Pictures of the Peds Ward

Educational Experiences Pay Off!

As part of our month at Mbingo, we have been giving afternoon lectures to the residents on medical topics. Mine of course all have to do with peds!  When I first arrived, I noticed that we were missing signs of dehydration, sepsis and shock.  Children can die if they are not resuscitated appropriately and I witnessed this happen the first few days I was here.  Yesterday I gave a talk on recognizing and treating dehydration/hypovolemia in children.  I really emphasized the signs of a sick child - poor pulses, cool extremities, high heart and respiratory rate and the importance of ongoing assessment and fluid management so they do not deteriorate.  Today Promise, one of the Nurse Practicioners, found me because he had just admitted a "child with severe dehydration".  We went to see him together and he pointed out all the things that we had talked about that indicated the child was severely dehydrated and hypovolemic.  The anterior fontanel was depressed, the eyes sunken, the skin was dry and tented when pinched, the hands and feet were cool with rapid pulses.  He had written orders to give a 20 mL/kg bolus of NS and for ongoing fluids and had planned to switch to oral rehydration fluids when the child was resuscitated and able to drink.  I agreed completely with his assessment and plan.  His recognition of how sick this child was and how to treat will hopefully save his life.  It's hard to come in as a foreign doctor for a month.  You have to quickly build trust with your colleagues at the same time you are trying to share information and knowledge that will better the care given.  It's important not to be too aggressive or arrogant or you will destroy that trust.  I feel very thankful that I have been able to create good relationships here and was able to teach such important concepts that made a direct difference in a practicioner's and a patient's life.  

Another beautiful hike...

Update on My Child with the Asthma Attack

The little girl I wrote about who was admitted in severe respiratory distress due to an asthma attack is greatly improved and was able to be discharged home yesterday.  It was a very reaffirming moment!  What's even more exciting is that when I came into round yesterday morning, one of the nurses had gotten a water bottle and was making a spacer for her to take home with a salbuterol inhaler to use when she had another asthma attack.  I was so impressed that they observed what we did and applied it to the patient.  It will definitely help keep her safer in the future.  And hopefully they will be able to do that for more patients with asthma.  The little girl is now a wild woman (probably from the exorbitant amount of steroids we gave her) and is running around the ward laughing and playing.  It was a great outcome.

Breathing better and running at the camera!

Making a spacer in the pediatric ward

It's moments like these that help remind me why I went into medicine.

How to Treat an Asthma Attack in Africa

We have had a tough and busy last few days working in the Pediatric Ward.  We are full beyond capacity and have admitted lots of sick children who we don’t know the diagnosis.  I woke up this morning and secretly prayed that we would have smooth rounds, that children would be improved and things would go well.

We had rounded on the first 5 beds when they wheeled in a little 2 yo girl on a stretcher.  She was laying very still under the covers and my first thought was that she was dead.  I came over and pulled back the covers and found a lethargic, unresponsive child who was working very hard to breathe, harder than I had seen before.  She had pulses, but would not respond.  When I listened to her lungs, she was not moving much air in and out and had a very prolonged expiration.   Her mother told us she had been healthy and started to work hard to breathe over last night.  I thought she was in respiratory distress due to an asthma attack.  

We put oxygen on her, and started breathing treatments with salbuterol and gave IM steroids.  After the second treatment, she started to wake up and push us away.  She was still working very hard to breathe but was moving more air and her oxygen saturation had improved.  I smiled both inside and outside in relief.  Finally something I knew how to treat and could help the child. 

After the second treatment, the nurses placed her in the bed and walked away.  She needed to continue salbuterol to keep improving, so I asked over and over for another treatment.  Finally one of the nurses said, “we have used all the salbuterol, there is none in this town or in Bamenda (the larger neighboring city)”.  I was shocked.  This previously healthy girl may die because we didn’t have any more of the medicine we needed.  It was the most frustrated I’ve felt in my time here.  I kept myself calm and started thinking through all of the other things we could do to treat her asthma.  We gave intramuscular epinephrine that didn’t have the concentration on the bottle or box anymore so I was very unsure if it was the right dose.  We started aminophylline – a drug that can easily become toxic and we don’t use in the US anymore.  All the things I normally use – albuterol, atrovent, methylprednisone, magnesium – weren’t available.  I didn’t have ICU nurses or respiratory therapists to watch her closely.  I didn’t have labs to check the drug levels of the aminophylline.  But we had to do something to keep her alive as she was deteriorating again in front of our eyes, so we did everything we could think of to do. 

