The skills lab where we would have the training is located on the fourth floor....up some very steep steps! It was a very humid, warm day--Yay! And the windows in the room were stuck only partially open--even better! This will fall into my "lessons learned" category....dress appropriately for the weather and don't worry about whether your arms are showing! Another lesson learned after seeing the photos today....horizontal stripes are NEVER a good idea, unless you are a stick figure....which I obviously AM NOT! So....I spent the day looking like a damp, shiny roly-poly.....but I digress.....
Alex, one of the directors of the obstetrics department, introduced us and thanked us for coming back as promised to do the HBB training. We then had introductions.
I introduced our group, and then one by one, each Rwandan learner stood and introduced themselves to us. We had 30 learners today. Laiecha was a favorite in our group....they all thought she was Rwandan! I was pleased with this, and a little surprised. On previous trips, the Rwandans have always gravitated toward the ones in our group who were blonde and blue-eyed because they are such a contrast to the Rwandans own dark skin and dark eyes. I was pleased for several reasons.....first because I think it is good for Rwandans to see a young black woman in a role such as Laiecha was filling on this trip. It gives them hope for their own futures. Second because I think it was good for Laiecha. I have never told Laiecha this, but she is one of my favorite people. She is generally quiet, doing her job and often staying on the sidelines....but ALWAYS observing. I was surprised after my trip in July when she told me she would be joining me on the next trip and that she had been saving money to go. I was also very excited! She told me she would not be comfortable teaching, but she would help the rest of us in any way we needed. Okay. I was good with that. Then, a couple of weeks before we left, she told me she had decided she would also teach because it would be good for her. I love you, Laiecha!
Those of you who know me will NEVER believe this, but I see myself in Laiecha sometimes. I used to be (a really long time ago) quiet and shy like Laiecha--no seriously, I was! When I got divorced from my first husband and became a single mom, I had to force myself to be more vocal--after all, it was my job to be an advocate for my kids, right? Eventually I found my voice....and now, my journey. Laiecha decided to step out of her comfort zone on this, perhaps, once in a lifetime adventure and spread her wings. I hope, Laiecha, that you realized how capable you are and that you can do great things! You make me proud! (I know, I have nothing to do with this, but I'm still proud for you because you are awesome!) I also hope this is not a once in a lifetime adventure for you, but rather the beginning of many adventures!
After the introductions, I began with the background information on the HBB program and the reasons it was designed. That is, specifically for resource-limited areas where infant mortality rates are high. This program was designed specifically to help such areas meet Millennium Development Goal #4 (MDG4), to reduce infant and child mortality by 2/3 by the year 2015.
We then moved on to the flip chart. I started with a story about a baby being born and not breathing. There was no one there to take care of the baby and the baby died. (This story was told to them as they sat with their eyes closed) After pausing a few seconds, I asked them to then imagine being at a birth and the baby is born and doesn't cry or breathe, but this time they are there. They know how to take care of the baby and the baby survives. At this point I squeeze the bulb that is supposed to sound like a baby crying--baby duck, maybe! But they got the point...they CAN make a difference with the proper knowledge and tools.
Next object lesson was to have them stand and when told to start, they were to hold their breath until they couldn't hold it any longer, at which time they could sit down. This brought giggles....Rwandans tend to be fairly formal and this was out of the realm of normal behavior for them, but they are also incredibly polite, so they did it anyway! The last person sat down in 36 seconds. I asked if they had found that exercise difficult and received many nods. I then told them to remember that feeling because that is how a baby feels who is not breathing at birth. Point taken. We now moved on to the crux of the program....the Golden Minute.
If any of you have ever worked in resource-limited areas, you will recognize the genius of this program. The creators, Dr. George Little and Dr. William Keenan, both neonatologists and both doing work in Africa and China respectively, designed this program based on their experiences. Amazing men! Did I mention that I had the extreme privilege of working with Dr. Keenan when I was fresh out of nursing school in St. Louis at Cardinal Glennon Children's Hospital? He is the most brilliant doctor, both in his knowledge and in his people skills, that I have ever known.....and I've known a lot of doctors! I'm pretty sure this man walks on water when no one is looking. And, he has devoted his entire career to the welfare of our tiniest patients, making their world a better place to be. I am very happy to be working on one of his projects.
The rest of the morning was spent going through the flip chart and discussing the Action Plan poster and the importance of the Golden Minute. We then gave a demonstration of the scenarios from the flip chart that the group would be practicing after lunch.
After our demo, one of the students came up to give a return demo....and she did a spot-on job!
The last photo above is for you, Michael (Eos Visions), because it is validation that we were right to be excited about this program for Rwanda. It's also your answer to the question you asked me about sustainability.....YES this program is sustainable, and KHI will prove that by continuing to train trainers in their curriculum who will then take this program with them in their practice out in the country. I am indeed a happy "momma!"
We still had a few minutes left in our morning before lunch was ready, so we invited the learners to come up and work with the simulator manikins for awhile.
Lunch, provided by Michael and the Eos Visions team, was in the courtyard under a large tent. We scattered outselves among the students so we could get to know them over lunch.
After lunch we broke into small groups and practiced the scenarios from the Action Plan.....and answered a lot of questions!
It was a long, productive day......and we had fun teaching and learning. At the request of the instructors, we finished by 3 p.m. so they could attend an important meeting. Let's see.....what to do with our free time?!? Well, add to the Rwandan economy, of course! After shopping......and constant cries of "Yvan, is this a good price?" we had dinner at another local hotel. Good food, good local beer, good friends, and a lot of laughs! Time for a good night's sleep so we'll be ready for the testing tomorrow!
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