38 (umfuziselo 2) [13], amaziko ezempilo angama-111, kunye nabanikezeli bononophelo ngaphambi kwexesha esibhedlele. Kwisithili ngasinye kwezingama-52, abaphandi baxoxa nodliwanondlebe omnye wesithili, uninzi lweGosa lezeMpilo lesithili othatha izigqibo kwinqanaba lesithili, kunye nabasebenzi abangama-38 ababalulekileyo abathatha inxaxheba kwi-EMS kunye nonakekelo lwezempilo.

 

Izixhobo zeAmbulensi kunye neengcali eziqeqeshiweyo zisilela eUganda: ukuqokelelwa kwedatha

Abaphandi abavela kwiYunivesithi yaseMakerere bahlengahlengisa isixhobo sovavanyo lwe-WHO Emergency Care Systems [14] eyenziwe nguTeri Reynolds nabanye [10]. Oku kubancede ukuba baqokelele idatha kwi-EMS kwizibhedlele zakwangaphambi kwesibhedlele kunye nakumaziko ezempilo. Esi sixhobo senziwe luluhlu lokutshekisha kunye nemibuzo emiselweyo, nevavanya iinkqubo zempilo ezintandathu: ubunkokheli nolawulo; imali; ulwazi; abasebenzi bezempilo; iimveliso zonyango; kunye nonikelo lweenkonzo. Baphinde bahlolisisa iingxelo ezivela kwizifundo zangaphambili ze-EMS eUganda [7,8,9] kwaye bazalisa izithuba kulwazi lombulelo kumbuso ophambili wolwazi ukujongana nodliwanondlebe negosa eliphezulu le-MOH.

 

 

I-EMS eUganda: Iziphumo zokujonga ngokubanzi kwizixhobo ze-ambulensi kunye nabaqeqeshiweyo abaqeqeshiweyo

Olu luhlu lulandelayo lushwankathela iziphumo ezifumaneka kumanqanaba ahlukeneyo kumanqanaba kazwelonke nakwilizwe jikelele. Iziphumo ezithe kratya kwiikhonkco ekupheleni kwenqaku.

 

Idatha kwi-EMS e-Uganda: ingxoxo

I-Uganda yajika yaba nokunqongophala okunzulu komgaqo-nkqubo wesizwe, izikhokelo, kunye nemilinganiselo kwicandelo lezonyango likaxakeka. Oku kusilela kuboniswa kulo naliphi na icandelo lezempilo. iimveliso zonyango, kunye nokulungelelanisa.

Iindawo zonxunguphalo kumaziko ezempilo zingenazo izixhobo ezisisiseko zeenqwelo zezigulana kunye namayeza kokubeka esweni nokunyanga iimeko ezahlukeneyo zonyango ezingxamisekileyo. Oku kusilela okukhulu kwezixhobo namayeza kwabonwa kuwo onke amanqanaba enkqubo yezempilo. Nangona kunjalo, amaziko ezempilo abucala kunye nee-ambulensi zazilunge ngakumbi kunaseburhulumenteni. Ukufumaneka okulingeneyo kunye nokusebenza kwezixhobo zeenqwelo yezigulana ekuphenduleni kwiimeko zonyango ezingxamisekileyo kwakuthetha ukuba abaguli babefumana ukhathalelo oluncinci kwinqanaba lesibhedlele sangaphambi kwesibhedlele, emva koko basihanjiswa basiwa kumaziko ezempilo ababenezixhobo ezilunge ngakumbi zempatho.

Iinkonzo ze-ambulensi zazibethwa zizixhobo ezingekho mgangathweni, ukulungelelanisa kunye nonxibelelwano. Ubuncinci i-50% yababoneleli be-EMS ekwenziwe udliwano-ndlebe nabo baxela ukuba abakaze bazise amaziko ezempilo ngaphambi kokudlulisela imeko zonxunguphalo apho. Ukuba izibhedlele, kubandakanya izibhedlele zokudluliselwa kwengingqi, azizange zifumane ii-EMS ezingama-24 ngosuku. Ewe, abantu ababukeleyo nezihlobo bahlala bebodwa ekuncedeni abaguli. Kwaye izithuthi zokujikeleza kwamapolisa yayiyeyona nto ixhaphakileyo (kubathengi abangama-36 kwabangama-52) yokuhambisa abaguli abafuna ukhathalelo olungxamisekileyo.

Uphononongo luye lwachaza i-ambulensi njengemoto engxamisekileyo enikezela zombini izinto zothutho kunye nokhathalelo kwindawo yangaphambi kwesibhedlele, oko kwakuthetha ukuba uninzi lwabanikezeli besibhedlele sangaphambi kwesibhedlele babengenazo ii-ambulensi, kodwa yayingabanikezeli bezothutho olukhawulezileyo. Ngaphezu koko, kuwo onke amanqanaba, bekukho ubungqina bokungabikho kwemali ngokwaneleyo kwi-EMS.

