Wednesday, August 22, 2007

Neonatal Resusitation --A Major Humanitarian Initiative

According to the World Health Organization, nearly one million babies die each year due to birth difficulties. Of all newborns, as many as 10 percent have breathing difficulties at birth and require some assistance. With proper training and minimal equipment, many of the deaths of newborns due to breathing problems can be avoided.

The Church of Jesus Christ of Latter-day Saints works with national health organizations and ministries of health from countries around the world to identify areas where training in neonatal resuscitation is most desperately needed. The Church then sends volunteer physicians and nurses to instruct birth attendants in these areas. These local attendants are then able to train others. This Church program has trained tens of thousands of birth attendants at a cost of $5.9 million (USD).

In 2006, the Church conducted training in 23 countries, including Albania, Bolivia, Botswana, Brazil, Cambodia, Colombia, Democratic Republic of Congo, Dominican Republic, Ecuador, El Salvador, Egypt, Ghana, India, Jordan, Lesotho, Mongolia, Namibia, Nigeria, Panama, Peru, Thailand, Turkey, and Ukraine.

This sounds like such a wonderful project and it truly is. Here in Kinshasa this project was done last year and the training went very well but the perpetuation of the training did not happen. The idea is to train the trainer. The church trains professionals and gives them training equipment including a resusitation kit and a baby training manniquin. These people then commit to go out and train others in the procedure to help the training spread to all surrounding birthing facilities. It was decided to do the training again trying to reach new participants. The project was planned for here in Kinshasa and across the river in the Republic of Congo in Brazzaville. Dr. Michael Preece came last March and worked with the Christensens, the couple we replaced and put together a plan for this training. We started working on the program as soon as we came. This was like putting to gether a training conference and right up our ally as I have participated many times in such conferences and even planned a few. Farrell was an expert in working with government officials and getting commitments from people so we were off and running. We had several meetings to finalize plans and involved the Health Ministers from both countries in our planning.

Meantime back in Salt Lake City, Dr. Preece put together a team of physicians to come and do the training. He had Dr. Adly Thebaud, a psychiatrist from Orlando Florida and his wife Dr. Josette Romain, a general practioner, Dr. Steven Grover an OBGYN from Denver Colorado and Dr. Steven Preece, presently in Medical Training at John Hopkins. They were accompanied by Dr. Preece's wife Merilee administrative assistant and Adly Tabou and Geoffrey Grover sons of the doctors.

The dates were set for Aug 6, 7 in Kinshasa and Aug 9,10 in Brazzaville. We worked hard to organize and make all the many preparations needed for here in Africa. We knew that doing things here are different and that we had to do it the Congolese way and we felt we were covering all the bases.

I must first say that the team was wonderful, the participants were eager learners, the program is generous and brings great hope to practioners struggling with less than ideal conditions.

That said I have to just give you a flavor of our struggle and some things we learned about planning a conference in the DRC.

*Just because shipments have arrived in the country it doesn't mean that you can get them out of customs in time for your conference. First the materials for the training were shipped late and did not arrive in time to clear customs and a national dignitary died requiring custom officials to take 3 days off to mourn the deceased.

*Don't count on a hotel being adequate if you haven't stayed there yourself. The hotel arranged for the team was less than adequate not even having the rooms serviced when we arrived with a tired team that had been traveling for 24 hours and were in desparate need of a shower and sleep even though we had gone to the hotel earlier that day to verify reservations and let the people know that the tearm would be arriving late in the evening and we didn't want any problem with them giving away their rooms etc.

*You shouldn't worry about offending the Minister by pre writing an invitation and asking him to sign it and then send it out yourself. The Minister of Health in Kinshasa sent the invitation to the participants but changed the date on the invitation causing us to have to delay our training one day and eliminating our travel day between conferences.

