Patients treated in the outpatient clinic
EMERGENCY’s commitment to the Complexe Pédiatrique: 5 years of assistance to guarantee the right to free and high-quality healthcare.
Following a coup in March 2013, the Central African Republic has been overwhelmed by fighting and insecurity which has crippled the country and had a devastating impact on an already fragile healthcare system.
In the context of this national emergency, we immediately offered our services to the health authorities and started to collaborate with the only public paediatric hospital in the country – the Complexe Pédiatrique in Bangui – in which 2 paediatricians and the only 2 paediatric surgeons in the country worked.
When we arrived, the hospital was crumbling. For this reason, our project included the restructuring and renovation of the two operating rooms and the entire operating block, transforming the hospital into a centre of excellence at a national level. Our surgical team immediately got to work, and since 2013 has performed more than 12,380 procedures.
From emergency to stability
After the outbreak of civil war, we broadened our admissions criteria to include general surgery; traumatology; orthopaedic surgery; treatment of burns victims; and victims of road traffic or domestic incidents. We continued with the restructuring project and increased our involvement in the paediatric activities of the centre, also setting up a triage system. Each and every day we treated about 190 patients, 40 of whom were assigned a ‘code red’ status.
At the request of the hospital management, we gradually assumed management responsibilities for most of the centre’s activities: the emergency room, the intensive and sub-intensive care departments, as well as logistic and auxiliary services such as the laundry and the laboratory. In 2017 we started to support the remaining services.
In light of the results obtained in the emergency surgery department, the hospital management asked us to further support the management of the medical and training activities within the facility.
At the paediatric outpatient clinic, we saw approximately 3.000 patients each month. 79% of them were under five years of age and most suffered from gastrointestinal diseases, malaria and pneumonia.
During our time at the Complexe Pédiatrique, we committed ourselves not only to respond to immediate healthcare needs, but also to promote the growth and improved functioning of the entire national health system.
Together with local staff we promoted a new administrative and hospital management system, introducing patient care protocols; diagnostic service management; the effective cleaning and sanitising of rooms; maintenance of hospital premises; and improved systems for the ordering and distribution of medicines.
Faced with the absence of a nationwide healthcare network, we also established a referral system for patients accessing provincial health services in rural areas.
Training programmes to qualify local medical staff
The lack of qualified personnel remains one of the biggest gaps in the national health system. There are only 250 doctors throughout the entire Central African Republic. EMERGENCY is committed to the training of medical and nursing students, who carry out their practical training at the Complexe Pédiatrique. Since 2015 we have collaborated with the Faculté des Sciences de la Santé of the University of Bangui. Since February of 2016, we trained 90 nursing students and over 70 medical students every month. In addition to this, we oversaw the qualification of 14 paediatric specialists.
Transferring operational responsibility to local health authorities
In the space of 5 years our involvement transformed the hospital, and has catalysed the reconstruction of the national health system. Thanks to the active participation of domestic and international institutions, all of the hospital’s services, including the distribution of medicines, are available absolutely free of charge. The right to free and high-quality healthcare has always been a fundamental component of our humanitarian work. The right to medical treatment is an inalienable right belonging to all human beings and, as such, must be respected without discrimination.
At the point that the Complexe Pédiatrique acquired clinical and administrative autonomy we agreed with local authorities the timeframe for a gradual handover of operational responsibility. Until this process was fully finalised, we continued to supply and staff the hospital as required in order to guarantee complete functionality, uninterrupted and free-of-charge care. We have also ensured that the funds promised by institutional donors for the management of the Complexe Pédiatrique over the next 3 years will remain available to the hospital, even in the absence of EMERGENCY, ensuring its economic viability.
On the 30th of June, the handover was formalised, and operational responsibility for the facility was transferred from the director of the hospital to the Central African Health Ministry. There to witness the event were senior representatives from the Central African Government, the Minister of Health, officials from the Italian Agency for Development Cooperation, ambassadors from Italy and the European Union, and, most importantly, our patients and their parents. It was an important and exciting moment for many of us who have invested a great deal of energy to ensure the project’s success.
Our work in the Central African Republic continues with ongoing activities at the Bangui Paediatric Centre which, since December of 2017, has been repurposed to dedicate itself entirely to the care of chronic patients. We are also continuing to support the National Blood Bank, the only facility capable of collecting and distributing blood throughout the country for life-saving treatments.
For more information
With the assistance of the Italian Agency for Development Cooperation, which has supported our work in the Central African Republic since October 2015, we have documented the full story of our time at the Complexe Pédiatrique in Bangui. The direct testimonies of those who took part in the challenge touch on all the crucial phases of the project: from our initial arrival through to the final stages.