COVID-19 Triggers Critical Care and ICU Capacity Building by WHO in Fragile, Conflicting and Vulnerable Countries – Afghanistan
COVID-19 Triggers Critical Care and ICU Capacity Building by WHO in Fragile, Conflicting and Vulnerable Countries – Afghanistan

COVID-19 Triggers Critical Care and ICU Capacity Building by WHO in Fragile, Conflicting and Vulnerable Countries – Afghanistan

February 24, 2022 – Before the COVID-19 pandemic, the most fragile, conflict-ridden and vulnerable countries in the Eastern Mediterranean region had little or no intensive care unit (ICU) or critical care capacity, despite their serious need to respond to patients dying among other from gunshot wounds, lack of trauma treatment and infectious diseases.

With the advent of COVID-19, the populations of these countries became the most vulnerable. In addition to their minimal access to critical care, all existing facilities were overwhelmed by COVID-19 waves, and many healthcare professionals were immediately relocated to provide care to critical patients in COVID-19 intensive care units.

Through the WHO Regional Office for the Eastern Mediterranean’s response to COVID-19 in the early days of the pandemic, the countries of the region began receiving medical ventilators and other biomedical equipment for the treatment of COVID-19 cases. However, avoidable deaths continued to occur, and high death rates were observed in fragile, conflict-affected, and vulnerable countries, where COVID-19 mortality after hospitalization approached 100% in some cases.

A multifaceted answer

Chiori Kodama says that “When COVID-19 started, resource-constrained and fragile, conflict-ridden and vulnerable countries had a very small number of ICU doctors and nurses. Thus, many healthcare professionals were recycled from different areas so they did not know how to deal with critical “patients in intensive care units despite their tireless efforts to save lives. We had to start from scratch.”

Demand-driven training was thus developed by WHO’s regional COVID-19 clinical management team and rolled out through on-site and online missions to frontline health professionals in resource-limited and complex emergency and middle-income countries in the region.

On earth

In Afghanistan, practical ICU / critical care training provided by field missions and WHO consultants benefited 7,834 health workers. “I am the only female doctor caring for COVID-19 patients at the Afghan Japan Hospital in Kabul,” said Razia Ghafaari. “The support provided by WHO and the EU to our hospital enabled us to take care of our patients from many provinces in Afghanistan, especially those in the intensive care unit. “

Dozens of health workers were trained in Pakistan, and 8 training workshops were delivered during the field mission to Somalia.

In Iraq, the training of intensive care / critical care coaching workshops and the assessment of the intensive care unit improved the skills of 87 chief physicians and nurses working in the COVID-19 intensive care unit, while the use of biomedical equipment and fire safety training enhanced the capabilities of many healthcare professionals across the country. . Cascading training for intensive care / critical care at the national level is planned well in advance.

In the Occupied Palestinian Territory in the Gaza Strip, 2 field missions offering training in ICU / critical care have promoted the capacity of 985 doctors and nurses. Zaharia Sakallah, a customer service agent, fought a fierce battle with COVID-19 for 58 days at a hospital in Gaza. The hospital’s healthcare staff, who were not previously trained in ICU / critical care, received the WHO training with a focus on life-saving skills. “I am slowly but surely on my way back to full health,” says Sakallah, “the support I received from the medical teams […] is invaluable and I think is the main reason behind my recovery. “

Yemen in particular – which had no ICU / critical care capacity in public hospitals before the COVID-19 pandemic – benefited greatly from joint efforts with the WHO Country Office and 3 field missions deployed by the WHO Regional Office training 1259 ICU / critical care health personnel, upscaling of medical oxygen and performing ICU assessments to identify immediate needs for life-saving supplies and fill the gap. As a practical expression of regional solidarity, Oman is committed to providing technical support within ICU / critical care to strengthen the capacity of health professionals in Yemen, and form a “friendship project” between the two countries.

And online

In addition, virtual training was provided in all of the above countries, as well as in 5 other fragile, conflict-affected and vulnerable countries and middle-income countries in the region, for the benefit of over 10,000 healthcare professionals. In addition, a number of webinars were launched in all 22 countries in the Eastern Mediterranean region, which improved the skills of over 20,000 health professionals.

In addition to COVID-19

Dr. Kodama stressed that “In addition to the Regional Introductory and Intensive Care Introductory Package for Physicians and Nurses, we also had to develop an ICU assessment tool for resource-constrained settings because we did not have one when COVID-19 launched. assess current ICU capacity, which was crucial to our timely delivery of life-saving items on the ICU. “

WHO efforts are currently being implemented in the transition from the initial increase response in this area to sustainable capacity building that allows adequate critical patient care beyond COVID-19 to enable healthcare professionals to respond to more critical issues. The project is scheduled to be introduced to several of the region’s fragile, conflict – affected and vulnerable countries, and the project is currently being piloted in Yemen. To this end, on February 1, 2022, the WHO Regional Office deployed its emergency preparedness consultant, Dr. Gary Greg Kuniyoshi, to Yemen for 3 months, to provide technical support and direct bed-side coaching with the aim of more effectively improving intensive care practices in frontline health care workers.

A snowball effect

A number of health ministries, as well as a list of hospitals in FCV environments, have also requested such technical assistance from the WHO Regional Office to consolidate the lifesaving skills of their frontline health workers, requiring long-term and sustainable national intensive care / critical care training programs.

Thanks to cascade training led by WHO offices and the tireless efforts of the regional office’s COVID-19 clinical management team, the cumulative number of the region’s professionals, who are now better equipped to respond to the needs of intensive care / ICU patients, can potentially save their lives, has come to exceed 40,000 health professionals.

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