Newswise — Nick Maxwell was in the second day of teaching a group of 20 Nigerians the skills necessary to serve as emergency medical technicians when a bus carrying a group of student nurses overturned.
As the EMT classes were taking place at a hospital with the closest proximity to the accident, Maxwell, a fellow EMT and teacher Jessica Bedi, and their students found themselves thrust into a teachable moment and also a learning one.
“We were in the middle of practicing oxygen therapy and we looked up and half the class was gone,” said Maxwell, a Creighton University senior from Plymouth, Minnesota. “On Day Three, we were going to talk trauma and shock. But now, you got to see how they operated. It provided a great opportunity to coach them and observe some of their procedures and also note the little cultural differences you find when you see how healthcare is practiced in different parts of the world.”
The students improvised, finding ways into rooms to secure bandages and gauze and return to the matters of treatment. In the end, despite some severe injuries including a broken neck vertebra and ample blood loss, all of the crash victims survived. Maxwell and Bedi’s students had an illustration of how emergency medical services worked and the local government of Calabar, Nigeria, got a lesson in the importance of emergency out-of-hospital care.
“We were the ones learning something new with that,” said Bedi, a graduate student in nutrition and ayurvedic medicine at Bastyr University in Kenmore, Washington, who met Maxwell as he trained to be an EMT in Minnesota. “It was most interesting to see how they triage because it was, in a way, much better than we triage in the U.S. Something that might have taken us 10 minutes to do took them about 45 seconds.”
As much as the Americans were in Nigeria to help teach, Bedi said, she and Maxwell found themselves in Calabar more to facilitate a transfer of knowledge and an exchange of information.
“They have a real heart for the care they provide and the people they serve,” Bedi said. “It was just a matter of giving them some of the knowledge we had to help them further the already excellent job they were doing.”
When it comes to emergency medicine, Calabar is hoping to create a wider system of care, including the use of EMT services and out-of-hospital care.
“Out-of-hospital emergency care is almost virtually unknown in this part of Nigeria,” said Fr. Andrew Ekpenyong, Ph.D., a diocesan priest and a professor of physics at Creighton who is working to build research hospitals in Calabar and is looking to further relationships both in Nigeria and in the U.S., to help the emergent facilities’ missions. “I knew that this kind of care was needed, I just didn’t know how needed it really was. But when I met Nick, I knew I had the guy who could help make it a priority.”
The hospital Ekpenyong is helping build in Calabar will have clinical research facilities, with mobile clinics to facilitate some of the work Maxwell helped launch. The new hospital will be named for Nigerian Archbishop Joseph Ukpo.
Taking a cross-training approach to the classes, Maxwell and Bedi’s aim was to deliver the information most integral for students to immediately begin delivery of out-of-hospital emergency care. With the bulk of the students already well-versed in basic medical education, the aim was to begin showing the specific skills necessary for EMT and out-of-hospital work.
The culminating event in the course was a mass-casualty drill in a torrential rainstorm the students undertook in the middle of Calabar. At the two most-trafficked roads in the city, Maxwell and Bedi set up a major traffic accident, complete with victims soaked in ketchup to simulate blood. With the University of Calabar Teaching Hospital administration, high-ranking Nigerian health ministry officials and the press and public looking on, the students triaged, treated and cleared the victims from the scene in fewer than 12 minutes.
Bedi said while having the nation’s power-brokers as an audience was important, the larger sphere the demonstration reached was the people of Calabar.“The citizens of Calabar stopped their cars and watched what their community was going to offer them in emergency medical care,” Bedi said. “They saw all this unfold, in the pouring rain. It really was a beautiful way to present this in a way the entire community could witness.”
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