Creating change through collaboration: a twinning partnership to strengthen emergency medicine at Addis Ababa University/Tikur Anbessa Specialized Hospital--a model for international medical education partnerships

Background: Morbidity and mortality due to the lack of an organized emergency medical care system are currently high in Ethiopia. Doctors, nurses, and other medical staff often have limited or no formal training on how to handle emergencies. Because of insufficient human and resource capacity needed to assess and treat acutely ill patients, many who are injured may die unnecessarily, at the site of injury, during transport, or at the hospital.

Objectives: This article describes the development of a twinning partnership between Addis Ababa University (AAU), the University of Wisconsin-Madison (UW), and the nonprofit organization People to People (P2P), to strengthen emergency care at Tikur Anbessa Specialized Hospital (TASH) and increase the number of trained emergency medical professionals.

Methods: The partnership applied the six-phase twinning partnership model, with the overall goal of enhancing and strengthening emergency and trauma care by building institutional and human resource capacity. This was achieved by 1) developing local leaders in emergency medicine (EM), 2) creating training modules adapted to the Ethiopian context, 3) launching an emergency training center, and 4) supporting academic program development. The authors evaluated the program's effectiveness based on our achievements toward these goals.

Results: Results include: 1) eight Ethiopian faculty completed a condensed EM fellowship in the United States. Now six Ethiopian physicians serve as EM faculty and two as pediatric EM faculty. 2) Nine emergency training modules were adapted to the Ethiopian context. 3) An emergency training center was opened in 2010 and to date has trained over 4,000 Ethiopian medical professionals. 4) Two academic training programs (EM residency and masters nursing programs) were initiated.

Conclusions: With many complex factors affecting the burden of emergency care, innovative and interdisciplinary collaborations are needed in Ethiopia to train medical workers, build local leadership capacity, strengthen infrastructure, and inform policies. The short-term achievements of this twinning model could suggest that long-term, institution-to-institution collaborations that are driven by local stakeholders are an effective strategy to create equitable relationships and build sustainable health systems and may serve as a model for other global health partnerships.