Watson Institute for International and Public Affairs

Advancing Emergency Medicine Research in Ethiopia

As the practice of emergency medicine (EM) develops in Ethiopia, HI² International Fellow Temesgen Beyene Abicho, lecturer at Addis Ababa University College of Health Sciences, has dedicated himself to advancing a robust clinical research base to support this emerging field. Since the start of the emergency medicine specialty almost a decade ago, there have been significant advances both in terms of health workforce and the expansion of needed resources. However, the research base to support EM and disaster preparedness is lagging, and clinical research done elsewhere is rarely relevant to the local context of Ethiopia. Dr. Beyene Abicho shares with us his insights and ongoing research.

Q&A with Temesgen Beyene Abicho (HI² International Fellow)

HI² -- Can you please tell us about your current role at Black Lion Hospital?

I am a lecturer at Addis Ababa University College of Health Sciences, Black Lion Hospital, and chief resident in Emergency Medicine and Critical Care. As a chief resident, I supervise my juniors, and act as a liaison between my colleagues and the department. Thus, I am a clinician at the Emergency Center, a clinical researcher, and an instructor to my juniors.

HI² -- How has your clinical experience in the emergency department informed your research?

Emergency medicine is a young specialty in Ethiopia which needs more research, particularly in resource limited settings. My clinical work is a continuous inspiration for my research because as an emergency clinician I see lots of new presentations which leave me with new research questions. One example here is atrial fibrillation which is one of the most prevalent cardiac emergency presentations. It has no relevant literature, and research has not been done on the topic in Ethiopia. Hence, I came up with the idea of doing my residency thesis on atrial fibrillation and its associated factors for patients presenting to my emergency center. My findings indicate that we have one of the highest burdens of atrial fibrillation at my Emergency Center (16.5%). In general, my clinical experience is a continuous motivation for further clinical research.

HI² -- What are your research interests, i.e. research accomplishments, current projects, and future directions?

My primary research interests focus on Emergency Care clinical research, disaster preparedness and planning, leadership in disaster situations, and Emergency Medical education development in low income countries. As an Emergency Medicine (EM) resident, I am committed to developing not only my clinical skills in the Emergency Department but also my skills in clinical research. Thus far no research base exists to support EM practice and clinical research done elsewhere is rarely relevant in our setting. As the practice of EM develops in Ethiopia, research to support that practice must develop as well. Hence, I would like to become an expert in the field of clinical research so I can lead that development.

My first publication was on Emergency Medical Education, and I have written five more abstracts which are now accepted and published. I have presented my work at the World Association for Disaster and Emergency Medicine conference in Toronto. Further, I have served as a junior reviewer for Global Emergency Medicine Literature Review Group 2016, and plan to continue as a senior reviewer for the year 2017. In addition, I am the local chairperson for remote site representing my colleagues for clinical research training from National Institutes of Health, Introductory Principles and Practices of Clinical Research.

I recently completed a year-long program on clinical research at Harvard Medical School, Global Clinical Scholars Research Training Program (GCSRTP), which is aimed at building skills in clinical research, providing knowledge to address issues critical for success in contemporary clinical research, and developing a global network. With the skills developed throughout my trainings, I plan to apply for further clinical research fellowships, disaster fellowships, as well as Emergency Department leadership fellowships. I hope to develop research projects, possibly multi-site projects within Ethiopia that address questions pertinent to the practice of EM in low-resource settings.

HI² -- Can you please describe your ongoing work of guideline development for national disaster medical assistance team formation?

Upon completion of the two-week on-site training program in Humanitarian Response and Post-Conflict Resolution (BIARI) in 2016, I volunteered for the Ethiopian Ministry of Health to serve in an Emergency Medical Response Team on disaster preparedness and planning. I worked with an interdisciplinary team in drafting a guideline on National Disaster Medical Assistance Team. For the last year, we developed the draft document on team composition for disaster medical assistance, and resource requirements. Our subsequent plan is to finalize the guideline and train response teams on its implementation.

HI² -- What does the disaster preparedness situation in Ethiopia look like in terms of the availability of trained health workforce and necessary medical resources?

Since the start of the Emergency Medicine specialty almost a decade ago, there have been significant advances in disaster preparedness both in terms of health workforce with around 30 Emergency Physicians, hundreds of Emergency Medicine and Critical Care nurses, trained first aid responders, and expansion of needed resources. Our Ministry of Health has its own Emergency Directorate who closely works with our Emergency Center in training health workforce and assuring fair resource allocation.

HI² -- Can you please elaborate on your volunteer work in media based public awareness of disaster preparedness?

This is a radio based public awareness program on disaster emergencies, road traffic accidents, and their impacts on life style. On this awareness program, I have talked on basic earthquake precautions to take in case such a disaster happens.

HI² -- If you could give one advice to international organizations interested in providing humanitarian assistance in times of natural or man-made disasters in Ethiopia, what would it be?

What I would advise them is to come and talk to our Initiative on disaster medical assistance where they can get professionals and para-professionals for humanitarian assistance. Also, I would like to state that a few BIARI alumni in Ethiopia and I are thinking of creating a humanitarian initiative which will provide direct assistance in situations like this.

Q&A conducted by HI² Summer Intern Yokabed Ashenafi