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On March 5, 2014, the Johns Hopkins International Injury Research Unit (JH-IIRU) will formally launch “Improving Trauma Care Systems to Reduce the Burden of Road Traffic Injuries in the Sultanate of Oman,” with a signing ceremony in Muscat.

The project will assess the trauma systems in order to improve hospital and pre-hospital care. The first stages of the project will engage members of the Omani government and The Research Council (TRC) as well as potential stakeholders and collaborators, such as the Ministry of Health and academic institutions such Sultan Qaboos University.

In February, JH-IIRU team members Amber Mehmood, Kent Stevens and Katharine Allen visited several hospitals, including the Royal Hospital, the Armed Forces Hospital, Khoula Hospital Sultan Qaboos University Hospital, Sohaar Hospital and Nizwa Hospital for potential collaborations.

JH-IIRU director, Adnan Hyder will participate in the signing ceremony, which will also include H.E. Dr. Hilal Al Hinai, Secretary General of The Research Council; Dr. Saif Al Hiddabi, member of the steering committee of the national road safety program; and Dr. Talal Al Belushi, board member Oman Road Safety Association (ORSA)

Next steps for the project will include both quantitative and qualitative assessment of various components of trauma care in Oman, training workshops for clinical and research capacity building in trauma/injury prevention and pilot testing hospital based trauma registries.

Stakeholders and decision makers across health and allied sectors must play a key role in developing and implementing innovative solutions to road traffic injuries and trauma care, especially in developing nations, according to recommendations published in a new report developed by researchers at the Johns Hopkins Bloomberg School of Public Health. The report was issued as part of an international health summit held in Doha, Qatar on December 10.

"Road Injuries and Trauma Care: Innovations for Policy," written by professor of International Health and director of the Johns Hopkins International Injury Research Unit (JH-IIRU), Adnan Hyder, together with JH-IIRU faculty Prasanthi Puvanachandra and doctoral student Kate Allen, identified the best available evidence, good practices and promising innovations emerging around the world on road traffic injury prevention and trauma care.  Developed with a team of global experts, including colleagues from the World Health Organization, The Global Road Safety Partnership, private sector and Bloomberg Philanthropies, the report was released as part of the inaugural World Innovation Summit on Health, 2013 (WISH-2013).

“Road traffic injuries kill more than 1.2 million people worldwide each year and injure an additional 20 to 50 million. They are the 8th leading cause of death globally, and the leading cause of death for young people aged 15-29 years,” said Hyder. “Our report assesses the current spectrum of available innovations to address road traffic injuries and trauma care, contextualizes the work that needs to be undertaken to move the field forward and synthesizes this knowledge into practical policy recommendations for decision-makers.”

Perhaps most importantly, the report takes a global and multi-sectoral perspective, with sensitivity to those regions of the world that face specific social, economic and financial challenges, to examine the current work being done and provoke both discussion and action, especially in those areas requiring immediate attention or urgent retooling of approaches.

“The symposium in Qatar—the first of its kind—stresses the pivotal role innovation plays in addressing global health challenges,” said Professor David Bishai, forum member and senior technical advisor to JH-IIRU. “I believe the resulting report represents an important milestone for global health.”

The report concludes by setting forth ten recommendations the authors hope will be taken up by decision-makers and serve as a foundation for future work, including urging stakeholders to promote and use evidence-based innovations for road safety and trauma care, and asking global health leaders and UN agencies to ensure road safety and trauma care are included as key concerns for sustainable global health.

The summit, a high-profile initiative aimed at promoting and facilitating innovations in the delivery of healthcare around the globe, was attended by high-level officials, key decision-makers, government officials, academics, researchers and business leaders focused on tackling some of the most pressing global health challenges like road traffic injury and trauma care, as well as mental health, obesity and end-of-life care, among others.

“The cost of dealing with the consequences of these crashes, including trauma care, is in the billions of dollars. Moreover, in low- and middle-income countries, the rate of road traffic injuries is twice as high as in developed nations. While road safety issues have recently begun garnering more attention, the reality is that road injuries are responsible for more than one third of the world’s injury burden. These shocking numbers are unacceptable and represent a call to action for the global health community,” added Hyder.

JH-IIRU director, Adnan Hyder, speaks at the inaugural World Innovation Summit for Health

"Road Injuries and Trauma Care: Innovations for Policy" is available for download at http://www.wish-qatar.org/reports/2013-reports.

