Friday, November 08, 2013
Andrea Tenner, MD, MPH, Assistant Professor, Department of Emergency Medicine, reported for her first shift in the emergency department at Muhimbili National Hospital in Dar Es Salaam, Tanzania, on the morning of March 29, 2013. Later that day, a 16-story building under construction in the city collapsed, killing 36 people and sending 18 people to the ED. While it was an intense beginning to her 15-week visit to the east African nation, it was also an impressive demonstration of the capabilities of Muhimbili’s Emergency Medicine Department (the first in the country) and the residents who staff it. Dr. Tenner grabbed the opportunity to “jump in with both feet,” learning more about the department’s emergency response, as well as its day-to-day working, providing her with a real-world basis for the teaching she was there to do.
As a member of the Section of Global Emergency Health in the Department of Emergency Medicine here at the University of Maryland, Dr. Tenner has traveled to Africa many times to work with emergency medicine specialists in various countries. During her trip earlier this year, she was there for the purpose of supporting an educational consortium established to teach residents in classrooms and clinical settings, deepen their knowledge, and expand their skills. The consortium and the Emergency Medicine Department at Muhimbili were established through a partnership between the Government of Tanzania, the global healthcare company Abbott, and its foundation, the Abbott Fund.
During her time in Dar Es Salaam, Dr. Tenner presented more than 100 hours of classroom instruction and worked more than 500 hours in the ED supervising residents. These residents will be the first emergency medicine specialists in Tanzania. A consortium of American universities, including the University of Maryland, Baltimore, are working in conjunction with the Abbott Fund in supporting their education. As a member of the core faculty for the Muhimbili emergency medicine residency, Dr. Tenner helped launch the novel emergency medicine curriculum developed by the consortium, which is soon to be endorsed as the official curriculum of the African Federation for Emergency Medicine.
Six residents, mentored by Dr. Tenner, are now developing a quality improvement assessment of operations at Muhimbili National Hospital. This project, developed by the residency, involves studying American emergency response systems first-hand and assessing local needs and resources in Tanzania. Once they complete their assessment, the residents will analyze their data and compile a proposal for changes, which will be presented to administrators at Muhimbili National Hospital. One of the residents is making plans to come to the University of Maryland Medical Center for a six-week rotation. Two others, also being mentored by Dr. Tenner, are studying how the Muhimbili National Hospital disaster response has changed since the Emergency Medicine Department was established, including the response to the Good Friday building collapse mentioned above.
Dr. Tenner’s tour of duty in Tanzania began with an urban mass casualty incident and ended with the visit of an international dignitary. President Barack Obama visited Tanzania in early July, a few days before Dr. Tenner was scheduled to leave. In advance of the President’s arrival, Dr. Tenner supported the planning and coordination of medical services, standing ready with the local emergency medicine residents, who were the primary service providers.
International information exchanges like this not only encourage new thinking and development but also establish cross-cultural connections and partnerships that benefit both sides. Dr. Tenner’s role in representing the University of Maryland in this exchange with Tanzania is no different. “I cannot tell you how inspiring it was to work with the Tanzanian EM residents—the pioneers of emergency medicine in that country,” says Dr. Tenner. “Their enthusiasm and work ethic are impressive. They have to take on the roles of both student and administrator, tackling disaster planning and providing exceptional care for national and international dignitaries, as well as the day-to-day functioning of the ED. I am thrilled to be able to contribute to the development of such amazing leaders and to collaborate with the consortium dedicated to their success.”
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