*The opening and closing ceremonies are much more important than we gave them credit for and the dignitaries plan to arrive late and make an entrance and we were unaware of this cultural issue and did not factor this time element into the schedule

*In the Congo even though they have bathrooms with toilets and sinks they don't necessarily have running water in them and you have to bring your own paper towels and toilet paper and pay a fee of $50 a day for cleaning. You have to flush the toilets by pouring a bucket of water in them. You have to wash your hands in a communal bucket of water.

*Just because you schedule rooms and tables and electrical outlets and lights it doesn't necessarily mean you will get them as there may not be tables available or outlets that work or lights that have light bulbs in them.

*In Brazzaville you can reserve a good hotel (for a price) and eat safe food at the hotel (for a price) but it will not fit into your project budget (at that price).

*If you want to loose weight when you are on a mission just schedule a large conference for a large amount of money and have everything go wrong and you can loose 23 lbs. in a very short time. (Farrell not Marilyn)

Oh my, what a great time we had. The training was wonderful and as you can see the participants received great practical experience. While one doctor teaches the group in a class setting the other doctors take the other half of the participants and demonstrates the procedure and have them do return demonstration. By the time the training is finished participants have been shown the best practice and many of their old wives tales have been corrected and replaced with good procedure.

These practioners are working under very primitive conditions and work hard providing a place for mothers to come and have their babies. They were greatful for the information and touched that doctors cared enough to take their time to come and train them. Just to put the need for this training into perspective consider what one of the nurses told us that in the main hospital in Brazzaville in the past 12 months they have had 1467 infant die in the first minute of life.

Geoffrey Grover planned on doing his service project for his Duty to God Award and brought newborn kits to share. We went to two different hospitals and shared the new born kits with the new mothers. When we went to the King Asani Hospital the mothers of the preemi infants were so pleased with their gifts they sang and danced for Geoffrey.

Pascal one of the mission employees and our great friend and our keeper went with us to the King Asani hospital to help transport the team. While we were visiting the preemie unit he asked the nurse if his wife had been in that day. It seems they are trying to adopt a baby. The nurse said yes she was, as a matter of fact this is your baby and handed him this precious little boy. Pascal nearly fainted and had a hard time holding the baby properly and so Farrell instructed him in how a father is suppose to hold a baby.(picture)

Well our experiences continue. This NRT project was a wonderful experience. We learned so much and will be following the participants for the next 6 months to evaluate how the training is perpetuated through out the area here in Kinshasa and through out the whole Republic of Congo as the participants in the RC came from all over the country at the expense of the church. They committed to take the information home and train the centers in their area. This was the first time that the church has covered a whole country in one training.

We are already thinking about where we might take the NRT program next year. We would love to see it go to the other side of the DRC to Lubumbashi but we will have to see if we can put it in our budget next year.

Meantime we are on to other projects and just got our cassava food project passed this past week. We will have to travel to the center of the DRC to Laputa, a remote farming community. More about that program in the future we get started.

Another thing we have learned about our mission is there is never enough time and never enough money to do all the things we see needing humanitarian help. Just know that all your money you give to LDS Charities goes to the people you intended it to go to. The criteria under which we work to spend those monies is very strict and much consideration is given to where the monies are best spent. It is a great trust we feel in having this opportunity to serve in humanitarian service.

The other night when we were in Brazzaville Farrell said he would really like to go home and sleep in his own bed. I was shocked and told him I never thought I would hear him say that while we were on our mission thinking he meant Salt Lake City home. He laughed and told me no, he wanted to go home to our apartment in Kinshasa and sleep in his Congolese bed. I guess we are settling in pretty good.

As they say in Africa " Safe Journey!"

Elder and Soeur Barlow


Mimi and Papa in Provo said...

Elder and Soeur Barlow: keep up the good work. Those little babies are the sweetest things in the world. You are doing great work for the members and the country in general. All our love and prayers, Doug and Linda Rich

Scarehaircare said...

Keeop thinking of the blessings you are stockpiling. You deserve every single one of them. xoxo