• ashirk@gmail.com
  • Kijabe, Kenya
On emergency care. . .

On emergency care. . .

Four years ago, Shruti and I sat at my kitchen table and tried to envision what a concise and concentrated curriculum on pediatric emergency medicine would look like. How would we teach the thing that was so ingrained in our medical DNA that it seemed like breathing?

We talked. I typed. 40 weeks came together and then we started to teach, almost immediately.

First two, then 4, then 7, then 3 more clinical officers came through the program . . . one by one I watched emergency medicine and critical care for children seep into their conciousness.

Their petrified fear of children dissipated, replaced by a healthy respect for the precise care a child needs. I didn’t spend every call night at the hospital from dawn to dusk. We saw our mortality rates drop. We saw our PICU and HDU expand, and baby after baby went home well.

We taught it again, and again. I learned. They learned. We learned. The whole pediatric team came together to make it come alive.

And they loved it. They loved seeing sick kids get drastically better. . .and the critical role that they played in it happening.

Friends and colleagues dreamed bigger, taking it from a weekly program to a full scale diploma and we began to put together a formal curriculum to send to the clinical officer’s council. Wayne worked on format and resources and bullet points and took the document from 2 pages to 80.

The Council came. We explained. We revised. They asked more questions. Gave more guidance.

We got a new panel, with new ideas, and we adjusted again.  And again. And again. We struggled and persisted.

How do we set this apart from just pediatrics, but emphasize the distinction of care that is needed from 1 day to 15 years ?

In addition, emergency care is unique. The first 5 minutes have to be perfect, no matter who, no matter what.  One misstep, and all can be lost. But when the team runs seamlessly, it is the difference between life and death.

Nothing could be watered down. Nothing essential left out.

We also had one more essential thing to teach. In the emergency and the chaos, we have to trust that we are the team God has put together for that child, at that moment, and let that faith steady our hands and expand our limited resources.

It is a beautiful and nuanced balance.

And after all the back and forth- after all the philosophizing and rewriting- last week, the Clinical Officers Council approved the program. I had to call Bob to confirm the email. . .5 years of planning and escalating and expanding vision – approved. In a minute. In a 5 o’clock on a Tuesday email.

A higher diploma in Pediatric Emergency and Critical Care in Kijabe. 
A way to definitively expand and strengthen emergency and critical care of kids in Kenya beyond the fellowship, beyond Kijabe’s doors yet again.

To say I am excited is an understatement. A little scared. A bit awestruck. Grateful for the team I have around me and the endless stream of people who believe in it.

Celebrate with us for a moment. We are getting ready to recruit our first class.

I can’t wait to look back at this a decade from now.

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