Imida yolu phando ziimpazamo zemilinganiselo yokuxhomekeka kwiingxelo zokuzenzela ezinye zeziphumo (umzekelo, ukusetyenziswa kwedatha xa ucwangcisa). Nangona kunjalo, uninzi lweziphumo eziphambili (ukubakho kunye nokusebenza kweemveliso zonyango) kuphononongo kulinganiswe ngokujonga ngokuthe ngqo. Iziphumo zabaphandi zilungelelanisa ezo zivela kwezinye izifundo zisebenzisa indlela efanayo efumanise ukusilela kobunkokeli, umthetho kunye nenkxaso-mali njengezithintelo eziphambili kuphuhliso lwe-EMS kumazwe asakhasayo [16].

Elinye elinikwe ingxelo kweli nqaku yayiluvavanyo lukazwelonke ke ngoko iziphumo zazinokuchatshazelwa kulo lonke elaseUganda. Iziphumo ezo zinokufunyanwa ngokubanzi nakwamanye amazwe anengeniso ephantsi kunye ephakathi e-Afrika angenazinkqubo ze-EMS [1] kwaye anako, ke ngoko, ukusetyenziselwa ukukhokela iinzame ezijolise ekuphuculeni iinkqubo ze-EMS kwezi zicwangciso.

 

Ukuququmbela…

IUganda ineenkqubo ezahlukeneyo zamaziko ezempilo abaguli banokufumana kuwo unyango. Nangona kunjalo, kwezi zinto zifunyanisiweyo apha ngasentla abaninzi banokubuza 'Ngaba i-Uganda ine-EMS?'. Kufuneka sichaze ukuba olu phononongo lwalwenziwe ngexesha apho kwakungekho mgaqo-nkqubo we-EMS, akukho migangatho, kunye nolungelelwaniso olubi kakhulu kumanqanaba kazwelonke nakwilizwe jikelele.

Ngokweziphumo zeDyunivesithi yase Makerere,, ke, kubonakala kububulumko ukugqiba kwelokuba, enyanisweni kwakungekho EMS, kodwa inani lezinto ezibalulekileyo ezinokuphinda zilungiswe njengesiqalo sokusekwa kwenkqubo. Oku kuyakucacisa isizathu sezixhobo zeenqwelo yezigulana kunye nokunqongophala kwabasebenzi abaqeqeshiweyo. Nangona kunjalo, bekukho inkqubo eqhubekayo yokuqulunqa imigaqo-nkqubo kunye nezikhokelo zokusekwa kwe-EMS.

 

