21.01.26
This blog was adapted from the original piece which can be found on the Global Emergency Care Collaborative website on www.geccouk.com
Two recent RCEM visits last November and December to the “Cradle of Humanity” in East Africa led to a positive meeting between health professionals from across the globe, thanks to a 10 month health partnership grant
In 2025, The Ethiopian Society of Emergency and Critical Care Professionals (ESEP) was awarded a £200,000 grant from Global Health Partnerships, as a part of the Global Health Workforce Programme which involved a partnership with RCEM. The grant was secured through the Global Health Workforce Programme – funded by the UK Department of Health and Social Care (DHSC). But with only a 10-month timescale attached to the grant, speed was of the essence; what can really be done in such a short timeframe?
Ethiopia is a land-locked, ethnically-diverse East African country with a human history dating back to origins of humanity, which is why it is sometimes called the “The Cradle of Humanity”.
With a population of approximately 130 million, it has a fast-growing economy, and a strategic location within the Horn of Africa. But it also has significant poverty, has been exposed to recent conflicts and subsequent displacement, and is highly vulnerable to food insecurity and climate-related emergencies.
The healthcare system in Ethiopia is tiered. At the Primary Level it comprises health posts, health centres and district hospitals. At a Secondary Level there are general hospitals. Finally at Tertiary Level there are specialised hospitals. Each type of provision serves an increasing number of people – with health posts covering a few thousand and specialised hospitals covering many million.
Only basic emergency care can be expected at district level hospitals, and even general hospitals are limited in their emergency provision. More emphasis has been placed within tertiary hospitals in terms of Emergency Medicine (EM) development so far, but the provision remains variable.
Bespoke EM training was developed in 2010, at a single institution, and was closely aligned to the specialty of Critical Care. However, the 2025 Marburg outbreak, COVID-19 pandemic and multiple natural disaster responses have really brought the speciality to prominence for the country’s Ministry of Health.
The speciality training itself is currently three years long, but those entering into it usually have significant experience in generalist areas of post-graduate medicine already. There is much debate regarding the length of EM training, which is an inevitable discussion as the speciality embeds more formally, because, very simply, there is so much for EM practitioners to learn how to do.
Not unlike other Low and Middle-Income Countries (LMICs) with a young EM speciality, very quickly the question is being asked of where Paediatric EM training fits. We have seen the same, for example, in Ghana and in Pakistan. This stands to reason given the high burden of child illness and injury which accompanies the health profile of LMICs.
So back to the whistlestop grant. The ESEP team had very much hit the ground running in terms of direction and precision in their strategy and planning – especially with the ear of the country’s healthcare leaders. They are taking the lead as the first speciality in the country to develop national accreditation for individual sites’ training programmes which is a huge step in unifying the national EM training environment.
The Ethiopian team have taken on advice and experience learned from African colleagues including those in Rwanda, Ghana, Uganda and South Africa during their summer meeting facilitated by the grant.
During the summer meeting, RCEM was able to connect the team with Professor Ellen Weber, who has since been providing mentorship to help Dr LemLem Beza grow their new Pan-African Journal of Emergency and Critical Care. This meeting also sparked a strengthened partnership with The African Federation of Emergency Medicine and led to some preliminary discussions to develop a College of East African Emergency Physicians. This is an exciting development for the region as a vehicle for sharing best practice relevant to a not-dissimilar context, and if it really takes off, is likely to be a source of support and strength for the speciality of EM from here on.
Leadership training has been identified as a critical requirement for EM residents and nurses both in terms of the day-to-day running of an ED, and because they will be developing a new emergency care service in a hospital as the speciality expands. The RCEM EM Leaders programme has offered a very sound basis for this. However, it is very clear that a bespoke and locally-adapted programme will be beneficial, especially preparing residents for those higher-level leadership positions.
As well as journal development, ESEP are in the process of expanding the Basic Emergency Care (BEC) course. The WHO BEC course commenced in 2018, in partnership with the likes of the International Federation of Emergency Medicine and the International Confederation of the Red Cross.
Its premise is to impart a systematic approach to early recognition, assessment and initial management with an emphasis on injuries and some key syndromic patterns, such as difficulty in breathing, shock and altered mental status. It is an adaptable course designed to meet healthcare worker training of multiple levels, as well as flexibility to fit into humanitarian settings. Its delivery ranges from a five-day face-to-face model to a hybrid online model with some optional modules in conflict-related injuries.
It is always very humbling and eye-opening to learn how systems work in other countries, and sometimes it feels surprising that as an outsider, you can be found to be even slightly useful.
The ESEP team were very keen to learn how we work in the UK so that they can take what will work for their system and adapt it, knowing that we’ve had a lot longer to both work things out, and indeed get things wrong – although in quite a different landscape. This is especially true as the ESEP team explore the best way to approach trainee engagement and accreditation of training centres, and indeed sustaining and maintaining high standards.
Certainly some of their early challenges mirror many of our own UK concerns – for example: how should rotations be managed? How do we ensure adequate training in trauma? What is the best model to provide mentorship through training? How can we ensure less central and less popular training sites are staffed well enough to balance service provision?
The current pace and energy of Ethiopian EM development can really only have an upward trajectory. Whilst the grant period itself is almost over, it is quite clear that the ESEP/RCEM partnership is very much only beginning, and will continue beyond the follow-on grant which has been awarded by Laerdel to support Basic Emergency Care training.
Further reading: New initiative launched to strengthen Emergency Care in Ethiopia – RCEM