Africa Fire Mission (AFM), in collaboration with its international research and implementation partners, received support from the Laerdal Foundation to launch Active Bleeding Control (ABC): A Pilot Life-Saving First Aid Program in Sub-Saharan Africa. The project aims to reduce death and disability from life-threatening bleeding in Sub-Saharan Africa through contextualized training for first responders and community members. This includes a focus on reducing deaths from life-threatening bleeding in high-risk road traffic accident corridors in Nairobi. This was the first year of a three-year grant and we were able to make significant progress with implementing a contextualized program for Sub-Saharan Africa.
Volunteers participating in ABC training.
Our goal for the training of trainers was to create a replication model for training. Since the end of March 2025, volunteer instructors have trained more than 790 individuals. The training has already been conducted across two countries (Kenya and Malawi) and eight cities/ counties (Figure 3). This training equips community members with critical skills to stop lifethreatening bleeding. Participants in the Active Bleeding Control trainings come from diverse backgrounds, including transit workers, workers in the hospitality industry, students, community health promoters, public health officers, teachers, church groups, museum staff, firefighters and EMTs. Interest in the program is growing, and replication of the training is gaining momentum as our instructors actively engage with their communities. We are now over halfway to our goal of training more than 1,000 individuals in life-saving active bleeding control techniques and are actively developing strategies to expand training access for transportation personnel.
These successes highlight the need for this program and the success of our replication modelfor training. Contextualizing the Active Bleeding Control (ABC) curriculum for the Sub-Saharan African context has proven essential to the program’s acceptance and effectiveness. Our focus groups highlighted that cultural norms in many communities discourage bystander involvement in emergencies, often due to fear of legal consequences, misunderstandings about disease transmission, or social taboos around touching blood or injured persons. In some cases, people are explicitly advised not to help, out of concern for personal liability orsuperstition. Additionally, limited awareness about basic first aid practices andmisconceptions about bleeding injuries can lead to harmful delays in care. By adapting training materials to reflect local language, beliefs, and lived experiences—and by incorporating trusted community voices—we are addressing these barriers and fostering anew culture of empowered, informed responders within the community.
Empowering trainers to volunteer their time to impact their communities has also proven tobe a successful model fostering increased buy-in as well as long-term commitment for sustainability and growth of the training program.
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