# Emergency Health Systems ![man riding motor bike on dirt road](/sites/g/files/omnuum6866/files/styles/hwp_21_9__1920x825/public/humanitarianinitiative/files/ehs_hero.jpg?itok=Yn628vww) **Founded**: 2019 **Faculty Lead:** Sean Kivlehan, MD, MPH **Status:** Active Program **Regions of Focus:** Tanzania, Uganda, Nigeria, Ukraine, Pakistan, Haiti, Turkey **Research Theme:** Risk, Resilience and Response ## Description Strong emergency care systems improve the effectiveness of humanitarian action. An effective humanitarian response must include strengthening of emergency care systems to build resilience. The HHI Emergency Health Systems program works to bridge the gap between system development and humanitarian response and improve the quality and access of emergency care for those who need it most. This mission is achieved through intertwined research, education, and advocacy efforts. By evaluating, implementing, and disseminating normative emergency care guidance, the Emergency Health Systems program aligns humanitarian response with the Sustainable Development Goals to increase the capacity of front-line providers and improve emergency care delivery processes and outcomes. ## Projects ### Operational Management for Emergency Departments (OMED) (September 2024- Ongoing) Partnered with International Medical Corps and other key stakeholders to design, develop, and deliver a series of specially tailored Standard Operating Procedures (SOPs) to create and support the operational management infrastructure of emergency departments. This project builds on the Ukraine Trauma Care project where large numbers of Ukrainian physicians, nurses, prehospital providers, and civilian first responders were trained in trauma care, mass casualty management, and CBRNE preparedness and response. ### Ukraime Trauma Care Virtual Case-Based Community of Practice (CoP) (September 2024- Ongoing) Partnered with Project ECHO to establish a virtual case-based community of practice to provide continuous support, mentorship and peer learning opportunities for a network of trauma care trainers in Ukraine. This project builds on the Ukraine Trauma Care project, which not only trained thousands of Ukrainian physicians, nurses, prehospital providers, and civilian first responders in trauma care, mass casualty management, and CBRNE preparedness but also developped a cadre of over 200 skilled trauma care trainers, ensuring sustainable capacity-building for emergency and trauma care nationally. ### Ukraine Trauma Care Project (July 2022- August 2024) Partnered with International Medical Corps to implement a comprehensive trauma care training curriculum to hospitals, clinicians and the community in Ukraine in the following seven domains both in primary and train-the-trainer formats: Advanced Trauma Life Support (ATLS), Trauma Nursing Fundamentals (TNF), Pediatric Trauma Fundamentals (PTF), Pre-Hospital Trauma Fundamentals (PHTF), Mass Casualty Management (MCM), Chemical, Biological, Radiological, Nuclear and Explosives (CBRNE) and Stop the Bleed (StB). ### WHO Global Health Cluster Represent HHI at the Global Health Cluster and participate in cluster projects, most recently including the COVID-19 Technical Task Force and the Capacity Development Consultation Group. ### WHO Emergency Care Toolkit Support the dissemination and evaluation of the WHO-ICRC Basic Emergency Care course and associated products. ### Academic-NGO Consortium Work closely with several NGOs to provide emergency care and COVID guidance for field operations and support a roster of emergency physicians available for field deployment. ### Fellowship in Global Emergency Medicine The Brigham and Women’s Hospital Department of Emergency Medicine supports two fellows who participate in development, disaster response, and displaced populations work. ### Global Emergency Medicine Literature Review A team of 24 reviewers and editors from around the world who conduct an annual review of literature focused on humanitarian and emergency care as well as an annual systematic review. ### Global Emergency Care Organization Collaboration Active participation in organizations support the advancement of emergency care and humanitarian action around the world. ### Academic