Mary and Brian are two family medicine/psychiatry residents that are in Mbingo with our group.  They happened to see me and I filled them in on our situation.  They had a very hard time believing there was no salbuterol and went to the pharmacy to see what other options there were.  They found out we had lots of salbuterol inhalers, just not the nebules.  We use the nebulized form in young children because they cannot inhale on demand to take the inhaler.  But when you attach a long tube called a spacer to the inhaler, you can activate the inhaler into the spacer and then have the child breathe the air with the medicine out of the spacer.  We raced home to make a spacer out of a water bottle and duct tape.   I was very grateful to have creative friends here who were willing to help me find a way to take care of my sick patient.  We brought the homemade spacer back up to the ward and showed the nurse.  She looked confused for a moment and then reached far back into the supply cabinet and pulled out a single spacer, like the ones we use in the US.  We had had one the whole time, but either no one mentioned it or knew what it was for.  It will still be a long night for the child and her family, but I am much more hopeful that now she will survive.  Even though today wasn't as smooth and easy as I hoped it would be, I learned how to quickly work with the resources I had to give care in Africa.  

The Cost of a Life in Africa

Azaelle has sickle cell disease, meaning his red blood cells have a genetic defect that causes them to be sickle shaped instead of round.  The sickled cells can get stuck in small blood vessels and rupture causing anemia, pain, lung problems, strokes, infarctions of bone and lots of other complications.  Azaelle was admitted with a pain crisis in his foot, had been improving and we almost discharged him over the weekend.  When we rounded yesterday, he was requiring oxygen, was very sleepy and looked terrible.  I was very worried about him.  He didn’t have pneumonia or another pulmonary problem to explain his oxygen requirement.  He had a loud murmur and I was concerned his hemoglobin (part of the red blood cell that carries oxygen) was low.  That could explain his oxygen requirement and he would need a transfusion. 

Azaelle is here with his Uncle.  His mother is pregnant and unable to travel the long distance to Mbingo, and his father works far away.  As I was trying to figure out why Azaelle needed oxygen and what to do about it, his Uncle demanded to be discharged.  He said he only had 9000 francs and the hospital bill was already 8300 francs and he could not afford another night.  Everyone treated at Mbingo must pay their bill before they leave.  There are many people that sit around the hospital grounds for weeks waiting for family members to bring more money for their bill.  He said that he had to be at his job tomorrow otherwise he would be fired.  The nurses, residents and I worked all day to explain why his nephew was so sick and needed to stay in the hospital to get care.  When we took him off oxygen he dropped to 68% oxygen saturation and had trouble breathing.  I wanted to scream “look at him, don’t you understand?”  He wasn’t even the child’s parent, what gave him the right to choose to take him out of the hospital and risk his life.  But there was no way he would change his mind; he had to go now.  

Many times during the day the nurses threw up their hands and asked me to write an order to discharge the child against medical advice.  I refused.  The child would die if he left.  I didn’t think there was a choice, he wasn’t going to leave and I certainly wasn’t going to write an order saying that he could.  Even if the order said I explained the risks and benefits and they were leaving on their own will.  I tried to be empathetic to the situation.  Having no money to pay the bill and then loosing your job is a terrible situation.  But loosing a child has to be worse.

I enlisted the help of the chaplains and don’t know if they were the ones that talked him out of leaving, or if we argued so long that there wasn’t enough light in the day to travel.  Either way they stayed, and almost 12 hours later, I was finally able to get the hemoblobin level I wanted.   The hemoglobin had dropped from 6.9 three days ago to 4 (normal levels would would be above 12, but many sickle cell patients live at 10).   We gave Azaelle a blood transfusion and this morning he was much improved.  The family is still here because when you receive a blood transfusion at Mbingo, the family must donate blood to replenish the hospital's supply.  The Uncle is not willing or unable to donate blood and they are waiting for a family member to come and give their blood.  I’m just happy that it bought me some time to care for Azaelle. 

