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Sixty-nine percent of people worldwide do not have access to emergency and essential surgery when needed, with lack of anesthesia services a primary barrier. In Kenya, there are vast regions where the cesarean section rates are less than 1%, the result of which is untold death, disability and suffering. The ‘Every Second Matters for Emergency and Essential Surgery – Ketamine’ (ESM-Ketamine) program is a ground-breaking collaborative effort to address this crisis by providing a bridge solution for the anesthesia gap. The goal of the ESM-Ketamine program is to support the march toward universal health coverage by increasing access to surgery for the most vulnerable populations.

The ESM-Ketamine package was designed and launched by a consortium of innovators from the African Institute for Health Transformation at Sagam Community Hospital, the Kenya Ministry of Health, the Siaya County Health Directorate, and faculty from the Massachusetts General Hospital and Harvard Medical School. Additional collaborators include leaders from the Kenya Obstetrics and Gynecology Society (KOGS), the College of Surgery for East, Central, Southern Africa (COSECSA), as well as the Health Directorates from Wajir, Turkana, Mandera, and Garissa Counties, among others.

This manual may not be reproduced without written permission from the Division of Global Health Innovation at Massachusetts General Hospital

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