Consortium for Emergency Systems A research network spanning several institutions in the US focused on implementing and evaluating emergency care interventions globally. ## EHS creations [### Save a Life Educational Videos ](/save-life-educational-videos) ![waxwork dummy strapped in a gurney being raiseed into an ambulance by two men](/sites/g/files/omnuum6866/files/styles/hwp_16_9__480x270/public/humanitarianinitiative/files/save_a_life_toolkit_feb23.jpg?itok=M8oVJQ8f) [### CBRNe in humanitarian settings ](/cbrne) ![CBRNE training in Ukraine](/sites/g/files/omnuum6866/files/styles/hwp_1_1__360x360_scale/public/humanitarianinitiative/files/cbrne_screenshot_2024-09-04_at_11.38.43.png?itok=cAsG9VKr) ### Methodology expand\_more The Emergency Health Systems program strives to apply rigorous methods to evaluate the effectiveness and impact of emergency care interventions in humanitarian and limited resourced settings. Quantitative and qualitative approaches are used as part of our program’s implementation science efforts. Systematic and descriptive reviews of the literature describing interventions of interest are performed to better understand the available evidence. ### Publications expand\_more Download 7 citations download- [BibTeX](/bibcite/export?pager_style=no_pager&number_of_items=7&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1604366&content_filter%5B1%5D=1604316&content_filter%5B2%5D=1604301&content_filter%5B3%5D=1599971&content_filter%5B4%5D=1438253&content_filter%5B5%5D=1432680&content_filter%5B6%5D=1414392&&format=bibtex) - [EndNote X3 XML](/bibcite/export?pager_style=no_pager&number_of_items=7&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1604366&content_filter%5B1%5D=1604316&content_filter%5B2%5D=1604301&content_filter%5B3%5D=1599971&content_filter%5B4%5D=1438253&content_filter%5B5%5D=1432680&content_filter%5B6%5D=1414392&&format=endnote8) - [EndNote 7 XML](/bibcite/export?pager_style=no_pager&number_of_items=7&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1604366&content_filter%5B1%5D=1604316&content_filter%5B2%5D=1604301&content_filter%5B3%5D=1599971&content_filter%5B4%5D=1438253&content_filter%5B5%5D=1432680&content_filter%5B6%5D=1414392&&format=endnote7) - [Endnote tagged](/bibcite/export?pager_style=no_pager&number_of_items=7&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1604366&content_filter%5B1%5D=1604316&content_filter%5B2%5D=1604301&content_filter%5B3%5D=1599971&content_filter%5B4%5D=1438253&content_filter%5B5%5D=1432680&content_filter%5B6%5D=1414392&&format=tagged) - [Marc](/bibcite/export?pager_style=no_pager&number_of_items=7&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1604366&content_filter%5B1%5D=1604316&content_filter%5B2%5D=1604301&content_filter%5B3%5D=1599971&content_filter%5B4%5D=1438253&content_filter%5B5%5D=1432680&content_filter%5B6%5D=1414392&&format=marc) - [PubMedId](/bibcite/export?pager_style=no_pager&number_of_items=7&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1604366&content_filter%5B1%5D=1604316&content_filter%5B2%5D=1604301&content_filter%5B3%5D=1599971&content_filter%5B4%5D=1438253&content_filter%5B5%5D=1432680&content_filter%5B6%5D=1414392&&format=pubmed_id) - [RIS](/bibcite/export?pager_style=no_pager&number_of_items=7&sort_field=bibcite_year--desc&&content_filter%5B0%5D=1604366&content_filter%5B1%5D=1604316&content_filter%5B2%5D=1604301&content_filter%5B3%5D=1599971&content_filter%5B4%5D=1438253&content_filter%5B5%5D=1432680&content_filter%5B6%5D=1414392&&format=ris) ### 2024 J.H. Drake, G. Kiwango, D. Kitapondya, F. Mashili, and S.M. Kivlehan. 2024. “[Descriptive Analysis of Road Traffic Crashes Encountered by Tanazanian Motorcycle Taxi Drivers Trained in First Aid](https://www.sciencedirect.com/science/article/pii/S2211419X24000314)”. African Journal of Emergency Medicine, 14, 4 J.H. Drake, G. Kiwango, D. Kitapondya, F. Mashili, and S.M. Kivlehan. 