There have been many times I haven’t been able to care for a patient the way I would want to; the way I would in the US.  I have had to find ways to work within the system with the resources available.  This is one time I chose to stand my ground on something I believed strongly about.  I have been unable to save or help many children here in Mbingo, but I knew I could help this child and would not make the decision to let him leave.  I wondered if I had made the wrong decision – if the family would be in debt and loose their jobs for my choice.  One of the chaplains who helped talk to the Uncle yesterday stopped me as I walked to dinner tonight and reaffirmed the choice I made.  He said that he was so grateful for doctors who cared enough about a child in Africa to make a hard decision and fight for them to get the care they needed.  I won't always be able to fight for the children I take care of.  Some will be too sick or we won't have the resources available to help them.  But I know that I did the most that I could do for this child and I hope that his Uncle will one day understand.

The Things Medicine Can't Provide

I haven’t made many posts about the pediatric ward and the patients I’ve taken care of. I think the reason is that the first week we arrived in Mbingo, we experienced what every doctor dreads – we had three children die. The first died of Burkitts lymphoma after starting chemotherapy. Another was brought in to the ward already deceased from complications of HIV. The third child died from septic shock despite our best efforts to save her. I can still hear the mother’s wails and the silence of the rest of the peds wards; each mother secretly relieved it was not their own child but fearful they could be next. It was a baptism by fire to practicing medicine in Africa. I pushed my feelings deep inside, as I so often have to do when taking care of sick children, in order to keep working.

Today we visited the peds ward not just as doctors, but as people that cared about the patients and their families. We sat and visited with the mothers. We brought mobiles that the Schlaudecker children made and hung them in the windows. We handed out balloons and crayons with coloring pages to all of the children. One by one, smiles crept across faces, mothers laughed and opened up to us. I learned more about the families I was caring for in that afternoon than I had in all the mornings rounding. And it was therapeutic!

The boy in bed 1 is an adorable 6 year old who has had weight loss and fever for the last 8 months. His mother has been sick with worry watching her son waste away and took him from doctor to doctor until coming to Mbingo. We believe he has TB, though the tests we have are negative, and he started treatment one week ago. He looks fatigued and malnourished and is too quiet and sad appearing for a 6 year old child. As I visited with his mother, the boy sat up in bed and started coloring, which was more than I’d seen him do the whole week he has been admitted. His mother said she was so happy to see him play again.

Another child is an adorable 4 year old recently diagnosed with HIV and possibly TB and is very ill. He is too weak to sit up for long, but when we gave him his balloon he smiled and laughed and batted it back and forth between his mother, both looking like they had forgotten how sick he was for a minute. His mother said she hopes that getting to play will help him build some of his strength back.

Then there’s a 15 year old girl who came in with paralysis of an unknown cause. We suspect that she has conversion disorder (manifesting stress as the symptom of paralysis) triggered by her father getting put into prison. She sat up in bed and smiled for the first time, eagerly waiting for us to come to her.

I’ve seen how even with the best medicines and care, children can be damaged or die, in Africa and America. But the statistics and hope here are even grimmer. I’m not able to make my patient’s TB meds work faster or cure their HIV, no matter how much I want to. But today, I was able to help them play and be kids, which I believe helps them to heal. I was able to look the mothers of the children I cannot cure in the eye and make a connection; to show them that there are people in the world that care deeply for their families. I was able to give them something that medicine alone is unable to give.

Water in Afria

Every morning in Africa I try to take a shower.  Every morning freezing, cold water just drips out of the spigot.  There's barely enough to wash off the soap.  I quickly rinse off and make the best of it.  Later, I found out that the others in my house who took showers in the evening had lots of hot water that didn't run out.  We couldn't figure out why there was no water in the morning.

This morning I woke up at 6 am to the sounds of little feet running on the concrete outside my window.  Then came the sound of running water.  For an hour the water ran and when I finally got out of bed to see what it was, I found African children filling up their buckets from a spout off the back of our house.  I ran to the sink; there was no water.  I ran to the shower; there was no water.  They were taking our water!  Then I thought, "Our water? What makes me think that the water is mine?  Because there are pipes bringing the water directly into my house, it makes it mine?"  I looked out further behind our house and could see African women giving their children baths.  I guessed that inside their homes there was water boiling on stoves for breakfast or to purify it to drink.

