Learning from developing countries in delivering emergency and trauma care: Lessons from an emergency medicine global health partnership in Ethiopia

Background: Health care providers in Ethiopia have limited or no formal training for handling emergencies. As a result, morbidity and mortality due to trauma and injury are high. Many patients die unnecessarily – at the site of injury, during transport, or at the hospital – because emergency systems are lacking. In 2009, two tertiary care medical centers (one in the U.S., one in Ethiopia) formed a partnership based on the 6-phase twinning model to enhance and strengthen emergency & trauma care at the Ethiopian tertiary hospital. Methods: Over the duration of the partnership, more than 80 US-based health care professionals participated in exchange trips to Ethiopia to deliver educational trainings, provide clinical mentoring, and assist in program development. A survey based on WHO health systems competencies was developed to assess what the health professionals may have learned and integrated into their practice to measure "reverse learning." Results: Survey results revealed that US-based health workers experienced change in five of the six WHO health systems competencies: service delivery, health workforce capacity, health information systems, medical technologies, and leadership/management. Among practicing emergency workers, changes were reported in how they approached their practice of emergency medicine and/or injury prevention. Conclusion: Our study shows that this global health partnership model produced mutual educational, clinical, and professional benefits with significant reverse learning for U.S.-based partners. Further tools should be developed to better measure reverse learning, as there is much learning and innovation to be gained from developing countries to solve our global health challenges.