2024. “[Descriptive Analysis of Road Traffic Crashes Encountered by Tanazanian Motorcycle Taxi Drivers Trained in First Aid](https://www.sciencedirect.com/science/article/pii/S2211419X24000314)”. African Journal of Emergency Medicine, 14, 4 - add\_circle do\_not\_disturb\_on Abstract ### Introduction In Dar es Salaam, Tanzania, death from road traffic crashes (RTC) occurs at roughly double the global rate. In this study, we sought to understand the locations and types of vehicles involved in RTC in Dar es Salaam encountered by a cohort... David Mills, Alexis Schmid, David Lewander, Michelle Gonnet, Oleksii Lopatniuk, Oleksandra Demetska, Olena Sorokina, Anna Bolonska, Ramona Sunderwirth, Sean Kivlehan, Kathleen Murray, and Michelle Niescierenko. 2024. “[Expanding Trauma Education During War: Pediatric Trauma Fundamentals Training in Ukraine](https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1448075/full)”. Frontiers David Mills, Alexis Schmid, David Lewander, Michelle Gonnet, Oleksii Lopatniuk, Oleksandra Demetska, Olena Sorokina, Anna Bolonska, Ramona Sunderwirth, Sean Kivlehan, Kathleen Murray, and Michelle Niescierenko. 2024. “[Expanding Trauma Education During War: Pediatric Trauma Fundamentals Training in Ukraine](https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1448075/full)”. Frontiers - add\_circle do\_not\_disturb\_on Abstract **Introduction:** On 24 February 2022, Russia launched a large-scale offensive in Ukraine, resulting in significant casualties to civilians, including children. As part of a seven-stream trauma education initiative, a novel pediatric trauma fundamentals... Joshua Drake, George Kiwango, Fredirick Mashili, Deus Kitapondya, and Sean Kivlehan. 2024. “[Effectiveness of a Bleeding Control Course for Public Transit Drivers in Dar Es Salaam, Tanzania](https://www.journalofsurgicalresearch.com/article/S0022-4804(24)00374-3/abstract)”. Journal of Surgical Research Joshua Drake, George Kiwango, Fredirick Mashili, Deus Kitapondya, and Sean Kivlehan. 2024. “[Effectiveness of a Bleeding Control Course for Public Transit Drivers in Dar Es Salaam, Tanzania](https://www.journalofsurgicalresearch.com/article/S0022-4804(24)00374-3/abstract)”. Journal of Surgical Research - add\_circle do\_not\_disturb\_on Abstract ### Introduction In Dar es Salaam, mortality from road traffic injuries is roughly double the global rate. Most civilians are transported to hospitals by laypeople. We examined the impact of a bleeding control course among taxi drivers. ### Methods Before-after... ### 2023 Timothy B. Erickson, Donell Harvin, Alexis Schmid, Gideon Loevinsohn, Anna Poriechna, Oleg Martyshyn, Kryrylo Kliukach, Meaghan Sydlowski, Jonathan Strong, and Sean M. Kivlehan. 2023. “[Evaluation of Chemical, Biological, Radiological, Nuclear Explosive (CBRNE) Knowledge Change and Skills Confidence Among Front-Line Providers During the Russia-Ukraine War](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171778/)”. Disaster Medicine and Public Health Preparedness Timothy B. Erickson, Donell Harvin, Alexis Schmid, Gideon Loevinsohn, Anna Poriechna, Oleg Martyshyn, Kryrylo Kliukach, Meaghan Sydlowski, Jonathan Strong, and Sean M. Kivlehan. 2023. “[Evaluation of Chemical, Biological, Radiological, Nuclear Explosive (CBRNE) Knowledge Change and Skills Confidence Among Front-Line Providers During the Russia-Ukraine War](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171778/)”. Disaster Medicine and Public Health Preparedness - add\_circle do\_not\_disturb\_on Abstract ### Objective: To evaluate the change in knowledge and skill confidence after implementation of a CBRNE training course during the Russia-Ukraine War. ### Methods: Pre/post-test study in the Ukrainian cities of Kyiv, Dnipro, Zaporizhzhia, and Odesa. Fifteen... ### 2022 Sean Kivlehan, Amy Allen, Olha Viun, Dmitry Makarov, Daniel Schnorr, Sonny Patel, Sergii Ryzhenko, Phuong Pham, and Timothy Erickson. 2022. “[Evaluation of Change in Emergency Care Knowledge and Skills Among Front-Line Healthcare Providers in Ukraine With the Basic Emergency Care Course: a Pretest Post-Test Study](/publications/evaluation-change-emergency-care-knowledge-and-skills-among)”. BMJ Open Sean Kivlehan, Amy Allen, Olha Viun, Dmitry Makarov, Daniel Schnorr, Sonny Patel, Sergii Ryzhenko, Phuong Pham, and Timothy Erickson. 