A model for emergency medicine education in post-conflict Liberia

Abstract The specialty of emergency medicine (EM) remains largely underdeveloped in many parts of the world including Africa. Within West Africa the Liberian health care system was presented with incredible challenges in the immediate post conflict years. One significant challenge facing the country was the paucity of health care providers. In 2006, only 122 physicians were practising in Liberia (one for every 26,782 citizens), only 87 of them Liberian national physicians. The public health indicators in post conflict Liberia suffered as a result of the overburdened system. Many indicators placed Liberia as having the worst health survivability in the world. Significantly, morbidity and mortality associated with unaddressed emergent presentations remained high. This article describes a unique paradigm for addressing the deficit in human capacity for emergency health care in the Republic of Liberia. This system was designed and supported by a consortium of academic medical centres in the United States working in conjunction with a local non-governmental organisation, Health Education and Relief Through Teaching (HEARTT). Since 2007, the consortium has delivered virtually uninterrupted emergency medical care and medical education at the largest teaching hospital in Liberia. The Liberian programme objectives included supervising and directing emergency medical care, providing a model for curriculum development, building capacity for medical education, and improving systems-based EM practice. The collaboration of multiple academic institutions in bringing emergency medical services and academic EM teaching to a post-conflict setting remains a unique model for introducing the development of acute care in a developing country.