IZALATHISO

1. UMistovich JJ, uHafen BQ, uKarren KJ, uWerman HA, uHafen B. Unonophelo olungxamisekileyo lwezonyango olungxamisekileyo: Impilo yeholo yaseBrady prentice; Ngo-2004.
2. Mold-Millman NK, Dixon JM, Sefa N, Yancey A, Hollong BG, Hagahmed M, et al. Imeko yeenkonzo zonyango ezingxamisekileyo (EMS) eAfrika. Intlekele ye-Prehosp iMed. Ngo-2017; 32 (3): 273-83.
3. I-Plummer V, iinkqubo zeBoyle M. EMS kumazwe anengeniso esezantsi: uphononongo loncwadi. Intlekele ye-Prehosp iMed. Ngo-2017; 32 (1): 64-70.
4. UHirshon JM, uRisko N, uCalvello EJ, SSd R, uNarayan M, Theodosis C, et al. Iinkqubo zempilo kunye neenkonzo: indima yokhathalelo olunamandla. I-Bull World Health Organ. Ngo-2013; 91: 386-8.
5. UMock C, uLormand JD, uGoosen J, uJoshipura M, uPeden M. Izikhokelo zononophelo oluyimfuneko lomothuko. IGeneva: Umbutho wezeMpilo weHlabathi; Ngo-2004.
6. I-Kobusingye OC, iHyder AA, iBishai D, uJoshipura M, iHick ER, iMock C. Iinkonzo zonyango ezingxamisekileyo. Ulawulo lwezinto eziphambili kwiDis. 2006; 2 (68): 626-8.
7. Bayiga Zziwa E, Muhumuza C, Muni KM, Atuyambe L, Bachani AM, Kobusingye OC. Ukulimala kwabantu ezindleleni eUganda: ixesha lokunakekelwa kwangaphambi kwesibhedlele ukusuka kwindawo yengozi ukuya esibhedlele kunye nezinto ezinxulumene noko ngamapolisa ase-Uganda. Int J Inj Contr Saf Inkuthazo. Ngo-2019; 26 (2): 170–5.
8. Mehmood A, Paichadze N, Bayiga E, et al. Uphuhliso kunye novavanyo lokuvavanywa ngokukhawuleza kwesixhobo sokuvavanywa kwangaphambi kwesibhedlele eKampala, e-Uganda. Ukuthintela ukonzakala. Ngo-594; 2016: A22.
9. I-Balikuddembe JK, Ardalan A, Khorasani-Zavareh D, Nejati A, Raza O. Ubuthathaka kunye neempawu ezichaphazela ukhathalelo olungxamisekileyo lwamaxhoba ezithuthi zendlela kwindawo enkulu yeKampala: isifundo esingumnqamlezo. BMC Emerg Med. Ngo-2017; 17 (1): 29.
10. UReynolds TA, uSawe H, uRubiano AM, Yenza uShin S, uWallis L, uMock CN. Ukomeleza iinkqubo zempilo ukubonelela ngononophelo olungxamisekileyo. Izinto eziphambili ngokubaluleka kolawulo lwezifo: ukuphucula impilo kunye nokuncitshiswa kwentlupheko yesi-3: IBhanki yeHlabathi yokwakha ngokutsha kunye nophuhliso / iBhanki yeHlabathi; Ngo-2017.
11. I-Acup C, Bardosh KL, Picozzi K, Waiswa C, Welburn SC. Iimpawu eziphembelela ukubekwa kweliso ku-b. Rhodesiense human african trypanosomiasis e-Uganda. Umdlalo we-Acta Trop. Ngo-2017; 165: 230-9.
12. I-Wang H, Kilmartin L. ngokuthelekisa indlela yokuziphatha yasemaphandleni kunye neyasezidolophini kwimo yoqoqosho eUganda: ukukhanya kwenkonzo yokusebenzisa ilizwi. J Urban Technol. Ngo-2014; 21 (2): 61-89.
13. IQela loPhuculo lweQGIS. Inkqubo ye-QGIS Geographic Information 2018. Iyafumaneka kwi: http://qgis.osgeo.org.
14. I-World Health Organization. Ingxamiseko kunye nonakekelo lwengozi iGeneva, Switzerland. 2018. Iyafumaneka kwi: https: //www.who.int/emergencycare/activities/en/.
15. IHartung C, uLerer A, uAnokwa Y, uTseng C, uBrunette W, uBorriello G. Vula ikhithi yedatha: izixhobo zokwakha iinkonzo zolwazi zokuphuhlisa imimandla. Kwi: Ukuqhubeka kweNkomfa ye-4 ye-ACM / ye-IEEE yoLwazi kunye neTekhnoloji yoNxibelelwano kunye noPhuculo. ILondon: ACM; 2010. iphe. 1–12.
16. UNielsen K, uMock C, uJoshipura M, uRubiano AM, uZakariya A, uRivara F. Uvavanyo lwesimo sokhathalelo lwangaphambi kokutshatisa kumazwe ali-13 aphantsi kunye naphakathi. Unonophelo lwe-Prehosp Emerg. Ngo-2012; 16 (3): 381-9.

 

ABASEBENZI

UAlbert Ningwa: ISebe Lokulawula Izifo Nempilo Yendalo, Makerere University School of Public Health, eKampala, eUganda

UKennedy Muni: ISebe le-Epidemiology, iYunivesithi yaseWashington, Seattle, WA, USA

UFrederick Oporia: ISebe Lokulawula Izifo Nempilo Yendalo, Makerere University School of Public Health, eKampala, eUganda

UJoseph Kalanzi: ISebe leNkonzo zoNyango oluNgxamisekileyo, Icandelo loMphathiswa Wezempilo, eKampala, eUganda

UEsther Bayiga Zziwa: ISebe Lokulawula Izifo Nempilo Yendalo, Makerere University School of Public Health, eKampala, eUganda

UClaire Biribawa: ISebe Lokulawula Izifo Nempilo Yendalo, Makerere University School of Public Health, Kampala, Uganda

U-Olive Kobusingye: ISebe Lokulawula Izifo Nempilo Yendalo, Makerere University School of Public Health, eKampala, eUganda

 

 

FUNDA KUNYE

I-EMS eUganda - Inkonzo yeAmbulensi yaseUganda: Xa iPastor idibana neDini

I-Uganda Yokukhulelwa ngeBoda-Boda, Iiteksi zeenqwelo zokuhamba ngeenqwelo moya

I-Uganda: I-ambulensi entsha engama-38 kuTyelelo lukaPapa uFrancis

 

 

SOURCES

I-BMS: IBioMed Central - Imeko yenkonzo zoncedo olungxamisekileyo kunye nonakekelo lwezempilo eUganda: Iziphumo zophando olwenziwe kuRhulumente weSizwe

Iingcebiso ZontangaImeko yenkonzo zonyango olungxamisekileyo kunye nonakekelo lwezempilo eUganda: Iziphumo zophando lweSizwe lweSizwe

Isikolo seKholeji yezeMpilo yoLuntu kwiNzululwazi yezeMpilo, kwiYunivesithi yase Makerere

 

I-WHO: ukhathalelo olungxamisekileyo