2022. “[Evaluation of Change in Emergency Care Knowledge and Skills Among Front-Line Healthcare Providers in Ukraine With the Basic Emergency Care Course: a Pretest Post-Test Study](/publications/evaluation-change-emergency-care-knowledge-and-skills-among)”. BMJ Open - add\_circle do\_not\_disturb\_on Abstract - [ descriptionPublisher's Version](https://bmjopen.bmj.com/content/12/6/e050871) **Objective:** Evaluate the change in participant emergency care knowledge and skill confidence after implementation of the WHO-International Committee of the Red Cross (ICRC) Basic Emergency Care (BEC) course. **Design:** Pretest/post-test quasi-experimental... - [ descriptionPublisher's Version](https://bmjopen.bmj.com/content/12/6/e050871) Frederick M. Burkle, Krzysztof Goniewicz, and Amir Khorram-Manesh. 2022. “[Bastardizing Peacekeeping and the Birth of Hybrid Warfare](/publications/bastardizing-peacekeeping-and-birth-hybrid-warfare)”. Prehospital and Disaster Medicine Frederick M. Burkle, Krzysztof Goniewicz, and Amir Khorram-Manesh. 2022. “[Bastardizing Peacekeeping and the Birth of Hybrid Warfare](/publications/bastardizing-peacekeeping-and-birth-hybrid-warfare)”. Prehospital and Disaster Medicine - [ descriptionPublisher's Version](https://www.cambridge.org/core/journals/prehospital-and-disaster-medicine/article/bastardizing-peacekeeping-and-the-birth-of-hybrid-warfare/F7985E335AFC8414D623C52219626A69) - [ descriptionPublisher's Version](https://www.cambridge.org/core/journals/prehospital-and-disaster-medicine/article/bastardizing-peacekeeping-and-the-birth-of-hybrid-warfare/F7985E335AFC8414D623C52219626A69) ### 2021 Indi Trehan, Sean M. Kivlehan, Kamna S. Balhara, Joseph Bonney, Braden J. Hexom, Amelia Y. Pousson, Nana Serwaa A. Quao, Megan M. Rybarczyk, Anand Selvam, Benjamin D. Nicholson, Nidhi Bhaskar, Torben K. Becker, and Global Emergency Medicine Literature Review (GEMLR) Group. 2021. “[Global Emergency Medicine: A Scoping Review of the Literature from 2020](/publications/global-emergency-medicine-scoping-review-literature-2020)”. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine Indi Trehan, Sean M. Kivlehan, Kamna S. Balhara, Joseph Bonney, Braden J. Hexom, Amelia Y. Pousson, Nana Serwaa A. Quao, Megan M. Rybarczyk, Anand Selvam, Benjamin D. Nicholson, Nidhi Bhaskar, Torben K. Becker, and Global Emergency Medicine Literature Review (GEMLR) Group. 2021. “[Global Emergency Medicine: A Scoping Review of the Literature from 2020](/publications/global-emergency-medicine-scoping-review-literature-2020)”. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine - add\_circle do\_not\_disturb\_on Abstract - [ descriptionPublisher's Version](https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/acem.14356) **Objective**: To identify, screen, highlight, review, and summarize some of the most rigorously conducted and impactful original research and review articles in global emergency medicine (EM) published in 2020 in the peer-reviewed and gray literature. ... - [ descriptionPublisher's Version](https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/acem.14356) [ More arrow\_circle\_right ](/publications) ## Team [### Anna P. Fang, MD ](/people/anna-p-fang-md)Global Emergency Medicine Fellow Anna P. Fang, MD is an emergency physician and Global Emergency Medicine Fellow at Brigham and Women’s Hospital. She graduated with a degree in economics from Yale University in 2014, received her medical degree from Harvard Medical School in 2021, and... ![Anna P. Fang ](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/2025-08/Fang%2C%20Anna%20-%20Headshot.JPG?h=f046e79e&itok=VK-xyHQ_) [### Catalina González Marqués, MD, MPH ](/people/catalina-gonz%C3%A1lez-marqu%C3%A9s-md-mph)Associate Director, Emergency Health Systems Program Dr. González Marqués works as an attending physician in the Emergency Department at Brigham and Women’s Hospital in their Division of Global Emergency Medicine and Humanitarian Studies and is an Instructor of Emergency Medicine at Harvard Medical School... ![screenshot_2024-09-18_at_3.19.40_pm](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/humanitarianinitiative/files/screenshot_2024-09-18_at_3.19.40_pm.png?itok=QYEvH2Cx) [### Dana Naamani, MD, MPH ](/people/dana-naamani-md-mph)Global Emergency Medicine Fellow Dana Naamani, MD, MPH, is an emergency physician and Global Emergency Medicine Fellow at Brigham and Women’s Hospital. Originally from Lebanon, she earned