Having had no formal emergency medical services previously, the First Responder Coalition of Sierra Leone (FRCSL) was formed in June 2019 in Makeni to facilitate the development of emergency first responder programs nationwide. The founding members of the Coalition included the Sierra Leone Red Cross Society (the first chairing organisation), LFR International (proposed the formation), the University of Makeni, Agency for Rural Community Transformation, and the Holy Spirit Hospital. The establishment of the Coalition was concurrent with the declaration by the 72nd World Health Assembly that emergency care systems are essential to universal health coverage. Between June and July 2019, the FRCSL trained 1,000 community members from Makeni to be first responders and equipped each trainee with a first aid kit.