EKITI-CANADA TRAUMA CENTRE Ekiti State, Nigeria

1. EKITI-CANADA TRAUMA CENTREEkiti State, Nigeria

2. Concept The project involves the building a state of the art Trauma Hospital that will cater for the residents of Ekiti State in particular and Nigerians in general. This is borne out of desire to provide quality and affordable emergency services to accident victims in a timely and cost effective manner. The aim is to make this venture a self sustaining under the management of experts in medical field with local and international influence in the field of medicine.

3. Trauma System A trauma system is an organised and co-ordinated effort which delivers the full spectrum of care to an injured patient, from the injury to transport to acute care to rehabilitation. It represents a continuum of integrated care between out-of-hospital and hospital providers with close co-operation of medical specialists and other health care providers in each phase of care. The trauma centre constitutes a medical facility where the acutely injured patient can receive full resuscitation, assessment and appropriate disposition on a 24 hour basis.

4. Features of Trauma Centre • Referral centre for seriously injured patients • Comprehensive external disaster response plan • Identifying the need for the new resources and research related to trauma centre • Demonstrating leadership role in the cost effective and efficient delivery of medical services in the specialised area of trauma management, including control, prevention programs and training • Provision of cares for patients who require intensive care following multiple trauma or surgical procedures (including burns, cardiovascular, vascular, thoracic, gynaecology, head and neck and urology surgery), or who need support for complex medical disorders (including cardiac, renal and oncology).

5. Units: The department will be a purpose built modern facility, designed to manage in excess of 50,000 patients per annum. It will be divided into 6 main clinical areas (units). Trauma Centre -- 4 resuscitation / theatre bays with overhead imaging Resuscitation Area--4 bays with everything required for full patient resuscitation Acute Area --17 bays including 2 seclusion rooms for psychiatric emergencies. Quiet Area -- 6 bed short-stay facility within the department. Fast-track -- 7 bays including facilities for ophthalmology & ENT examination. Neurosurgical Unit -- 2 procedure rooms for neurological assessment and management .

6. There is a dedicated imaging department with: · 2 general radiology rooms · 1 helical CT scanner Each year the Emergency & Trauma Centre attends to approximately 37,000 emergency patients. Of these patients, 50% have serious problems requiring a triage category of 3 or above. Approximately 297 (3.2%) require immediate resuscitation. More than 60% of patients presenting to the Emergency & Trauma Centre may require admission to hospital.

7. Staff at the Emergency & Trauma Centre • Director • Emergency Physicians • Nurse Manager • Nurses • Administrative and Other Support personnel Rotations out of the Emergency & Trauma Centre include: • Intensive Care Medicine • Anaesthesia • Paediatric Emergency Medicine • Hyperbolic Medicine • Medical Administration • Junior Medical Staff

8. Rapid Response: Fast-moving ambulances are required to evacuate patients from the scene of accidents. In the long term, subject to financial resources availability, helicopters are required to ensure fast evacuation. Most of the doctors whose services are required studied for advanced medical training locally and overseas.

9. Trauma and Neuro-surgery The Trauma Centre will conduct leading-edge research on trauma prevention, treatment and rehabilitation, with an emphasis on headinjury. The hospital's neurosurgical unit, one of the largest in Canada, specialises in traumatic brain injury and neurooncology (treatment of brain tumours). The Neurosurgery Program: • Trauma team equipped to deal with multiple trauma injuries in adults; • Multidisciplinary approach with professionals from diverse areas of expertise working together to provide patient-centred care;

10. Head injury clinic provides rehabilitation follow-up after discharge; • Trauma prevention programs; • State-of-the-art traumatic brain injury research laboratory, researching improved treatment options from mild concussion to major injury; and • Clinical trials unit to compare different treatment/rehabilitation options. • Neurosurgery areas of specialty: • Brain injury due to trauma; • Cancer that has spread to the spine; • Ear tumours; • Photo-dynamic therapy (treatment of tumours using lasers); • Pituitary tumours; • Tumours located at the base of the skull (previously considered inoperable); and • Vascular Neurosurgery, aneurysms and facial nerve conditions.

11. Funding: Local Sources of Funding • Ekiti State Government • Ekiti community associations in Nigeria • Other State Governments in Nigeria • Federal Government and agencies • Non-Government Organisations • Private and Public Organisations • Private and Public health institutions • Philanthropic Individuals International Sources of Funding • Ekitis (and indeed Nigerians) in Diaspora and their • World Health Organisation community associations • Canadian International Development Agency (CIDA)

12. Policy and Funding Plans • Multilateral Development Banks (MDBs) • Agency for International Development • Community Sector Investment Fund • International Red Cross • Health Fondations across the world The policy frame work will be developed as a separate document. A specialised fund-raising organisation may be employed to support fund-raising activities.

