The birth of an emergency department

Abstract

Emergency Medicine (EM) as a specialty is still quite new in South Africa and even more so in the province of KwaZulu-Natal. The province boasts no more than five Emergency Medicine physicians and four fledgling, specialist-run emergency departments. One of these, the emergency department (ED) at Edendale Hospital in Pietermaritzburg, is threatening to become a flagship ED in the city and the province, with a motivated EM team, acceptance and encouragement by all in-patient specialities, a hospital that is a prototype for the planned National Health Insurance (NHI) and massive infra-structure and facilities development, including the construction of a new, purpose-built, ED. This narrative will walk you through the ’birth’ of this ED from humble beginnings as an offshoot of the surgical department where the wooden walls of surgical outpatients were demolished to make way for resuscitation bays and dressing rooms were converted into ED ’minors’. Also the massive process of planning, designing and building a new ED. It will attempt to paint a picture of the administrative challenges overcome to develop an ED; myriads of meetings and confusing conformities to ensure acceptance by the Health Professionals Council of South Africa and the South African College of Emergency Medicine. It will outline the incredible academic progress, training programme and success in fellowship and diploma exams. But most of all, it will highlight the passion and commitment by ED staff at Edendale Hospital to build a comprehensive ED, efficient and excellent and one where staff have evolved from confused ’casualty’ cooks to EM doctors providing quality, comprehensive emergency care.