Jo's VSO adventure: NLS success

Every now and then I get a day when all the difficulties of volunteering seem worthwhile. This week I’ve had a whole week! It has been brilliant and it’s great to finally feel like you are doing something that might actually make a real long lasting difference.

When Susan and I first started working in the hospitals, one of the things we noticed is the complete lack of confidence most of the nurses and midwives have in resuscitating a baby who does not breathe at birth. This is a really critical part of a midwives job, but our direct observations were that it was done badly or not at all. Partly this is due to inadequate staffing, space and equipment but also it’s due to a lack of awareness and training. More than the basic resuscitation, we also found that the care of the newborn was often really poor. The babies who are admitted to the neonatal unit are frequently hypothermic, and they may not have been fed for hours and hours.

We decided that this was something we had to try and improve, and so since Christmas we have been preparing a newborn life support course for the nurses and midwives working in Harar. We applied to VSO for a grant to fund the project, and spoke to the regional health bureau who asked us to train health centre staff as well as hospital staff, and agreed to ensure that the government institutions have the basic equipment necessary. Then we prepared the course material we wanted to teach, based on UK newborn life support guidelines but also adapted to the WHO/ Ethiopian Paediatric guidelines. As well as basic newborn resuscitation we have includes sessions on ethics and document keeping ( as the quality of note keeping here is generally pretty appalling), and essential newborn care which covers how to support mothers in breast feeding and keeping babies warm amongst other things. Finally we persuaded UNICEF Ethiopia to donate the neonatal resuscitation training equipment in the form of 4 neonatalie complete kits!

The course is happening in 2 stages. The first stage started this week and we had participants from every hospital and health centre attending. We did two days training on the theory and practice of newborn resuscitation and then a final day discussing methods of learning and teaching, and asking our participants to think about how they would take what they have learnt back to their place of work, share it with their colleagues and put it into practice.

The course was really well received and all our feedback was extremely positive. On the 3^rd day we asked our participants in groups to prepare a micro-session explaining and demonstrating a particular aspect of newborn life support, and it was so lovely to see them demonstrating what they had learnt and explaining it to colleagues. The candidates who we thought were strongest we have asked to come back and help as instructors in phase 2, when we hope to train another 60 of their colleagues by running 3 more similar courses but without the third day.

The final part of the plan is to speak to the regional health bureau about setting up an annual professional development programme, where they run similar training regularly throughout the year so that all of the staff here get the chance to update their skills on a regular basis. Even if the final part is not successful we will have around 80 better trained health care staff working in Ethiopia and if they put their new skills into practise that alone will be a year well spent!