Everyone deserves access to clean water, and in Africa, that means you have to share.  Sometimes it's hard as an American to live this concept.  We are so used to having everything when we want it and how we want it.  Even when we don't realize it, we've lived that way for so long, it's hard to change our way of thinking.  I was able to take a nice, warm shower that afternoon and was grateful that there was water available in this area of Africa for everyone to share.

Sunset in Africa

My African Dress!

The women in Cameroon dress in the most colorful dresses and skirts.  When it rains for hours each day, it's fun to have bursts of color all over the place.  Each pattern and design is different from the last.  One of the surgeon's wives, Bertha, made all of us African dresses.  She is a very skilled tailor - my dress couldn't fit more perfectly, which is hard to do!  She picked out the fabric herself and designed each one uniquely.  She made all four of our dresses in 2 days which I imagine would be very hard to do!  She is talented and I feel privileged she made me such a beautiful dress.  

Fou Fou and Njamajama

We had our first real Cameroonian meal today.  Fou Fou and Njamajama!!! There are people all over the hospital sitting around at lunch and dinner eating this same meal.  Just thought I'd share!

Fou Fou
Fou Fou is a corn meal mixture.  Africans roll it into a ball and use it to scoop up the Njamajama.

Njamajama
Njamajama is a sauteed spinach mixture.  Cameroonians eat Njamajama and Fou Fou with their hands, but I braved cultural taboo and used a fork.  

Helping Babies Breathe is Underway

We just finished the second day of teaching Helping Babies Breathe to the midwives at Mbingo.  I've been so impressed with the 6 midwives we've worked with.  They have the insurmountable job of delivering and caring for all the babies born in Mbingo.  Many of the women try to deliver at home for days and come to the hospital when the delivery doesn't go well.  By the time they arrive, the baby has been stressed for a long time and is very difficult to resuscitate.  The midwives work so hard to care for these women and children and are very willing to participate in a learning opportunity that will help them improve their care.    

Helping Babies Breathe teaches the basics of neonatal resuscitation using a plan of action with the goal of the baby breathing on their own or with assistance within one minute of life.  The midwives learn through simulation and practice to master each skill.  We use Neo-Natalee to simulate a real baby.  She's filled with water and has the same weight and tone as a baby.  There is a bulb attached to her that when pressed simulates chest rise like the infant's breathing and an umbilical pulse.  You can suction her mouth and use a bag-mask to give breaths and assess how Neo-Natalee responds.  And she packs up flat so she fits in a suitcase!  The really interesting educational opportunity is that the learners take turns being Neo-Natalee (controlling her breathing and pulse in response to the resuscitation given) and being the resuscitator.  They then teach each other and give feedback.  

It's a great system and I've learned so much teaching it.  The Cameroonian midwives are very knowledgable and have been enthusiastic and engaged during the course.  They ask lots of questions and want to keep practicing with the simulator.  Erasmus was one of the midwives in the course today  who told a story of how he was working in a distant health clinic and a mother was brought in after labor for many hours.  The infant was breech and was stuck in the birth canal.  Erasmus did different maneuvers and was able to free the infant but the infant was very asphyxiated.  All  he had was a bag-mask and he ventilated the infant for a long time and then the baby started breathing on his own.  Erasmus said he was grateful that he was able to do that.  By sharing his story, I think it showed he bought into what we were teaching him.  That breathing for the baby who doesn't breathe on their own is the most important thing.  Many midwives and doctors here are taught to intubate the infant with a breathing tube, even if they don't have ventilators.  While they struggle to intubate the infant, the infant is without respiration or oxygen for many minutes risking brain damage and death.  At the beginning of the course discussion, many of the midwives wanted to immediately intubate but as we explained the importance of bag-mask ventilation and let them practice, they seemed more confident in their abilities and understood what we were teaching.  It was very uplifting to work together with people of a different culture and type of training to find the best way to care for their neonates.  I feel that I've made strong connections and friendships with these midwives through the course and feel very privileged to work with them.   