her medical degree from the American University of Beirut before pursuing a Master of Public Health... ![Dana Naamani](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/2025-11/Dana%20Naamani3129_316%202.jpg?itok=C3AXY7rM) [### Erica Nelson, MD, PhM, MAS ](/people/erica-nelson)Co-Director, Humanitarian Geoanalytics Research and Education Programs Faculty, Emergency Health Systems Program Erica L Nelson, MD, PhM, MAS is an Emergency Medicine physician who conducts research on the use of geospatial methods for public health and humanitarian response. After graduating from Trinity College Dublin with an PhM in International Peace Studies and... ![erica nelson headshot ](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/2025-02/Faculty%20EricaNelson.jpg?itok=Wj3swQJR) [### Geoffrey Anderson, M.D. ](/people/geoffrey-anderson-md)Visiting Scientist, Harvard T.H. Chan School of Public Health Geoffrey Anderson is a trauma surgeon at LA General Hospital and an Associate Professor of Clinical Surgery at the University of Southern California Medical School. He did his training at the Massachusetts General Hospital and LA County Hospital and has... ![Geoffrey Anderson smiling](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/2026-05/Anderson%20Geoffrey.jpg?itok=WlSs8OhE) [### Katie Murray, LLM ](/people/katie-murray-llm) Program Manager, Emergency Health Systems Katie is the Program Manager for the Emergency Health System’s Ukraine Emergency Care Education Program, collaborating with stakeholders across HHI, Brigham and Women’s Hospital, and additional external programmatic partners. Katie has over five years of... ![Katie Murray headshot](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/humanitarianinitiative/files/headsh2.jpg?itok=bT0fu9WP) [### Kurdvin Rasool, MA ](/people/kurdvin-rasool-ma)Visiting Scientist, Harvard T.H. Chan School of Public Health Kurdvin Rasool is a senior humanitarian leader, policy strategist, and academic with over two decades of experience in complex Level 3 emergencies and high-risk operational environments. His expertise spans humanitarian coordination, civil–military... ![Kenny Rasool ](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/2026-02/Screenshot%202026-02-11%20at%202.46.31%E2%80%AFPM.png?itok=fbjg0BM5) [### Lea Sinno, RD MPH ](/people/lea-sinno-rd-mph) Project Manager, Emergency Health Systems Lea Sinno is the Project Associate for the Emergency Health System’s Ukraine Emergency Care Education Program . She previously worked in the non-profit sector and built her experience with INGOs such as International Medical Corps and Action Against... ![lea sinno headshot](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/2025-02/Staff%20Lea%20Sinno.jpg?h=464dc575&itok=CYetPRBH) [### Morgan Broccoli, MD, MPH, MSc ](/people/morgan-broccoli-md-mph-msc)Faculty, Emergency Health Systems Program Morgan Broccoli, MD, MPH, MSc is an emergency physician at Brigham and Women’s Hospital, an Instructor of Emergency Medicine at Harvard Medical School, and faculty in the Emergency Health Systems Program at the Harvard Humanitarian Initiative. Her... ![broccoli_morgan_md](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/humanitarianinitiative/files/broccoli_morgan_md_2624-5x5.jpg?itok=c-xuvNOL) [### Sean Kivlehan, MD, MPH ](/people/sean-kivlehan)Director, Emergency Health Systems Program Director, Lavine Family Humanitarian Studies Initiative Sean Kivlehan, MD, MPH is an emergency physician at Brigham and Women’s Hospital, Assistant Professor of Emergency Medicine at Harvard Medical School, and Assistant Professor of Global Health and Population at the Harvard Chan School of Public Health. He... ![Sean kivlehan headshot ](/sites/g/files/omnuum6866/files/styles/hwp_4_5__690x865/public/2025-02/Faculty%20Kivlehan%20Sean%20Headshot.jpg?h=fb1196cc&itok=xC_formC) The Emergency Health Systems Team includes the following members based at Brigham and Womens Hospital. - [Prem Menon](https://connects.catalyst.harvard.edu/Profiles/display/Person/216065), MD - [Mariame Fofana](https://connects.catalyst.harvard.edu/Profiles/display/Person/220508), MD PhD - [Courtney Bearnot](https://connects.catalyst.harvard.edu/Profiles/display/Person/220623), MD MPH