Projects & Programs

• Basic trauma course for rural physicians
• Basic Trauma course for prehospital personnel
• Creation of a Trauma ED Form and a complimentary Trauma Registry data base
• Establishment of a Trauma registry in 3 provinces and 5 hospitals
• Establishment of an electronic interhospital referral system between the provincial hospitals and the definitive centers outside of the province
• Establishment of a volunteer paramedical system as a collaborative effort between the Red Cross, The Firefighters, and the Civil defense organization
• Establishment of an aerial paramedical system
• Initiation of road traffic injury prevention projects between the two major cities in the province of Morona Santiago.

Educational Trauma courses

The Basic trauma course is a three day course composed of didactic lectures and hands-on skill practice stations. The course is administered as a joint effort between the International Trauma System Development Program of the VCU trauma division, and the Cinterandes Foundation. It is jointly hos ted by the Provincial Ministry of health of Morona Santiago, and the College of Physicians of the Province of Morona Santiago. The basic trauma course was administered in June 2003, and May 2005.


The rural trauma course is based on a “patient pathway system”: tracing the management of the patient from the initial site of injury, to the health care posts, continuing on to the provincial hospitals, and subsequently to definitive referral centers. The course stressed basic trauma management of patients in a rural setting. The objective of the course is to deliver a reasonable systematic approach, given the resources available, to the management of patients who sustained traumatic injuries.

The presentation of this course in Ecuador was a major undertaking, and involved tremendous amount of preparation, technical support and facilitation from the local community and especially the support of the provincial ministry of health and our collaborative partners at the University of Azuay and the Cinterendes Foundation in Ecuador.The variability of the traumatic mechanisms seen and the difference in resource availability among the various regions (Jungle vs. Perihospital rural setting vs. Provincial hospital setting, vs. the definitive referral hospital setting) underscores the enormity of this task. The procedural aspect was flawless. The local participation was impressive. The impact will clearly be felt in the empowerment of the local physicians and healthcare workers in the appropriate care of the traumatized patient in the region of Morona Santiago, Ecuador.

Prehospital trauma course

The course is developed by the Center of education for trauma and critical care of the trauma division. It is composed of didactic sessions, hands-on skill building stations, and various drills between the ambulances and the receiving ED of the hospitals in Macas, capitol of the Province of Morona Santiago. The objective of the course is the administration of basic prehospital paramedic principles. It is hoped to be the first step in the formation of the first paramedic core composed of a joint collaboration between the Firefighters, the Red Cross, and the Civil Defense.

Trauma registry

The trauma registry is a joint collaborative effort between the ITSDP of The VCU division of trauma, the information technology CSIS of the department of surgery, and the statistical representation of the department of surgery (Mr. Luke Wolfe). The major impediment to system and research development in the developing nations is inadequate or nonexistent data.

The objective of this project is the identification of the true burden of traumatic injuries in the three provinces of Morona Santiago, Pastaza and Azuay, in terms of injury type, description and external causes. This is accomplished through the creation of a uniform and complete Trauma Emergency Department form that includes injury descriptions and mechanisms. On-going training of the residents and hospital administrators is carried out at each participating hospital. Additionally a matching electronic trauma registry is installed at each hospital with specific training administered to the hospital statistical department.

Patient Referral System:

A one-year pilot study examining the referral of patients in the province of Morona Santiago is carried out. The trauma patient referral system is a collaborative effort between the ITSDP program, the Morona Santiago Ministry of Health and five participating hospitals. The expertise of the VCU Information technology CSIS is utilized to create a simple, non web based electronic communication system to improve the inter-hospitals patient referral and documentation system.