13. Accountability& Transparency • Board of Directors made up professionals and community development experts of proven integrity. • Membership drawn from Nigeria, Canada, the United States and Europe. • Involvement of Audit and Oversight Committee. • Ekiti Kete Canada Trauma Centre Trust Fund will be opened, as a separate account, for deposit, disbursement, monitoring and controlling the financial management of the Centre. • Involvement of Association of Fundraising Professionals, Canada to monitor accountability.

14. Phase One This is the project launch stage, that involves the ceremony held in Toronto, Canada, on October 29, 2005, the acquisition of land in a suitable location and the building stage, where all the structures necessary for take off will be custom designed. Twin buildings - a three storey and five storey buildings are being proposed – • Level 1 Will be a car park with well equipped Ambulance department, with parking for at least 5 ambulances. • Level 2-Will be Outpatient area comprising of a- Resuscitation Area with 4 bays fully equipped for resuscitation. b- Acute area with 15bays for acute cases c-Fast tract with 10 bays to attend to not too serious trauma emergencies.This will include an Ophthalmology and ENT examination bays equipped with the necessary tools. Implementation This will be in phases with a view to becoming fully functional in five years.

15. d- Imaging Department Equipped with X ray rooms and CT scan unit. • Level 3.This will be the Operating Suite with 4 fully equipped theatre units with overhead imaging. 3 for General Surgery and 1 for Orthopaedic Surgery. • Level 4. Will be the Intensive Care Unit (ICU) comprising of 20 beds. • Level 5 Will be for Male and Female wards comprising of 30 beds. 10 of these beds should be post operative recovery rooms equipped with ventilators. It is important to stress the fact that appropriate administrative offices will be put in place as necessary.

16. This is the stage that all the necessary equipment required for the smooth running of the Hospital will be procured. This can be done concurrently with phase one if the finance is available. Phase Two Phase Three This is the staffing phase where all the necessary staffs will be employed to manage the Facility. • Director • Chief of Staff • Medical Consultant Specialists in Orthopedic (Trauma), General Surgery, Anaesthesia Emergency Medicine, Radiology Medical Officers

17. Nursing Chief Nursing Officer Matrons Registered Nurses Staff Nurse Nursing Assistants • Paramedical Secretaries/Clerks Laboratory Assistants X Rays Technicians Drivers Cleaners Orderlies

18. To make this venture a self sustaining one, it must be able to generate income from the services to be provided at a reasonable cost affordable to the target populace. Given the situation of things in Nigeria and Ekiti in particular affordability of the services to be provided will be too much for the majority of the clients that need the services so a need for alternative source of funding to sustain this facility is crucial to the continuity of care the centre will render. Operational Issues Intravenous Fluids A sustainable operation is only possible through good management and continuous funding. The Centre will engage in other activities that will be profit oriented and viable enough to support this project. One of such ventures is building a factory that makes Intravenous Fluids.This product is a consumable to all hospitals. With quality production and proper marketing, this constitute a regular source of income. The modus operandi for the smooth take off of this important aspect of the project is being worked out too and update will be forthcoming soon.

19. Cost Estimates (All in Canadian Dollars) Phase 1: Land & Buildings CA$1,000,000 Phase 2: Equipment 1 Outpatients Equipment Resuscitation equipments $560,000 25 Couches 30,000 Theatre Equip 1,000,000 Opthalmology Department 500,000 ENT Department 300,000 2 Radiology Departments X Ray Unit (1unit) 1,000,000 CT scan Unit (1unit) 1,800,000 MRI.(1unit) 2,360,000 3 Theatre Department Operating Suite (4units) 4,000,000

20. 4 Wards Male & Female ward equipment (30beds) 250,000 ICU Equipment (20beds) 1,000,000 Recovery Room Equipment (10beds) 250,000 5 Paramedical Equipment Ambulances (5 units) 1,000,000 Maintenance equips 250,000 Sub-total (Equipment) 14,300,000 Phase 3 – Personnel Recruitment 25,000 TOTAL PROJECT COST 15,325,000

21. Areas of concerns • Land – Location and adequate room for expansion Ideally, the Centre should be conveniently located close to an existing functional hospital or medical centre. • Accessibility to essential facilities like water, electricity and telephone services. • Good road network around. • Mortuary

22. How your Gift Helps Even the most brilliant scientists needs labs, equipment and colleagues to make discoveries that have the potential to save and change lives. Even the most compassionate, experienced doctor needs the technology to provide patients with the best care. And every patient needs and deserves rooms and facilities that are designed to encourage the healing process. Your gift of generous donations will help in the implementation of this laudable project, for the benefit of mankind and to the glory of God.