Cost of Having a Heart Defect in Africa

My first day in the hospital at Mbingo, I was consulted on a fullterm twin in the newborn nursery that required oxygen at birth and then was unable to wean off.  He had been feeding and growing well, didn't have any signs of heart failure or heart murmurs and all of his pulses were normal.  But as soon as you took him off oxygen, his saturations slowly decreased.  The question was lungs or heart?  We ordered a chest Xray and 3 days later it was performed and showed a normal sized heart.  An ECHO (ultrasound) of the heart was ordered but up until now has not been done.  Since he looked so well and without other signs of the heart being the cause of his oxygen requirement, we thought he had persistent pulmonary hypertension but expected that by now, on day of life 10, he would be off oxygen and home.  I spoke to one of the residents and asked what would happen if there was a heart defect.  His said that those children are sent 7 hours away to a hospital in Yaounde, Cameroon where they can sometimes do heart surgery, but that it was expensive and most families can't afford the cost.  I asked what happens if they can't pay to go to Yaounde?  He said, then we take them off oxygen and send them home.

As a mother, how do you make that decision?  Continue to give the brand new infant you brought into the world the oxygen or surgery they need and risk having the rest of your family starve.  Or take them off oxygen and bring your infant home unsure if they will live or die.  As a doctor, how do you make that decision?  You've entered a field where at the minimum, you work to "do no harm" and strive to help your patients each day.  But is the harm to the individual more or less important than the harm to the whole family?  This morning, the midwife decided to take him completely off oxygen and see how he will do.  I'm not sure the mother even got to make that decision.

Everyday I visit this mother and ask if the babies have names yet.  Everyday she answers, "no, not yet".  One of the midwives explained that people wait many weeks to name their children because names are very important.  Lots of family members give input and want the child named after their deceased relatives as a reminder.  The mothers get lots of suggestions and then decide which name is best.  I wonder if they really wait to see if their child will live or die before working so hard to choose their valued name.

Morning Hike

We woke up early this morning while it was still dark and set out on a hike to the top of one of the mountains overlooking Mbingo.  The hike started out pitch black with trees lining both sides of the trail so we couldn’t see very far.  The higher we climbed, the mud of the trail turned into dark red clay and the trees turned into shrubs so we could see for miles and miles in each direction.  The sun peeked out of the cloud cover illuminating a distant mountain covered in fog.  We were on the top of a mountain with jutting rocks and the valley below had rolling hills studded with small villages.  I wondered what all these mountains and hills had witnessed – how many births and deaths; celebrations and bloodshed.  But despite all the inevitabilities of humanity, the progress and mistakes made generation after generation, the mountains remain, towering constantly over this small valley, and it reminds me that there’s something much bigger than myself in this place.

Mbingo Baptist Hospital

Mbingo Hospital is an amazing place - it has 260 beds that include general medicine, surgical, pediatric and maternity beds.  They have a Cameroonian surgical and internal medicine residency program as well as a nurse practitioner training program and are very focused on education and improvement.  My jobs while I'm here include rounding with the residents on the 20 bed pediatric ward, presenting pediatric learning topics at afternoon conference and seeing sick infants in the maternity ward.  We've been working hard with the midwives getting ready for the Helping Babies Breathe course and getting information on how they practice neonatal care and where improvements can be made.   The midwives have all been very interested in how infants are taken care of in the US and were shocked to learn how premature some the babies we take care of are.  There's no lack of work or patients to see.  Here are some pictures of the hospital, the pediatric ward and the 6 bed NICU to give you a feel of where I am every day.  


In the Entrance to Mbingo Hospital

In front of the Pediatric Ward

The NICU - two incubators with the ability to give oxygen and CPAP

Triplet Infants that are doing great!

The other infants in the incubator

    

Some Pictures of Mbingo

Our house in Mbingo

Road to Mbingo Baptist Hospital

                                                

View from our house 

It's the rainy season so there it's very foggy and pours rain every afternoon and evening.   But the mountains are gorgeous and everything's so green.     

I'll take lots more pictures and post them as soon as I can!

Traveling to Mbingo

The city of Douala is like many other larger cities I’ve visited – full of people, abandoned and falling down buildings, crowded streets with mo-peds darting in and out through cars.  The streets of Duoala are lined with shops selling everything from produce to t-shirts to cheetah printed lazy-boys punctuated by roaming herds of cows.  As we drove out of the city and towards the northwest province the scenery changed.  The road was still lined with villages selling goods but as we got closer, the scenery became more and more beautiful.  There were hills lined with banana and papaya trees.  Some villages had huts made out of plywood, others square with mud bricks and others with round pointed roofs.  I loved passing the women wearing the colorful local prints – every kind you could imagine – with adorable Fulani children with their shaved heads strapped to their backs.  Of course the poverty was evident but the fatigue was wearing off and I was able to start appreciating the beautiful things about the country along with the rest.   
    
