20 November 2016

Summer of 2014 I spent a week in Uganda helping to run a pediatric anesthesia course (the same one I ran this week, in fact).  We had some downtime and for some of us it was our first time in that country, so we went for a hike, one of my favorite things to do.

I remember clearly as I was walking up the side of the mountain what I was thinking about.  Our first year of medical capacity building programs was finished; it was a tough year with a lot of discovery and successes led to greater dreams for the next year, a field service in Benin. (if you recall, we were scheduled to arrive in Benin in August of 2014, but ebola changed that plan… but at the time this story took place, my mind and heart were in Benin).

I was remembering my Peace Corps experience in Benin; I worked in the health center quite a lot of the time, and the staff let me see and do quite a lot.  I remember thinking how sparsely equipped it was; how they washed and re-used their disposable gloves, spent hours cutting bandages, and used rusty instruments. I remember being in the room during deliveries; sometimes the baby was strong and screaming and sometimes it wasn’t.  I knew there was something off about what I was seeing, but I didn’t know enough to do or say anything about it.  I wished I could have helped more than I did; I helped them to organize some paperwork and taught a few things but I remember desperately wishing I could have done more.

Fast forward a few years, and during the Congo field service I learned about Helping Babies Breathe, a newborn resuscitation program for low-resource environments (places that don’t have a NICU, supplementary oxygen, emergency drugs, etc).  Exactly the type of environment I had worked in.  As I was walking up the side of the mountain (really, just a hill, to be honest!) I wondered if it could be taught to Peace Corps volunteers, who could then teach it in their villages to the health centers.  It seemed a little crazy, not exactly what we do, but why not?  The algorithm is simple, easier in fact than a standard CPR course which is taught by and for non-medically trained people worldwide.

I pitched it to my boss who was there with me and we brainstormed how we could do it and ways to measure success.  The programs team supported the idea and a project plan was written; I was thrilled to be able to return to Benin and offer this teaching that I wished I could have had when I was a volunteer.  The key point is ensuring babies breathe in the first minute; we would teach the appropriate methods and supply all health centers with the materials needed, the materials that I knew my health center didn’t have when I was there.  So. Excited.

Then we were re-directed to Madagascar and had to adjust everything. The system is a bit different there, with a smaller percentage of births happening in the health centers but an active Peace Corps program, so we decided to go ahead.

It went so much better than I could have imagined!  So much good feedback from the volunteers and the people they trained; overall, a huge success.  It was so rewarding to talk to the volunteers who excitedly told stories of their health center workers saving little lives!  We’ve already done one training here in Benin, and hope to do another in the spring.  

Since the Madagascar project, we’ve been working on writing a paper about the experience, suggesting the model is a good one for wide dissemination of this teaching that has the potential to have a dramatic effect on newborn survival rates.  Finally, this week it got published!

Here’s the link: Link 

What a journey! A few years ago it was just a burst of inspiration while on a hike in Uganda, long before I was a graduate student and even thought about publishing anything!  Now it’s been shown to be statistically and scientifically beneficial and added to the global pool of knowledge… what an incredible thing it is to be a part of this place.  To see a dream come to fruition; to know that babies are alive today because of an idea and a pursuit and that maybe many more will be saved in the future is… incredible. 

Thank you, supporters and friends, for investing in me so I could invest in them.  What an honor. 

The HBB class in Madagascar

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