Center for Global Surgical Studies »  CGSS Blog »  An Ounce of Prevention: Soroti Trauma Registry Implementation

An Ounce of Prevention: Soroti Trauma Registry Implementation

Author: Dennis J. Zheng, BA

Date of Publication: Wednesday, April 26th, 2017


During the past eight months spent at Soroti Regional Referral Hospital, I was struck by the distinctive elements of life in northeastern Uganda, from the warmth and generosity of the Teso people to the constant presence of animal life roaming the hospital grounds. As I was there to continue a long-standing institutional collaboration between Soroti and UCSF by implementing a sustainable trauma registry, I took a keen interest in the characteristic injuries of patients presenting to the hospital. What stood out most about these patterns was their sheer consistency. As I issued my registry status updates to the hospital from week to week, falls from heights remained the most common cause of injury, while road traffic incidents maintained a firm grip on second place, and blunt force injuries were never far behind. After it became clear that hospital staff could consistently collect injury data—a great accomplishment in and of itself—they began to ask what the next steps for the project would be. Much of the published literature on trauma registries focuses on their role in forming the basis for clinician-focused quality improvement initiatives such as morbidity and mortality conferences. But their utility can also be extended to the domain of public health (Rogers, Campbell, Saleheen, et al., 2010). Working in a context with limited prehospital care and surgical resources, Soroti doctors and nurses were in agreement about the importance of injury prevention—the vaccine for the disease of injury, so to speak.

In this vein, many of the most important applications of the Soroti trauma registry have taken place beyond the fences of the hospital. After consultations with community members noted the effectiveness of communicating over the airwaves, we began a new campaign to disseminate injury-related information through the hospital’s weekly radio show on the Voice of Teso (88.4 FM).

Dennis884fmPictured above is Dennis Zheng, BA sharing injury-related information through a local radio station called the Voice of Teso.

Covering topics like road safety and prevention of falls in the home, I worked with a senior nurse and a series of intern doctors to communicate our registry findings and discuss ways to preserve the wellbeing of the Soroti young and old. Importantly, every hour-long program included plenty of time for listener call-ins, which ran the gamut from questions about snakebite treatment to comments of appreciation for the medical profession.

Fbsnakebitequestion

The Voice of Teso radio station's Facebook page allowed listeners to post their questions about the weekly radio shows.

The audience’s active participation indicated to me a significant knowledge gap relative to the major role traumatic injury plays in the lives of nearly all Ugandans. This theme was echoed when we joined with the local District Health Officer and District Health Educator to target one of the high-risk groups identified by the trauma registry (and similar registries worldwide) by initiating a program for youth injury prevention. Making visits to eight primary schools throughout the Soroti district, which encompasses nearly two million people, I worked with hospital staff to deliver talks about staying safe in the roads and staying out of fruit trees. We left behind metal signs with printed cartoon messages to serve as reminders that will hopefully stand the test of time.

Metalsigns

Cartoonmessages

As part of the effort to help prevent injuries based on the data collected from the trauma registry in Soroti, metal signs with injury prevention messaging and cartoons were created and placed around schools in Soroti. These signs focused on reminding children to be safe on roads and to avoid climbing fruit trees.

At the end of our visits, the District Health Educator remarked that while much of his time is spent on infectious disease campaigns, traumatic injury has been a silent killer in the region. It's our hope to continue addressing it through the trauma registry and more.

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