by Ben Nicholson, MD, PGY-2, Emergency Medicine
Kenyan EMS started as a direct result of the 1998 US Embassy bombing in Nairobi. Since then, providers have worked to develop a national curriculum, training content, and expectations for EMTs. In the coming months and years, the senior leadership has plans to expand EMS to more cities in Kenya and increase the scope of practice. This August, I spent an elective rotation working in Nairobi Kenya to evaluate the current curriculum that the Kenya Council of Emergency Medical Technicians uses to instruct emergency medical technician (EMT) students. This was part of a broader evaluation of the state of prehospital education across Kenya as the country stands ready to greatly expand their prehospital resources.
I interviewed EMT students, trainees on their clinical rotation, EMT instructors, and senior leadership. With players from many different stages of training, we worked through the current curriculum, how people view EMS and their role in EMS, the process for delivery of out of hospital care in Kenya, and the financial realities of providing this service. I met some wonderful people who taught me a great deal about Kenya and how the country has changed, particularly in the last decade.
As an educational assessment, I learned the processes involved in formally evaluating an educational product. Day to day, this meant interviewing people, typing up my notes, then summarizing these notes, and finally trying to extract themes from all of the interviews. Many days were spent Ubering around Nairobi or sitting in the garden at the guesthouse drinking Coke’s with cane sugar, pouring over my notes.
I spent time riding in the ambulance and seeing parts of Nairobi I otherwise would not have been able to safely travel. The EMTs drove me around Nairobi and gave me a personalized tour. Another interesting experience was meeting the senior EMT who oversees the training of the airport firefighters. He picked me up and drove me the 40+ minutes out to the airport for the meeting. The entire way we chatted about Kenya and EMS. This was a really great opportunity to meet someone from the country, across a shared interest, and understand more about the country and its people than would have otherwise been possible.
In the future, there is a great deal of opportunity for further collaboration and involvement. The EMS system has many areas of potential growth and refinement. One of the more exciting things was finding so many people who are passionate about EMS and have been working to develop it largely without any outside support or influence.
Overall, this was a great experience in terms of personal growth, learning how to conduct formalized research, and building relationships with folks in Kenya. It was certainly challenging, required a lot of self-motivation to stay on task, but I think it was well worth it.