Dreams to Reality.

19 April 2015

I’m back in my ship home after ten days up in Antananarivo; the days have been full and challenging yet fruitful, with strategic meetings about medical training programs for the next field service in Madagascar mixed in with running current healthcare education programs and trying to measure the impact of what we have done.

It’s exciting work – there was a moment this week when I came alive in a way I haven’t ever before. After three days of teaching pediatric anesthesia we took a day to invite the previous participants from the obstetric anesthesia course we held back in December to return and tell us how the course impacted them; their personal practice as well as their hospital and teamwork.  If I’m really honest I wasn’t expecting much; I mean, I hoped all our blood, sweat, and tears over the last two years of moving this medical training program from dreams to reality actually has left an impact but it’s hard to really know for sure.  Well, I had the opportunity to ask those questions, and the answer was a resounding YES, your training has affected me, my practice, my hospital and my patients. 


One anesthesia nurse who attended learned newborn resuscitation for the first time, and then everyone in his hospital saw that the babies he was delivering were all healthy, so they asked him to train them, too.  He did.  Now everyone there knows how to resuscitate a baby well and according to him, in the last three months at least a dozen or so babies that would have died are now alive.

Another anesthetist explained how the course taught her she needed to have a backup plan ready when putting a patient under anesthesia, in case plan A didn’t work.  When I asked her what she would have done in the past, she explained that if plan A failed everyone would be yelling at each other and trying to find the equipment and supplies for plan B while the patient was deteriorating on the table.  Now she has everything she needs, and a plan in place, and she is calm and ready to handle the issues.  She told me that others in her hospital saw how she did this, and how much better it was for her and for the patient, and asked her to teach them, too.  So she did. 

So many of the people we talked to said the most important thing they learned was to ask for help.  “I believed I had to do it on my own” is the common working environment here, and the freedom and encouragement to ask someone else to help them has left a huge impact not only on them as individual practitioners but also on their hospitals and colleagues; several comments were made about how now people in their teams communicate better, people know what they will do and what needs to be done, and the stress of saving a life is now a team effort, not balanced on the shoulders of one person who feels out of their league and overwhelmed with the expectations.  

They learned how to systematically evaluate and stabilize a patient; they learned how to respond to life threatening conditions with accuracy and confidence; they learned how to use specific tools in a better way and they learned how to communicate with others more effectively.  They didn't only just learn these things, though - they applied them, saved lives, and taught others how to do the same.  I could barely contain the tears as these stories flowed out of their mouths and I hastily scrawled what I could on my paper questionnaire; with French and English and excitement and joy all melding together into chicken scratch that is pure gold. What we do here really does make a difference.   

Somehow in the coming months this will all be written up into reports and papers and press releases; we find ourselves pioneering once again as we try to figure out how to measure success, and then to get their stories out into the hands of people of influence and favor and means and the courage to try and do something about it. I can’t even believe I get to be a part of this; I’m honored and grateful and humbled and excited to see where the coming weeks and conversations and travels and meetings bring us in the journey of making even more dreams into reality.  It was once just a dream that a hospital ship could bring hope and healing to the forgotten poor.  That dream became reality.  It was once just a dream that it could also bring world class medical training opportunities to those who are most in need.  That dream has become reality, too. It is still a dream that it could be a catalyst for transformation of an entire national health system.  That dream can become a reality.

Let’s do it.
Our SAFE faculty - from England, Canada, USA, Belgium, Ireland, and Kenya. What a privilege to partner with these incredible people to bring dreams into reality.  (Photo courtesy of Steph B)

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