International Emergency Care Group Needs You

May 2010

By Heather Hammerstedt, M.D., M.P.H.
ACEP News Contributing Writer

Around the world, lack of access to emergency medical and trauma care is a significant cause of morbidity and mortality.

While developed nations have both the transportation and medical infrastructure to handle acutely ill patients effectively, these are lacking in developing nations, presenting a significant challenge to those caring for the acutely ill. Additionally, once the patients reach the hospital, there are no providers with training in emergency care available to care for them.

Global Emergency Care Collaborative (GECC), a 501(c)(3) nonprofit founded in 2006, is a small group of board-certified emergency physicians dedicated to creating sustainable access to emergency care in the developing world.

GECC's initial undertaking was a partnership with Karoli Lwanga Hospital in Rukungiri district of southwest Uganda, Africa, where, in conjunction with Mission Doctors Association, the group built an emergency department onto the hospital.

GECC's focus has now shifted to training existing nursing personnel to staff the new emergency department, and to improving the effectiveness of care of these emergency patients.

In Uganda, as in most developing countries, there are not enough physicians to staff hospitals adequately, much less provide the specialty emergency care that has proven its value in the United States. GECC has developed a year-long emergency nurse practitioner (ENP) training program for providers in resource-poor areas. The first class of ENPs graduated this spring.

Dr. Mark Bisanzo, president and founder of GECC, said that recent data have shown that the ENPs are seeing close to 750 patients per month (and currently financed to run only 13 hours per day). He added that they are practicing on a level of strong second-year U.S. emergency medicine residents, performing multiple procedures (lumbar punctures, fracture reductions, osteomyelitis drainage), including procedural sedation, per day, as well as successfully resuscitating critically ill and injured patients.

Pediatric mortality, especially in children younger than 5 years, has been drastically reduced by the implementation of this program.

ENP leaders have been identified, among the first "class," who will be able to continue recruiting and educating future ENP classes. GECC's curriculum will be used for ongoing ENP courses for health care providers from around the region, who will be able to provide sustainable emergency care at their home institutions.

This undertaking is the first of its kind in Uganda, and likely in all of East Africa.

These training programs and education projects depend on volunteer emergency physicians. The GECC is currently looking for attending or fellow-level physicians who have an interest in and dedication to teaching and international health. Senior EM residents (PGY 3-4) are also encouraged to apply.

Duration of volunteer work is usually 4 weeks or longer. More information can be found online at

DR. HAMMERSTEDT is the vice president and secretary of GECC.
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