One in 10 children in Pakistan do not live to see their fifth birthday. Medical emergencies and injuries are significant contributors to child deaths. However, public awareness as well as government support and legislation for emergency care needs of children is lacking in health care facilities, experts noted at the third Annual Emergency Medicine Conference held at Aga Khan University.
The conference on ‘Emergency Care for Children’ organised by the AKU’s Department of Emergency Medicine (a Collaborating Centre of WHO for Emergency Medicine and Trauma Care), in collaboration with the Johns Hopkins University-Pakistan Fogarty International Collaborative Trauma and Injury Research Training Program - invited local and international experts to highlight the importance of emergency medicine, especially paediatric emergency care, and the consequences of neglecting it as a vital component of the overall healthcare system.
Paediatric emergency medicine is a highly specialised field and both paediatricians and emergency medicine doctors need to undergo further training once they complete their respective specialisations. Emergency Medicine (EM) is concerned with providing timely interventions in medical emergencies and must be recognised and valued as a separate field of specialisation for its impact to be felt.
“There is a global recognition that the first hour of emergency care belongs to emergency medicine especially in cases of trauma, shock and where resuscitation is required,” said Dr Nadeem Qureshi, Chair, International Emergency Medicine Programme, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. In such situations experts said morbidity and mortality can be significantly reduced by skilled emergency healthcare professionals.
EM is a relatively new field in Pakistan and was recognised as recently as 2010 by the College of Physicians and Surgeons Pakistan. However, paediatric emergency medicine is still not on the public and government radar. Presently there are healthcare professionals in Pakistan receiving on-the-job training in paediatric EM. However, with no formal recognition of the specialisation there can be no qualified professionals in this field.
Experts stressed the urgent need for legislation which would define standards for paediatric emergency care including skill set of professionals, equipment and systems. For example, public and private hospitals across Karachi have a combined total of 250 ventilators to cater for an estimated 20 million people. Only 20 of these are dedicated to paediatrics.
AKU is a pioneer in emergency medicine, setting up a separate emergency medicine department and including training in emergency medicine as a part of its core curriculum. Experts urged medical institutions to focus on human capacity development in emergency care through education, training and customising global practices to fit local requirements.
With every fourth person brought into AKU emergency department being a child, Dr Junaid Razzak, Founding Chair, Department of Emergency Medicine, AKU explained the sensitive nature of the highly specialised field. “While children in Pakistan are still dying of old diseases such as pneumonia and diarrhoea there is a new wave of diseases along with a major threat of road traffic injuries, cases of drowning and home-based injuries that healthcare professionals need to deal with,” he said. “Properly trained and skilled specialists providing early diagnosis and timely resuscitation can lead to a notable decline in paediatric morbidity and mortality.”
Elaborating on the pressing need for the field’s recognition, Dr Qureshi said, “Pakistan is burdened with seven per cent of global child mortality and with more than 50 per cent of the country’s population below the age of 20 years, there is an urgent need to focus on paediatric emergencies.” The developed world is already racing ahead in this field while Pakistan has barely started to walk, and immediate focus is required for there to be any hope of catching up, he concluded.
Rasool Sarang, Assistant Manager Media, Department of Public Affairs, Aga Khan University, Stadium Road, Karachi, on +92 21 3486 3920 or firstname.lastname@example.org