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Principal Investigator: Thomas F. Burke, MGH


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.


Latest Updates

From the Front Lines: A Surgeon on Increasing Access to Emergency C-Sections When No Anesthetist is Available

Aug 2018

Turkana County in Kenya faces unique barriers in access to care, particularly flooding, poor roads, and the rural environment. “Often people are five to six hours from the hospital, sometimes…


Closing the ‘anesthesia gap’ in the face of unexpected challenges

May 2018

As our in-country partner, Sagam Community Hospital (SCH) is the central training hub for ESM-Ketamine providers, we sat down with Mr. Javan Imbamba, a Clinical Officer at SCH, and Mr….


Related Resources

Peer Reviewed Health Systems & Services

Safety and Feasibility of a Ketamine Package to Support Emergency and Essential Surgery in Kenya when No Anesthetist is Available: An Analysis of 1216 Consecutive Operative Procedures

Peer Reviewed Injury & Rehabilitation

Intraoperative awareness and experience with a ketamine-based anaesthesia package to support emergency and essential surgery when no anaesthetist is available


ESM-Ketamine Manual

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