In continued support to improve Botswana’s emergency preparedness and response plan, WHO is conducting Basic Emergency Care (BEC) training sessions across the country. Developed by WHO in collaboration with the International Committee of the Red Cross (ICRC) and the International Federation for Emergency Medicine (IFEM), the training targets frontline health providers who manage acute life-threatening conditions with limited resources. The training content is designed to equip the participants with the necessary skills to provide emergency care to people in need.  Specifically, the BEC-trained healthcare workers are capacitated to minimize further harm to the patients, reduce pain, prevent potential complications, and save lives. 

The COVID-19 pandemic presented the need to strengthen health emergency response at all levels in the country. Public health emergencies are rising in frequency and severity primarily because of climate change, population mobility, urbanization, and increased density. More than three times more since 1980, outbreaks are reported annually worldwide, and Botswana is not an exception. These health emergencies affect a wide variety of populations, ranging from adults to children. While specialized care may not be always available in some places, a systematic approach to responding to health emergencies can save lives. 

During recent workshops in Greater Gaborone and Francistown districts, 55 basic emergency care clinicians who are actively involved in emergency response and management of COVID-19 patients were trained to provide lifesaving emergency health care in their areas.  

Since its inception in Botswana, in Okavango district, in 2022 the workshops have also been conducted in Chobe, Ngami, Ghanzi, Greater Phikwe, Greater Palapye, Mahalapye, and Kgatleng districts. As the WHO’s initiative has been well received by the Government of Botswana, the Ministry of Health proposed rolling it countrywide to improve the management of acutely ill patients in emergencies. Since last year, 2022, a total of 181 basic emergency care providers and seven master trainers have been trained. 

Healthcare providers must sometimes respond to patients with acute symptoms with unknown causes. As such, Basic Emergency Care training introduces a systematic approach to managing these potentially life-threatening conditions even before a diagnosis is known. The training is based on the clinical recommendations of the WHO Integrated Management for Adolescents and Adult Illness (IMAI) District Clinician Manual, the WHO Pocket Book of Hospital Care for Children, the WHO Emergency Triage Assessment and Treatment (ETAT), and the WHO Integrated Management of Pregnancy and Childbirth. It includes modules on the primary and secondary surveys of acutely ill patients in the emergency setting. Interventions taught at the training include management of trauma, difficulty breathing, shock, and altered mental status. Most life-threatening conditions, whether the original cause was medical or surgical, infection, or injury, will present with one of these. In some cases, the diagnosis may be known, while in others, intervention may be required before a diagnosis can be made, perhaps because of limited diagnostic resources but often because of the acuity of the condition. 

The Basic Emergency Care training, in the long run, is aimed at building a pool of WHO- and Ministry of Health-registered trainers in Botswana that can progress to master trainers who can provide in-country BEC capacity building. This will in turn capacitate the Ministry of Health with African Federation for Emergency Medicine (AFEM) accredited Basic Emergency Care providers based in all districts across the country.  

Botswana has very few referral hospitals for a population of slightly over 2.3 million people (2022 Population and Housing Census). In one of the most sparsely populated countries in the world, the current referral hospitals are at a great distance from one another. As a result, patients often need to be transported long distances to receive the life-saving interventions they require. Therefore, the importance of basic emergency care cannot be overstated, as it serves as the first line of defense in providing immediate assistance and potentially saving lives. It plays a vital role in safeguarding the health and well-being of the people of Botswana during critical situations. 

Basic Emergency Care training conducted by WHO plays a huge role in saving more lives in Botswana enabling healthcare providers to ensure prompt intervention and early recognition for referral to specialized health facilities for further patient care.