Every Second Matters–Ketamine Humanitarian Crisis

Grant awarded: £450,500

Lead organisation: Massachusetts General Hospital, Division of Global Health and Human Rights

Partnering organisations: UNICEF; County Ministries of Health African Institute for Health Transformation (AIHT) at Sagam Hospital; Maseno University School of Medicine Department of Anesthesia; College of Surgeons of East Central and Southern Africa (COSECSA)

Project length: 2016-2018

Study locations: Garissa and Turkana Counties, Kenya

Principal Investigator: Thomas F. Burke MD, FACEP, FRSM

  • Mid-level providers being trained on ESM-Ketamine at Sagam Community Hospital in Luanda, Kenya @ Sagam Community Hospital


Five of the 7.2 billion people on earth have limited access to emergency surgery when needed and one of the primary barriers is a lack of anesthesia services. We have compelling and encouraging preliminary data from our pilot program that introduced our ketamine anesthesia package in a non-humanitarian crisis setting.

This project aims to rigorously test the safety and effectiveness of Every Second Matters - Ketamine Humanitarian Crisis™ (ESM-Ketamine HC™) when administered by non-anesthetists in the crisis-affected regions of Kenya that border South Sudan and Somalia. We aim to improve access to emergency and life-improving surgery after implementation of the ESM-Ketamine HC package in Garissa and Turkana counties. By rigorously testing our novel, bounded and protocolized package, we will greatly contribute to the humanitarian field's understanding of the effectiveness of this intervention to address the anesthesia gap crisis during public health emergencies.

Expected outcomes:

This project will facilitate emergency, life-saving, and life-improving operations in hospitals located in the two target research counties. Additionally, in the short term, we anticipate gaining a clear picture of the feasibility, safety, and impact of the ESM-Ketamine HC package in these two humanitarian crisis settings, potentially guiding adjustments for process improvement or other actions.

The longer-term potential impact of a scalable, definable, and safe rescue anesthesia package is absolutely enormous across countless resource-limited settings, including those affected by humanitarian crises. If the ESM-Ketamine HC package intervention proves successful, scalable, safe, and effective, access to safe surgery with its potentially life-saving impact will be greatly enhanced.

Additionally, this critical data allows for the development of economic models that could more easily overcome and navigate the challenges of barriers-to-access due to cost of anesthetic services.


Elrha is a registered charity in England and Wales (1177110).

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