Building Emergency Care Systems on the Frontlines of Uganda’s West Nile Region
On Emergency Medicine Day 2026, we spotlight what it takes to deliver care when systems are still being built. In the West Nile region of Uganda, Dr. Sarah Oworinawe is doing exactly that, strengthening emergency care in a region where access is limited.
In the remote district of Yumbe, a single specialist is changing everything. Dr. Sarah Oworinawe is the only emergency medicine physician at Yumbe Regional Referral Hospital, serving a population of over 1.6 million people, including a large refugee community. Less than a year into her role, she is building a functional emergency care system from the ground up.
After completing her Master of Medicine (MMed) degree in emergency medicine at Mbarara University of Science and Technology (MUST), Dr. Sarah chose to go where the need was greatest. Her MMed specialisation was supported by a Seed Global Health (Seed) scholarship in collaboration with Ministry of Health.
She is one of only 27 locally trained emergency medicine physicians in Uganda, a growing but still critically small workforce developed through collaboration between Seed, the Ministry of Health, Makerere University, and MUST.
Building an emergency department
When Dr. Sarah arrived in Yumbe, emergency care existed but was limited and without structure. “There was no formal triage system, no organized resuscitation area, limited equipment, and minimal documentation,” she recalled.
Her first priority was working with the existing hospital team to establish a functional triage system. By categorizing patients into red (critical), yellow (urgent), and green (stable), care is now prioritized based on need.
Dr. Sarah has since established a dedicated resuscitation area and is supporting other facilities in the region, including Adjumani General Hospital, to develop both stabilization and resuscitation capacity.
For Dr. Sarah, building systems goes hand in hand with building people.
The impact
The results are already visible, Dr. Sarah explained. “Patients are beginning to receive more timely care. There is earlier diagnosis and faster intervention.”
She recalled a case of a critically ill mother referred to Yumbe with severe pre-eclampsia. The patient deteriorated rapidly, slipped into a coma, and required intubation.
“At that point, she needed ICU-level care that we could not provide,” she said.
Dr. Sarah mobilised an ambulance from Arua to transfer the mother from Yumbe to Gulu, a journey of more than 225 kilometres, to access life-saving specialized care. After stabilizing and intubating her, Dr. Sarah stayed with the patient through the difficult journey, navigating rough roads and delays crossing the River Nile at Obongi.
“Along the way, we had to stop multiple times to manage her airway, administer medications, and ensure she remained stable,” she adds. “We reached Gulu, where she was admitted to the ICU and managed appropriately. That mother survived, and it is one of the moments that has stayed with me. When a patient comes in at their worst and survives, that is the reward.”
How her training is supporting her work
Through Seed’s support to MUST, Dr. Sarah received training and bedside mentorship in emergency medicine. This included access to simulation equipment and structured learning opportunities that strengthened both her clinical and teaching skills.
“Programs like ECHO, led by Seed together with the Ministry of Health which provide structured online learning and mentorship sessions for health care workers, help me stay updated and connected. Medicine evolves quickly, and continuous learning is essential,” she said. “That foundation has made it possible for me to apply these skills in a real-world, resource-limited setting.”
In 2025 alone, Seed reached more than 6,000 health workers through ECHO training in various emergency response related topics.
Why strengthening emergency care is critical in places like Yumbe
Dr. Sarah said that Yumbe’s limited access to advanced care makes a strong emergency system essential because for many people, Yumbe Regional Referral Hospital is the only option. She added that Yumbe’s proximity to multiple border zones also makes the region vulnerable to the transmission of infectious diseases.
“Strengthening emergency care in the area means identifying critical illness early and providing timely intervention where it’s needed the most. That directly translates into saved lives and better outcomes,” she said.
A strong emergency system also reduces mortality and morbidity from trauma, obstetric emergencies, infections, and other acute conditions. The region hosts one of the largest refugee populations in the country, making emergency services even more critical.
“Strengthening health systems benefits both host communities and refugees,” she added.
Dr. Sarah’s work shows that strengthening emergency medical services in Uganda is not just about equipment or infrastructure, but also about people. Investing in highly skilled health workers, i.e., emergency medicine doctors, means Uganda is creating a cadre that has the skills and confidence to act when it matters most, strengthen the health system overall, and mentor and teach their colleagues to strengthen the quality of care and save lives.
