TWEYAMBE EMERGENCY SERVICES

Bringing pre-hospital care closer to the people most especially those living in slums which are the main dwelling places for the urban-poor through free ambulance services and first aid training.

There is critical shortages of acute pre-hospital care and first aid skills in such resource-limited settings, many people suffer or die from conditions that could be easily treated if resources were available and used in a more timely and effective manner. 

An estimated 60% of people in Kampala live in slums which are the main dwelling places for the urban-poor.

The factors greatly contributing to the shortages include but are not limited to:

• existing expensive ambulance service providers who need upfront payment for emergency transport and care.
• inadequate Emergency care resources.
• lack or poor first aid skill among the community members.
• insufficient skills/training of the first responders.
• avoidable delays to respond and transport patients to medical facilities.
• delay in seeking treatment.
• delay in making decisions to seek pre-hospital care.
• delays in patient handover at receiving hospitals.
• poor quality pre-hospital emergency services.
• poor quality hospital emergency care. 

The consequences include deaths, injuries, morbidities, disabilities and trauma.

Recognizing the increasing need for urgent access to medical services and more so the increasing number of death caused by lack of prompt pre-hospital care and medical attention, Tweyambe Emergency Services Ltd (TES) hopes to bring pre-hospital care and first aid training closer to the people most especially those in need through ambulance services to the people of Kawempe division.

TES hopes to provide ambulance services to the people and to run activities in order to develop capacity and build systems that will be a foundation of establishing a working model of an emergency response system initially in Kawempe division.

From 459 Road Traffic Incidents (RTI) victims (74.7% males and 25.3% females) and 23 EMS specialists (91.3% males and 8.7% females) who participated in the study between May and June 2016, 4 and 5 key weaknesses and capacities respectively were identified to affect the pre-hospital emergency care for RTI victims in the Greater Kampala Metropolitan Area.

Bringing pre-hospital care services nearer to the urban-poor, reducing delays in seeking pre-hospital care, assessment and taking the best course of action for the patient, quick hand over at the receiving health facility and providing basic first aid training skills.

The above is done through;

A fully equipped ambulance and well trained ambulance crew ready to respond 24hrs 7days every week and a fully functional call and dispatch phone.

Thorough assessment of patients at the scene and determining the best course of action to follow. Notifying the receiving health facility before patient transportation.

Health outreach camps where community members get free medical checkup and free first aid training sessions.

Patient follow-up

The process used is through the referral pathway system, call and dispatch that records all voice calls and Patient Care reports(PCR) for capturing patient data on scene.

The target population includes all irrespective of age, gender, class and economic status, but most especially the urban-poor/slum dwellers which comprises more of the unemployed youths.

The urban-poor/slum dwellers are those who live in cities and towns characterized by poor living circumstances and income, as well as a lack of essential utilities for a decent standard of life.

Some of the major health problems include poor nutrition, pollution-related health conditions, non-communicable and communicable diseases, poor sanitation and housing conditions, and related health conditions.

The urban-poor are under served in the following ways but not limited to; poor quality first aid treatment, insufficient skills/training of the first responders, inadequate EMS resources, and avoidable delays to respond and transport the patients.

Our solution will address their needs with;

• A free 24hr well equipped ambulance service with well trained ambulance crew always ready to respond to health emergencies.
• Thorough patient assessments on scene and a best timely course of action taken depending on the assessment findings, notifying the receiving health facility for quick hand over.
• A fully functional telephone that is always available and dispatch personnel to receive calls.
• Community heath outreach camps to create awareness of individual health status. During the health camps, counselling sessions are offered and patients found to need advanced medical care are referred. 
• Community free basic first aid training sessions.
• Patient care reports showing the patient demographics, assessment findings and current state of the patient is accurately filled and this reduces the doctor's time on deciding what next for the patient. follow up are also done by the ambulance crew to find out the patient outcomes after admission.

The team has gone through an extensive life support training from the current sponsor Canada Uganda EMS Society and undertake the crew through refresher courses.

The crew attends Continuous Medical Education (CME) sessions twice a month at the work station.

The team is made up of 12 members working in shifts (day and night) and having 3 members per shift.

The team has responded to over 1000 community emergencies and this has greatly contributed to better understanding the emergency conditions and how to address them. 

