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Technology and Pre Hospital Care in Tanzania

Casey McGillicuddy

In the middle of an emergency, how do you get the help you need? In a country like the United Kingdom, the solution is as easy as picking up your phone and calling a simple three-digit phone number for experienced, trained help to come get you and bring you to a hospital. That’s the basis for a prehospital system, named for medical care that takes place before a patient reaches the hospital, and it’s a vital part of healthcare. There is no formal prehospital system currently like that in Tanzania, but a growing number of volunteers are attempting to construct emergency systems in their local communities to respond to medical emergencies like car accidents, fires, and complicated childbirths.

What currently exists?

Currently, the people of Tanzania organize their own transportation to the hospital, either by private car or taxi. According to a recent survey by Research for Community Access Partnership (ReCAP), 85% of motor cycle taxi drivers say they have transported a passenger to a health facility in an emergency. Sixty-eight percent of surveyed passengers reported using motorcycle taxis to access health facilities. Motorcycle taxi drivers are currently filling a need in this country, but this should be a temporary measure. Taxi drivers are not equipped to handle medical emergencies or complicated patient transport. It exposes both the patient and the driver to increased dangers due to lack of training, and yet there is currently no other alternative.

Possible solutions:

Creating a prehospital service in your community requires four basic elements: responder training, vehicles to transport, communications infrastructure, and a leadership team to manage. Each of these comes with their own challenges, but a software, Beacon, has been developed as a way for local communities to handle their own emergency communication system.

A pillar of any prehospital system is communication. The ability for bystanders and even patients in the field to report the emergency location to dispatchers is the first link in the chain. The next step is for an organized deployment of personnel to the scene as quickly as possible to assess and stabilize the patient and, if necessary, transport them to a health care facility. In high income countries, the responsibility of emergency dispatch is handled by expensive software with associated costs of hundreds of thousands of US dollars. These systems are cost prohibitive and unnecessary in low income countries developing their own systems from the ground up.

Beacon is a decentralized emergency dispatch system that relies on the cell phones of trained responders to connect patients with the closest available help. Dispatchers can use Beacon to locate patients, track nearby responders, and ensure completeness of transportation. It has advanced mapping and resource allocation capabilities, but its costs are limited to that of the text messages that it sends to the responders. It’s a proven technology that has been used to respond to over 500 emergencies in Mwanza so far as a part of the fire department’s medical response. It can work in your community as well.

Beacon’s Features:

Beacon is web-based software that organizes emerging incidents with real time updates by the responders in the fields. It has many capabilities for the dispatchers, the responders, and those managing the systems.

For DispatchersDispatchers have access to the system’s data center where they are able to view maps that can be set up with nearby hospitals and the location of responders. In creating new incidents, dispatchers are prompted to input specific information including the emergency’s location on the map. This information is either sent to specific assigned responders or to all on-duty responders. Dispatchers are able to track multiple incidents from the website and receive updates from each case about arriving on the scene, requesting more resources, and patient transport.

For RespondersResponders have the option of receiving the information via SMS text or through a smartphone application. The SMS texts containing the descriptive information collected by the Dispatchers. The Beacon Emergency App allows responders to see where they are in relation to the emergency on the map with turn by turn directions. If the responder is unable to find the patient, they are able to connect with the dispatcher for more information. The responders can record their arrival and where they will be taking patients with Response Time Receipts sent to the them at the end of every closed incident.

For Managers – The managers and leaders of these prehospital systems can download individual reports or generate automatic summary reports in order to track the response times and number of incidents responded to by their system. This is a great way to measure the system to prove efficiency and effectiveness.

Next steps:

Prehospital systems around the world started as simple patient transportation services, similar to what Tanzania has today.  What needs to happen next is localized growth into a more formalized service provided by people with training in prehospital care. Beacon is a cheap and effective solution to one of the challenges in creating a prehospital system in your community by handling the communication tier of prehospital care.

 

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