The citizenAID app is free to download in Kenya.

It allows faster progression through the management of a scene and casualty than scrolling through a PDF document.

It takes up only 130 megabytes of storage space on the device and does not require an internet connection to use.

The app automatically updates in light of emerging threats such as acid attacks, unlike a PDF document.

The threats faced by the PF and the wider population are identical to those described in the app. These include responding to suspicious items, explosions, active shooter or knife attackers, and incidents involving vehicles as a weapon.

The citizenAID app provides detailed but concise checklists for scene management and follows the C-ACT paradigm taught in both the DMS Team Medic course and the PF TACMED course.

The app provides concise guidance on the assessment and treatment of multiple casualties using improvised techniques. These improvised techniques are emphasised in the PF TACMED course due to medical resupply constraints.

There are no other language options for the app other than English. All PF students spoke limited English but were more comfortable speaking in Kiswahili, the national language which is spoken by nearly 100% of the population.

The app is focused on a UK target audience with UK emergency telephone numbers and UK national police advice. Following this advice may not be recommended in Kenya and telephoning an incorrect number referenced in the app could result in a delay in response. There is a requirement for country-specific advice to be tailored to the target population.

The citizenAID triage sieve has not been validated and is simplistic. Validated triage sieves such as the MPTT-24 may be more appropriate for PF tactical medics to use.4 However, the citizenAID sieve is very straightforward and fast to use by a civilian who is untrained in taking pulse and respiratory rate, or a PF tactical medic who has experienced clinical skill fade.

Although the casualty assessment and treatment section of the app follows the <C>ABC paradigm, this is not explicitly stated, which does not reinforce the course material to students.

The app does not describe the full range of interventions that PF tactical medics can perform. For example, there is no breathing section describing the RIBS chest assessment mnemonic, or a treatment section describing the management of sucking chest wounds with improvised chest seals.

Not all of the target audience own a smart phone. There is therefore still a requirement for a hard copy pocket guide.

There is no section for instructors in the citizenAID app containing lesson plans. These need to be held in a separate document.

49 students qualified as PF citizenAID instructors from a variety of forward locations around the country. There is now an opportunity for training to cascade among the PFs when UK training teams are not in the country mentoring. As the app is free to download, there is no requirement to reproduce any reference material for this to occur in forward locations.

The PF conducts community engagement activity to educate local populations on, for example, counter-IED awareness. The target population for the citizenAID app is the civilian population. There is poor coverage of the national ambulance service network and prolonged response times. Training civilians at community engagement events and empowering bystanders at road traffic collisions or multiple casualty incidents could reduce preventable deaths following trauma. This is in line with the Ministry of Health’s third highest priority for strategic investment.5

Providing a translation for the citizenAID app would provide an opportunity for spread throughout the region where Kiswahili is spoken. This could include neighbouring countries where the threat of similar attacks is expanding.

To maintain interoperability, the courses could be delivered to other regional PFs which receive UK DE mentoring from other training teams.

The citizenAID app is not an overtly military reference source. There is therefore an opportunity to use this as an aide-memoire in other DE activity where a discrete UK military presence is required.

The citizenAID charity is a third-sector organisation and receives no government funding. It is reliant on sales of equipment and profits from the delivery of training courses to maintain liquidity. There are substantial monthly costs associated with maintaining presence in app stores and the app developer checking compatibility with new operating system updates. There is a risk that the charity will not be able to meet these costs and could collapse as a result. This would have a negative impact on the PF, and the TACMED course would need to be redesigned.

The UK training programme to become a citizenAID provider is delivered by Qualsafe. This official qualification is subject to strict training governance. Due to PF resource constraints in forward locations, it will not be possible to deliver the citizenAID provider course to the same UK standards. There is a threat that this is a concern to the citizenAID charity and they could remove their support.

The citizenAID train-the-trainer and citizenAID instructor course developed has not been validated by DMS training standards. There is a threat that, as this is not a recognised course, delivery on DE tasks will not be supported.

While the intentions of the citizenAID app are aligned to humanitarian principles, there is a risk of reputational damage to the charity if the app was used by PF or opposition groups who went on to commit Human Rights Act violations.

Responders to multiple casualty incidents in the UK are protected under the Social Action, Responsibility and Heroism Act 2015. It is unclear whether similar legislation exists in Kenya and whether civilians could be held accountable for their actions when treating casualties despite the best intentions.