For the last ten years, the division of trauma at the MUHC has been working closely with the CNIS and Muhimbili Orthopaedic Institute in Dar es Salaam, Tanzania, to improve our understanding of injury epidemiology and to improve the care of injuries and acute surgical disease.
Essential to any trauma system development, is a description of local injury epidemiology. Such information is invaluable for several reasons. First, it provides an understanding of the extent and severity of the problem. Such information is the basis for the generation of awareness required to tackle the problem. Second, it allows for the appropriate targeting of education programs. For example, a course focusing on the management of penetrating injuries may not be useful in a setting where most injuries are secondary to motor vehicle collisions. Third, injury epidemiology identifies potential needs for prevention programs. These may be implemented through improvements in areas such as local nonhospital-based education programs (i.e. elementary school pedestrian education), infrastructure, engineering, or law enforcement (i.e. speed limits).
The trauma registry developed by the CNIS targeted specifically for low- and middle-income nations was first implemented in Dar es Salaam in 2005; injury epidemiology has been collected since that time by our local partners. This data is currently under analysis and will form the foundation for further programs as described above.
In addition to the above mentioned research efforts, several education programs are currently in place in Dar es Salaam. First taught in Tanzania in 2005, the Trauma Team Training (TTT) Course is a course geared towards a team approach for the provision of trauma care in low- and middle-income nations. Initially, MUHC faculty were intimately involved in the course delivery. The main focus at the time was based on the concept of “train the trainer.” Since that time, the TTT course has been independently taught by our Tanzanian partners several times. Using the same approach as for the TTT course, several Essential Surgical Skills courses, have been conducted. These emphasize on common surgical emergencies and the provision of life-saving surgical care in under-resourced environments.
Bergman S, Deckelbaum D, Lett R, Haas B, Demyttenaere S, Munthali V, Mbembati N, Museru L, Razek T. Assessing the impact of the trauma team training program in Tanzania. J Trauma. 2008;65:879-883.