Emergency physicians at St. Paul's, led by Global Emergency Medicine Initiative Chair Dr. Andrew Kestler (left) and supported by Dr. Dan Kalla (right), head of St. Paul's Teck Emergency Centre, are training Emergency Medicine Fellows in Nepal.

Global Emergency Medicine Initiative

Promise Magazine: Spring/Summer 2016
by Joseph Dubé

When catastrophe strikes, St. Paul’s emergency doctors are accustomed to finding themselves central to the action.

“It has to do with our location,” explains Dr. Dan Kalla, head of the Teck Emergency Centre at St. Paul’s. “We’re at the epicentre of so many events and mass gatherings downtown. We’re the closest hospital, and as a result, when things like a Stanley Cup riot occur, we’re trained to adapt on the fly and respond quickly to these events.”

The impact of this expertise in disaster preparedness can be felt locally and internationally, from the streets of Vancouver all the way to Nepal.

Training emergency doctors in developing countries

Training emergency doctors in developing countries St. Paul’s emergency physicians, as part of a volunteer initiative developed to teach emergency medicine in developing countries, have made several trips to Nepal, where they’ve instructed a group of local doctors (fellows) in a number of core subjects, including pre-hospital care, disaster preparedness, triage and general emergency medicine.

“We were involved, and continue to be involved, in training emergency specialists in Nepal at the Patan Academy of Health Sciences in Lalitpur, a historic city close to Kathmandu,” says Dr. Andrew Kestler, emergency physician at St. Paul’s, chair of the Global Emergency Medicine Initiative (GEMI) and advisor to the Emergency Medicine Fellowship Program in Patan.

When the disastrous earthquake of 2015 struck the Kathmandu Valley, killing 9,000 people and injuring double that number, the fellows were able to draw on skills taught by St. Paul’s physicians and effectively lead the emergency response during the terrible aftermath.

“One of the basic items in the tool kit of an emergency doctor is emergency preparedness and response, so the people we helped train were very well equipped when the disaster hit,” says Kestler. “They had the opportunity to really become leaders during that incident.”

“There were anecdotal stories about how the hospitals where the trained fellows worked were much better prepared, or better able to handle the disaster, than some of the other hospitals.”

Funding new research in emergency medicine

Funding provided by Vancouver-based company Teck Resources has been essential in establishing both GEMI and supporting emergency care training in Nepal.

Using money from the Teck Emergency Centre Innovation Fund grant, Kestler developed the partnership between GEMI at Patan Academy of Health Sciences, the University of Alberta and the University of Calgary, which led to their shared success in Nepal. More recently, Teck donated an additional $20,000 to the GEMI collaboration with the Patan Academy of Health Sciences.

According to Kalla, Teck Emergency Centre Innovation Funds offer critical support for a wide range of worldclass research projects undertaken by St. Paul’s emergency department: “The Teck scholarships have allowed research, which has yielded a diverse and impressive score ñ everything from HIV research and testing to Dr. Kestler’s program in global emergency medicine.”

St. Paul’s emergency department has been unique in Canada in that its physicians have long funded research out of their own clinical salaries.

“It’s a sort of tithing program, where up to four per cent of our earned income goes back into subsidizing research,” says Kalla. “However, we obviously don’t have an endless resource.

“All of our researchers go above and beyond. However, Dr. Kestler stands out because the program he’s led has had a global impact,” says Kalla. “What they are doing in Nepal is phenomenal. They’re going over there on their own money and time and giving altruistically to train these doctors, and with the St. Paul’s name attached to it. It makes good global citizens of us all.”

The Tithes that Bind

For the past 20 years, the physicians of St. Paul’s emergency department have contributed funds from their own salaries to support in-house research in emergency medicine. The practice was initiated by a group of doctors who agreed to contribute four per cent of their collective salaries into a fund earmarked specifically for research.

To date, St. Paul’s emergency doctors have contributed well over $1 million for research—an effort that has also helped attract many of the best and brightest minds in emergency medicine. Their collective efforts have helped fund and lead world-leading research in atrial fibrillation, cardiac resuscitation, sepsis and soft tissue infection, to name but a few.

Emergency medicine is a relatively new discipline and as such there is a monumental amount of clinical, patient-oriented research that needs to happen now. The physicians of St. Paul’s are committed to seeing it done.

To learn more about how you can support research and innovation in emergency medicine at St. Paul’s, please contact St. Paul’s Foundation at 604-682-8206 or donate online at http://helpstpauls.com/donate