DAR ES SALAAM, Tanzania, August 21 (IPS) – The 14-year-old girl arrived at the hospital fighting for her life. After a tragic hit-and-run car accident, she was rushed into the emergency department with serious abdominal injuries. Every passing minute brought her closer to death.
“There was internal bleeding,” recalls Dr Iddi Muhammad Juma, a surgeon at Tanzania’s Same District Hospital. “We performed an ultrasound and took her to theatre immediately,” he tells IPS.
When surgeons opened her abdomen, they found a ruptured spleen floating inside the abdominal cavity.
Applying the structured emergency approach taught in the World Health Organisation’s Basic Emergency Care course, the team stopped the bleeding and removed the ruptured spleen. The girl survived.
For Juma, the case illustrates how a systematic response to an emergency saves lives.
“If we had delayed, she could have died. Because of the BEC training, we acted quickly to save her life,” he says.
His experience highlights changes across Tanzania as the government improves emergency care in rural hospitals to save the lives of the injured and critically ill patients.
Tanzania has expanded access to healthcare over the past two decades, but emergency care remains weak. Many district hospitals lack trained staff, equipment and essential supplies, while clinicians — especially in rural areas where patients often travel hours for treatment — have had little practical training in rapidly assessing and handling life-threatening emergencies with limited resources.
To address the problem, the Ministry of Health, in partnership with the Emergency Medicine Association of Tanzania (EMAT) with support from WHO, has launched the Accelerating Community and Transformative Learning for Basic Emergency Care (ACTxBEC) initiative to train health workers in 250 hospitals countrywide to manage medical emergencies using evidence-based practices designed for resource-limited settings.
Michael Kiremeji, an official at the Ministry of Health, says the initiative aims to strengthen emergency and critical care at district hospitals where most patients first seek treatment.
“We want to ensure that timely and quality life-saving emergency care is accessible to every patient regardless of where they live,” he tells IPS
He says many deaths and disabilities caused by trauma, obstetric emergencies and severe infections can be prevented if health workers have the skills to rapidly assess, stabilise and manage critically ill patients.
Doctors say the training has improved teamwork, confidence and decision-making during emergencies, showing that life-saving care depends more on skilled, decisive action than on advanced technology.
Perched on a wind-swept highway linking Tanzania’s commercial capital, Dar es Salaam, with the northern Kilimanjaro region, Same District Hospital has long grappled with a steady flow of road crash victims, especially during holidays when travel peaks, doctors say.
Before the BEC training, the hospital could only stabilise patients with severe chest, abdominal or pelvic injuries before referring them to Kilimanjaro Christian Medical Centre (KCMC), about 100 kilometres away.
“We learned how to quickly identify air or blood in the chest and insert life-saving chest tubes. We also mastered simple airway techniques like the chin lift and jaw thrust—basic life-saving skills.” Dr Juma tells IPS.
Hundreds of kilometres away at Tumbi Regional Hospital in Tanzania’s Coast Region, Dr Sami Kyaruzi says the BEC course has simplified doctors’ responses to emergencies.
He recalls a 45-year-old man with stab wounds who arrived at the emergency room alert and breathing normally. A chest X-ray showed blood and air trapped in the chest, but his condition initially appeared stable.
Within minutes, however, his breathing became laboured, his blood pressure dropped and one side of his chest bulged unevenly. While the sudden decline could have puzzled many clinicians, Kyaruzi recognised the signs.
“We immediately relieved the pressure in his chest with a needle, then inserted a chest tube,” Kyaruzi tells IPS. “His condition improved quickly, and he was later discharged.”
Despite his emergency medicine background, Kyaruzi says the hands-on demonstration during the course changed how he puts that knowledge into practice.
“We learned how to assess trauma patients, stabilize the neck and spine, support breathing, and deliver oxygen correctly.”
He believes Tanzania should invest in simulation laboratories where clinicians can hone their life-saving skills before facing real emergencies.
“Investing in emergency care training is a necessity,” he says. “Strengthening capacity at the district hospitals will save many lives.”
At Bagamoyo District Hospital on the Indian Ocean coast, Dr Makubi Gyalisi says the change brought by the BEC programme has improved his confidence.
Now head of the hospital’s emergency department, Gyalisi oversees critically ill and injured patients. But before attending the training, he says managing life-threatening emergencies was hard.
“The training changed the way I handle emergencies. I now approach critically ill patients with confidence and follow a systematic process,” he says.
That confidence was tested when a young man arrived after a grisly car crash. His right leg had been chopped, he sustained severe head injuries and was terribly shocked.
The emergency team adeptly followed the structured approach taught during the BEC course.
“We assessed his airway and breathing, treated his shock with IV fluids, immobilised his neck and prepared him for blood transfusion before referral,” Gyalisi says.
Doctors contacted orthopaedic specialists in Dar es Salaam to explain his condition and the treatment already provided.
“They really appreciated the steps we had taken,” he says.
For Gyalisi, the case demonstrated that survival often depends less on where a patient is treated than on how quickly and systematically care begins. “The training improved my confidence and skills to manage emergency cases in an organised and systematic way,” he says
Across Tanzania, life-threatening emergencies continue to strain district hospitals, often the first point of care for critically ill patients.
From Kilimanjaro to Bagamoyo and Kibaha, district hospitals face a shortage of staff, medicines and equipment to handle emergencies.
As Tanzania expands the ACTxBEC initiative to more health facilities, frontline doctors hope those transferable skills will help provide timely life-saving care to patients before it is too late.
IPS UN Bureau Report
© Inter Press Service (20260821085841) — All Rights Reserved. Original source: Inter Press Service
