Emergency Care in Namibia☆,☆☆,★
Section snippets
INTRODUCTION
Namibia is an independent nation in southwest Africa, bordered by Angola and Zambia on the north, South Africa on the south, and the Atlantic Ocean on the west. It was declared a German protectorate by Bismarck in 1884, and at that time was called German Southwest Africa. After World War I, it was declared a mandate of the League of Nations and administered by South Africa.
Protracted fighting between South Africa and the South West African People’s Organisation (SWAPO) resulted in Namibian
HEALTH CARE ORGANIZATION
The Namibian National Budget allocates approximately 14% to the Ministry of Health and Social Services; for comparison, about 20% is allocated to education. Patients pay approximately $1 (US$) for outpatient visit and $4 (US$) for hospital admission. These fees include medication and, if necessary, tertiary care referrals outside of Namibia.
Medical officers are the backbone of the state-run health service. They are in some way comparable to residents but in other ways to family practitioners.
PREHOSPITAL CARE
The prehospital care system reflects the geography and economy of the nation as a whole. The state provides patient transport to the state-run hospitals. There is no 911 system because only about 4/100 people in the country have telephones. Most native patients arrange their own transportation to the hospital, or are brought from clinics to the main hospital by state transport. There is no basic or advanced EMS system provided by the state. The Namibian “EMS system” is privately owned and
EMERGENCY CARE
The only true “emergency department” in Namibia is at Katatura State Hospital. All other hospitals have “emergency rooms” covered by on-call staff physicians, who are summoned if patients present after clinics have closed. Katatura State Hospital emergency services treats about 100 adult medical/trauma and about 50 pediatric patients daily. The admission rate is about 30%, and about a third of emergency patients are transported from regional clinics by the state-run ambulance service. There is
FUTURE DIRECTIONS
The geography, sparse population, and economic realities in Namibia preclude the development of emergency medicine as a separate specialty in that country.
The amalgam of the state-run health care system and private enterprise meets medical needs efficiently. Medical developments in South Africa 3 can be expected to continue to have a positive impact in Namibia, especially in trauma care. The specialty of emergency medicine should undertake efforts to share knowledge in areas of common interest
References (3)
The title “BAA” and, to a lesser extent, “AEA.”
Trauma and Emergency Medicine
(1995)
Cited by (9)
Emergency care capacity in Sierra Leone: A multicentre analysis
2024, African Journal of Emergency MedicineDeveloping and implementing emergency medicine programs globally
2005, Emergency Medicine Clinics of North AmericaCitation Excerpt :This basic anatomy of development incorporates building emergency care capacity and infrastructure followed by training and clinical care standardization and leadership development [11]. Universal components of development can be seen in a series of published articles describing the state of EM in many countries [12–40]. Establishing EM as an independent medical specialty benefits health care systems in many ways.
Understanding diversity among prehospital care delivery systems around the world
2005, Emergency Medicine Clinics of North AmericaCitation Excerpt :In resource-poor systems and in cultures where patients do not accept the provision of medical care from nonphysician providers, there may only be a driver with limited first aid skills to transport the patient to the hospital [12]. In some systems, when patients present to the hospital emergency department, they may be tended to by physicians in training, medical officers, or on-call physicians with inadequate training [17,18]. Others countries use the “Franco-German model” by taking the physician to the patient [4].
Prehospital trauma management
2001, ResuscitationEmergency medicine in Namibia [4]
1999, Annals of Emergency MedicinePrehospital trauma care systems: Potential role toward reducing morbidities and mortalities from road traffic injuries in Nigeria
2012, Prehospital and Disaster Medicine
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From the Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC, * State Hospital, ‡ and Medical Rescue International Namibia, § Windoek, Namibia.
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Reprint no. 47/1/92373
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Address for reprints: Judith E Tintinalli, MD, MS Department of Emergency Medicine University of North Carolina at Chapel Hill CB 7594 Chapel Hill, NC 27599-7594