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Building a High-Level Isolation Unit in Rwanda and Establishing a Training Program for the Medical Management of
Alexander Uhrig1, Edson Rwagasore1, Laura Dorothea Liebau1
1Alexander Uhrig, MD, is Medical Director, Medical Intensive Care Unit, and Director, Critical Care Medicine, Berlin High-Level Isolation Unit, Department of Infectious Diseases, Pulmonary and Critical Care Medicine; Maximilian Gertler, MD, is a Tropical Medicine Consultant, Institute of Tropical Medicine, and International Health, Charité Center for Global Health; Thomas Cronen, MD, is an Infectious Disease Consultant, Department of Infectious Diseases, Pulmonary and Critical Care Medicine; and Miriam Songa Stegemann, MD, is a Training Coordinator, Berlin High-level Isolation Unit, an Infectious Disease Consultant, Department of Infectious Diseases, Pulmonary and Critical Care Medicine, and Director of Antimicrobial Stewardship Program; all at Charité - Universitätsmedizin Berlin, Berlin, Germany. Edson Rwagasore, MD, MSc, is Division Manager, Division of Public Health Surveillance and Emergency Preparedness and Response, and Claude Mambo Muvunyi, MD, PhD, MSc, is Director General; both at the Rwanda Biomedical Centre, Kigali, Rwanda. Laura Dorothea Liebau, MSc, and David Villinger, MD, are Consultants, Medmissio Institute for Global Health Würzburg, Germany. Florence Masaisa, MD, is an Associate Professor and Chair, Department of Internal Medicine, University of Rwanda, and a Physician, Hematologist, and Head of Clinical Education and Research, University Teaching Hospital of Kigali; all in Kigali, Rwanda. Leopold Bitunguhari, MD, is a Senior Lecturer of Medicine, University of Rwanda, and a Physician, Department of Internal Medicine, University Teaching Hospital of Kigali; both in Kigali, Rwanda. Turid Piening is a Training Coordinator, EFFO-COE Project, and a Research Associate, and Thomas Paerisch, MD, is Project Coordinator, EFFO-COE Project, and a Research Associate; both at the Center of Biological Risks and Special Pathogens, Robert Koch Institute, Berlin, Germany. Menelas Nkeshimana, MD, is Head, Department of Health Workforce Development, Ministry of Health; a Consultant Physician, Department of Internal Medicine, University Teaching Hospital of Kigali; and a Lecturer, University of Rwanda; all in Kigali, Rwanda.
Abstract:
Rwanda is a country in East Africa, a region characterized by highly mobile populations and outbreaks of high-consequence infectious diseases occurring on a regular basis. To increase the level of outbreak preparedness in the region, the Rwandan government and the German Ministry of Health signed a joint agreement to construct a new high-level isolation unit in Rwanda, the first in East Africa, and implement a training program for Rwandan healthcare workers to equip them with the necessary skills and knowledge for medical management of patients under high-level isolation conditions, including intensive care treatment. To better understand the scope and format of the planned training program, a needs assessment was performed based on findings from a standardized survey of 4 intensive care units in Rwanda as well as observations from 2 members of a German high-level isolation unit who completed clinical internships at Rwandan hospitals. In this case study, we describe the necessary steps to promote the sustainability and capabilities of the new high-level isolation unit in Kigali and ensure the successful implementation of the training program.
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