Uganda has….

  • nearly the same population as Canada (36 million)
  • one of the highest rates of traumatic injuries in the world (largely due to road traffic injuries)
  • few health professionals and limited resources to treat this overwhelming burden (over 300 orthopaedic surgeons in Canada; 26 in Uganda)

The Global Burden of Disease Study estimates that 10% of global deaths are due to injuries and that if the current trend persists, this burden will greatly increase in the next 20 years. Trauma and particularly road traffic injuries are a major but neglected public health challenge. The World Health Organization (WHO) in 2004 determined that motor vehicle related injury is seriously harming global health and development. Their World Report on Road Traffic Injury Prevention recorded a 63% reduction in road traffic fatality rate in Canada between 1975 and 1998 while at the same time predicting an 80% increase in the fatality rate in Sub-Saharan Africa between 2000 and 2020. It is imperative that countries like Canada share their knowledge and expertise with countries like Uganda to reduce the impact of trauma on human suffering and poverty. This project will aim to educate health care providers in Uganda in systems and techniques for delivery of trauma care. This will result in a sustainable improvement in the care of individuals who are injured and will reduce the rates of death and disability secondary to trauma. The proposed project fits with Makerere University’s Department of Orthopaedics mandate to provide education for medical students, surgical trainees, nurses and paramedical personnel in the care of trauma and particularly musculoskeletal trauma in Uganda.

Mulago Hospital is the national referral hospital and training hospital for Makerere University receives the majority of severely injured people of poor economic status in the country. The project will help with the direct delivery of care to those individuals and will create a sustainable program for the region as it is currently only one of only two orthopaedic training centres in East Africa.

Success in this low resource setting could provide groundbreaking progress and training modules for under resourced areas. The ability to create effective training modules and build capacity in this setting will create an effective paradigm that can be applied to numerous settings. The issue of disability due to neglected injury creates a burden on the health care system and economy of, not just Uganda, but many low-income countries and even rural and remote areas of middle income and high-income countries. Road traffic injuries, just one area of orthopaedic trauma, are set to rank third in disability adjusted life years (DALY) by the year 2020. Current systems for treatment must be immediately improved to handle this growing disease burden.