Recently, JH-IIRU director, Adnan Hyder and associate director, Kent Stevens, were invited to participate in surgical Grand Rounds at Virginia Commonwealth University (VCU) Medical Center.

While there, Dr. Stevens presented on care of the injured patient in the developing world, focusing on the Unit’s trauma care efforts in Kenya as part of the Bloomberg Philanthropies Global Road Safety Program.

There are four specific aims of the trauma care efforts in Kenya, 1) to understand and evaluate the transport systems in the country (both formal and informal); 2) to evaluate the existing emergency response system; 3) to explore the triage capabilities of participating hospitals/healthcare facilities;  and 4) to evaluate hospitals’ resources and infrastructure available for the injured patient.

In order to accomplish these goals, it is important to have multi-sector engagement including hospital administrators, practitioners and clinicians as well as the local and national governments and Ministries of Health. It’s equally important, Dr. Stevens said, to focus efforts on areas that will have the most impact.  

In order to be most effective, the Unit’s trauma care efforts are focusing training of both pre-hospital and in-hospital trauma care providers while also developing and implementing trauma registries,  and working to develop a dependable EMS communications system. The Unit is also advocating for increased stakeholder engagement in order to strengthen trauma care legislation in the country. Dr. Stevens is also developing a Trauma Care Quality Improvement Program and is o recommending continuing the trauma care evaluation using the Trauma Care System Profile (TSP) tool.

Improving the care of the injured patient in Kenya must be a multi-step approach that involves numerous organizations working in the country in an ongoing effort to ensure longevity of the program.

On October 10-11, JH-IIRU hosted two experts to discuss care of the injured patient in low- and middle-income countries. Hosted by associate director, Kent Stevens, the experts met with members of the JH-IIRU team.

Dr. Razzak is a long-time JH-IIRU collaborator and affiliated faculty member who is currently serving as the chairman of the Department of Emergency Medicine at Aga Khan University and Director of the WHO Collaborating Center in Emergency Medicine and Trauma at the Aga Khan University in Pakistan. Dr. Razzak is also part of the Aman Foundation, a non-profit trust located and operating in Pakistan. The foundation aims to make strategic interventions in the country to support development in the areas of healthcare, education and nutrition. Dr. Razzak is CEO of AmanHealth, which oversees the foundation’s emergency medical service, AmanAmbulance. This service consists of a strategically positioned network of 100 state-of-the-art ambulances, with doctors and emergency medical technicians (EMTs) on board to provide comprehensive, round-the-clock coverage to the city of Karachi.

Dr. Rizwan Naseer is the Director General of The Punjab Emergency Service (Rescue 1122), the largest emergency humanitarian service of Pakistan. Rescue 1122 was developed in response to the failure of repeated attempts to revitalize and modernize the old organizations mandated for emergency management. Because of the services performance during emergencies and disasters in recent years, Rescue 1122 has been designated a Disaster Response Force by the Provincial Disaster Management Authority (PDMA), Government of the Punjab.

The experts discussed the Bloomberg Philanthropies Global Road Safety Program, as well as trauma care efforts in Kenya and how to apply the work of JH-IIRU, the Aman Foundation and Rescue 1122 in the developing world.  

By all accounts, the meeting was very successful, and JH-IIRU looks forward to further collaborations with Dr. Razzak and Dr. Naseer.

Dr. Kent Stevens, right, gives Drs Junaid Razzak (left) and Rizwan Naseer (center) a tour of the Hopkins ER

This month, the Johns Hopkins International Injury Research Unit (JH-IIRU) is featured in the latest issue of The Globe, the newsletter of the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.

The article highlights not only the unit’s overall capacity-building activities in low- and middle-income countries and the training of trauma care professionals as it relates to the Road Safety in 10 Countries project (RS-10) but also features new grants the unit is working on in the global field of injury prevention.  One such grant is the Chronic Consequences of Trauma, Injuries and Disability (Chronic TRIAD), an NIH award that will strengthen work on the long-term health and economic consequences of injury and disability in Uganda.

The piece also outlines new courses in injury prevention and a seven-module on-line certificate program in road traffic injury prevention and control that will be available this spring, all at the Johns Hopkins Bloomberg School of Public Health.   

To read the entire article, titled, “International Injury Research Unit: Successful Capacity-Building Programs Lead to New Grants and New Initiatives,” click here: http://www.jhsph.edu/departments/international-health/the-globe/winter-2013/index.html