Stakeholder's meetings involving Local council leaders, religious leaders, Law enforcers, Health care providers, educationist are conducted to discuss achievements, challenges, solution to challenges and way forward.

The organization has worked with Kampala Capital City Authority (KCCA) under Population Service International (PSI) in the Kampala Slum Maternal and Newborn Health (MANE) project. 

A well equipped ambulance will always be available with a well trained crew ready to respond at any time of day or night.

The ambulance services is free especially to the urban-poor within Kawempe division. There will be no time wasted in bargaining since the ambulance service is free of charge.

The solution will change the market and enable broader positive impacts from others in the following ways;

• through community outreach camps, the community members will develop a culture of getting medical checkups to know their health status.
• improved methods and ways of handling health emergencies by the community members through learning the basic first aid skills.
• reduced mortality rate since there is easy access to the free ambulance service, early and fast decision making to call for an ambulance, on scene assessment and fast patient hand over at receiving facility.
• the free ambulance will change their mind set about the long existing concept that ambulance are expensive and meant for the rich.
• the living standards in the slums will improve.

Impact goal includes;

•  Reducing mortality rate in the urban-poor by next year by at least 25% 
• Having more well equipped ambulances and at least 30 trained ambulance crew responders.
• Having more community members skilled with basic life support skills through community out reach camps and first aid training.
• Having trained community ambassadors (Village Health Teams) to be the contact and focal persons in the community and performing initial first aid care before the ambulance arrives on scene. 

Call and dispatch (CAD) method is used with a telephone that is always available and dispatch personnel to receive all in-bound calls.

Call logs are recorded including initial time of call, type of call (transfer, trauma or medical), time spent from the scene to the receiving facility, total time of the call and the total distance travelled.

Patient Care Reports (PCR) are used to capture patient details including the demographics, location of call, contacts, chief complaint, history of chief compliant, medical history, patient assessment findings/condition, vital signs (Heart rate, blood pressure, blood sugar, Oxygen saturation, lung sounds, heart tones, breathing rate, temperature), treatments provided on scene and enroute.

During publicity, health outreach camps and first aid trainings, the community members are advised to always go for health check-ups irrespective of their health status.

website- www.tweyambeemergencyservices....

Email- tweyambeemergency@gmail.com

Twitter- @TweyambeAmblanc

LinkedIn- linkedin.com/in/tweyambe-emergency-19a56426

Facebook- Tweyambe Emergency Services

WhatsApp- +256 704 239 329

Our solution currently serves 80 to 100 people per month.

In the next year we hope to serve over 300 people per month.

We currently have one ambulance and 11 ambulance crew responders covering a wide area.

We offer free ambulance service that is expensive to maintain including renting space for the offices and administrative cost.

There is a challenge of handling People With Disability (PWD) since they need special equipment especially on the ambulance.

We currently have only one sponsor (Canada Uganda EMS Society) and a contract of 3 years with them that is ending in 2024.

Escalating prices that makes the ambulance supplies and equipment very expensive.

Some community members do not accept to get medication from health facilities and prefer to go to traditional healers.

Kampala Capital City Authority (KCCA) emergency call and dispatch who call and dispatch us for the maternal, neonatal and medical cases in the government aided health facilities.

Great Lakes Life saving company for basic first aid training and camps in the country.

Kawempe1 Youth Leaders Development Group work with us during community outreach camps and networking support.

Services offered;

• Pre-hospital care services
• Basic First aid training
• Community outreach services where people get to know their health status

Key customers/beneficiaries

All gender and age with medical cases, neonatal and maternal cases

How are the services done

• Through a 24 hour available free ambulance along with a well equipped ambulance crew.
• Community outreach services, its mobilization spearheaded by youth leaders, local council leaders as well as rotary youth group. These mobilize according to where the activity is going to take place. Other partners do join us during outreach so as the number of participants are well managed.
• Trainings are conducted depending on the schedule of our beneficiaries.

Why do they need the Services

• Lack of access to affordable pre-hospital care in the community and the surroundings.
• The community members need the training skills so as they can offer initial first aid training before the arrival of ambulance.
• They need community outreach services so as they consider health check ups as a life style.

FINANCIAL PATH WILL BE THROUGH

•  Sustained donations and Grands
• Selling branded products
• Selling the service through trainings
• charging ambulance services to those out our area of operation
• Raising investment capital
• Contracts to Government