What have I been spending three out of the last four weekend’s doing? I’ve been training 60 hospital staff (mainly nurses and midwives) on newborn resuscitation and care. Using many different resources I created a two day training course which was delivered with the help of the paediatric masters translating and my fellow volunteers, Romil and Claire, helping with the practical sessions.
The training course is part of the project I’m working on to improve neonatal health. The training on newborn resuscitation on the first day gave people the knowledge and skills needed to resuscitate a baby. Everyone was great at taking part in the sessions, which included resuscitation scenarios – something that was completely foreign to the staff as it is not a teaching method used here. In the UK no training is complete without practice scenarios! We even had proper resuscitation mannequins which moved their chests when effective ventilation breaths were given. These were a mixture of the types we use in the UK and also a special mannequin called a NeoNatalie. These great dolls are blow up resuscitation dolls! They are fabulous to use and a great solution for resuscitation training in many countries.
The second day was for teaching about universal newborn care practice, Kangaroo Mother Care (skin to skin with the mother wrapped in clothes and perfect for keeping babies warm), breastfeeding (everyone needs help and no matter where you are it doesn’t always come automatically to every mother and baby), neonatal sepsis, jaundice and the special care that preterm babies need.
At the end of the course we had practical and written tests. Some difficulties were created as not everyone can read English well and unfortunately I didn’t have a Tigreyan translation. Everyone did well on the practical section of the test and successfully resuscitated a NeoNatalie! The enthusiasm and active participation from everyone involved was fabulous to see. Hopefully the information and skills learnt will be taken back the wards around the hospital and put to good use. As one of the participants commented – “the babies born after this course will have a great advantage.”
The start of this week was a bit different to the other weeks I’ve spent here. On Monday and Tuesday I was teaching a course for 3rd year student midwives at Axum University. I had been asked by Diane, one of their professors and one of the friends I’ve made here in Axum. The previous week I’d been busy writing all the lectures, planning learning activities and practical skill stations. I also wrote a student course book and trainers manual. Of course I was using all of the available resources I had from the UK, Ethiopia and other volunteers. It was all finally completed in time.
We took a bajaj out to the university, which is on the outskirts of town, and got to the lecture room. In the end we started only an hour late! The overhead projector arrived after about 20 minutes. We had some students after about 30 minutes – who then left again. In the mean time the chairs in the classroom had to be protected from other classes who kept trying to pinch them as they didn’t have enough in their room. Finally I managed to get started. As we started so late all of my careful planning went out the window and I started to drop activities left, right and centre to make sure that we didn’t run too late. What really surprised me though was when at 11.25am when I wanted to start a new activity they put up a fight saying it was lunchtime – the official time for it to start is 12 noon. Eventually with Diane coaxing them we managed to do the activity and still get them out before 12. Most of the staff head off back into town on buses supplied by the university for lunch but Diane and myself joined her husband and went to one of the university cafes. The chairs were set outside in what ever bit of shade could be found. Only fasting food was available (no meat) as it’s a fasting time here in the run up to Christmas on 7th January.
After lunch it was time to return to the classroom. This time we started only about 20 minutes late. The electricity was more temperamental in the afternoon going off twice which required some quick improving and drawing on the board to continue the lectures. Finally the day finished. I don’t think I’ve talked that much in a long time. I gave all of the lectures with only a couple of group tasks and 1 video as a break in the talking. I’ve not been so exhausted by a days work since I got here. No idea how teachers do it every day as well as all the lesson planning and marking.
On the way back home I stopped at the hospital to try and get hold of resus babies for the practical the next day. Unfortunately only adult dolls had been prepared but I did manage to do some real resus on a preterm baby on the ward who I noticed kept stopping breathing. We managed to start some CPAP and the baby is now doing well.
On the Tuesday I headed to the hospital first to try to get hold of baby resus dolls while Diane went to the university to start the course. After about 20 minutes the librarian turned up and I managed to collect the dolls from exactly where I thought they were! Tuesday was a more practical day teaching hands on skills – kangaroo mother care, breastfeeding counseling and the essential newborn resus. The students enjoyed getting chance to learn about newborn resus. It was an effort to get them to remember to say they were checking the breathing during each assessment of the baby and also not to jump in with chest compressions when they weren’t needed! Testing them at the end they seemed to do well and have learnt from the day. There was only 1 student I tested who really didn’t seem to get it but after I talked him through it and put him down as needing more practice he was insistent on trying again – even trying to push in front of students who hadn’t had a go yet. When he did finally retest there was a marked improvement, which was great to see.
In the evening after getting back into town we decided that a treat was needed after all the hard work. Pizza out with Diane and her family plus my housemates was a great reward!