Cameroon Field Report: 2016

Published on April 18, 2016
Although it faces some of the same trauma care challenges as its neighbors, EM is already an officially recognized specialty in Cameroon, and two new emergency centers have opened here recently.

Cameroon is a West African country with a population of approximately 22 million people and two official languages, English and French. The country is divided into ten regions, which are further divided as divisions and subdivisions. The health sector in Cameroon includes private and public health sectors. There are 5 referral hospitals, 70 general hospitals, 50 private hospitals, and a wide network of public and private health centers with a vast diversity of medical specialties.

Emergency medicine has quickly developed over the last few years in Cameroon, from not being considered an independent specialty in the 1980s to a fully recognized and flourishing specialty today.

Unfortunately, the current healthcare system does not meet the increasing needs of the public in Cameroon. Public spending on health was only 2% of GDP in 2012. Growing numbers of road traffic accidents and inadequate pre-hospital transportation systems, coupled with the limited number of trained hospital staff and appropriate equipment, can help explain the rising number of deaths from emergency situations.

Sadly, Cameroon is a typical example of a developing African country with an under-developed pre-hospital system. The well-known “golden hour” of trauma specifies that patient outcomes are improved when patients are transported to a designated trauma center within 60 minutes of injury. In Cameroon, the average response time for EMS ranges from 35 minutes in major towns and cities to sometimes no response in the rural interior. This lack of reliability leads citizens to independently transport patients, family members, and friends to nearby health centers without ever calling 119, and may help explain the high degree of morbidity and mortality from pre-hospital emergencies in Cameroon.

In an interview with Shu Olivier Niba, president of the Cameroon Association of Medical Students Promoting Emergency Medicine (CAMSPEM), Dr. Kwa Kidze described his department as congested and noisy at the best of times. Dr. Kwa is the EM district medical officer of the Ndop Subdivisional District Hospital in the Ngoketunjia Division. He and one EM nurse usually staff a department roughly 80 square meters that sees everything from snake bites to road traffic crashes and burns. Reflecting the opinion of many others, Dr. Kaw also claimed that the lack of an adequate pre-hospital transport system, mandatory equipment, and even space are common problems faced by EDs throughout the country. Nevertheless, he acknowledges that the specialty is growing rapidly and generating much interest.

At present, the Ministry of Higher Education, together with the Ministry of Public Health, is making efforts to train more EM physicians in the oldest state medical school, the Faculty of Medicine and Biomedical Sciences of the University of Yaoundé. Two new emergency centers, Centre d’Urgence de Yaoundé and Centre d’Urgence de Douala, have also opened, and both have quickly become leading institutions in the country.

International organizations and foreign countries have also contributed by providing aid to Cameroon’s health system in general, and to EDs in particular. One example is the $40 million of equipment recently provided by the US government to Centre d’Urgence de Yaoundé.

The development of EM student groups throughout the country also reflects a desire for better training of future emergency physicians, for the advancement of the specialty, and for public education and support. As a result, these student groups focus on educating communities in providing basic first aid while calling for new professional training programs and facilities.

While much work remains to be done, the rapid expansion of EM in Cameroon in recent years likely foreshadows a promising future for the specialty and for patient care.

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