Mbingo looks like a picture straight out of a book.  The hospital and houses are set in a valley surrounded by tall hills covered with lush green shrubs and palm trees and waterfalls tumbling down the sides in the distance.  It's the rainy season so there's mist and fog rolling over the highest hills and down into the valley.  

Most people who work in the hospital live close by so the valley is dotted with all sorts of different houses.  Everyone you pass greets and smiles at you, which is very refreshing after a long trip.  It’s evident that the people of Cameroon are very kind.  I want to take pictures of everything but don't want to be rude so am holding out until I get to know people better.  Which is a little ironic because a Cameroonian guy took a picture of Liz, Jane and me today with his cell phone as we walked by!  Who's the tourist now?  Hopefully I'll have some pictures to post soon so everyone can see how beautiful it is here.            

Arriving in Cameroon

Traveling is always hard, but I’ve learned to expect the lines, delays, language barriers and hours without good sleep.  I find the hardest part of any travel experience is the arrival.  Somehow in all the excitement of planning, I build up expectations of how my destination will be.  Those initial expectations are rarely met.  Whether it’s the fatigue or the new and different environment, I usually feel overwhelmed and a little disillusioned when I first arrive.  But I’ve learned to take a deep breath and wait.  Inevitably the beauty of each place, the personality of its culture and the experiences waiting for me reveal themselves and I fall in love with travelling all over again. 

My initial thoughts arriving in Cameroon were probably swayed by lack of sleep, a long delay and an even longer flight.  We arrived at the airport late at night; it was very dimly lit, giving it an eerie feel.  It’s the rainy season so the air was thick and damp and smelled like a mixture of smoke and sweat.  We stood around the baggage claim getting pushed closer and closer to the conveyor belt by anxious Africans all wanting to get their luggage.  Slowly bags came up the conveyor belt and one-by-one were claimed.  The belt ground to a stop as the last bag was picked up and I was left on the continent of Africa with nothing.  I took a few deep breaths and fought back the tears stinging my eyes and returned to my group.  I smiled and made everyone, including myself, believe it was all OK.  My brain wanted to tick off every item in my bag – how much it cost, how much I needed it on my trip.  Instead I forced myself to think about the things I did have and was thankful for.  The first thing that came to mind was that I was thankful for my safety.  Safety is something that many people in Africa don’t have and there were far worse things happening around Africa at that same moment.  I was very thankful for travelling with great friends who let me borrow mosquito nets, shampoo and clothes (thanks to the Schlaudeckers, Mary, Brian and Sara!).  And I humbly realized that I’m lucky enough to have the ability to replace every item in that bag.  Something like loosing my luggage is inconvenient, but not devastating for me – but there are many others who have less and a loss like that would be devastating. 

So yet again, not the ideal start that I imagined for my trip to Cameroon, but a very important part that will help define the rest of my time here.  

Why I'm Going to Cameroon

Thank you so much for joining my blog!  I can't wait to go to Cameroon and tell everyone about what I'm doing.  

I guess the overriding reason why I feel compelled to spend a lot of money and time away from all of you in a country this far away is that I've been blessed with knowledge and education that very few get to experience.  Mbingo Baptist Hospital is working very hard every day to educate Cameroonian medical residents and other health practitioners while improving patient care in the region and I feel I can add to that mission.  I strongly believe the most effective way to improve someone's life is to empower them through education.  Then they can not only improve their own lives, but educate others and the cycle continues!  My goal in going to Africa is to share my knowledge in pediatric and neonatal care with others so they can better care for these little guys in the future.  Just as important as what I have to give is what the people I meet in Cameroon have to teach me.   There’s so much I have to learn both as a doctor and as a person and can’t wait to share everything I experience in Cameroon.

I'm most excited to start teaching the Helping Babies Breathe neonatal resuscitation course.  There are 3.6 million neonates worldwide that never make it past their first month of life each year.  A substantial amount of these deaths could be prevented - mostly through education and very simple changes in care.  You don't necessarily need ventilators and advanced ICUs to save the lives of most of these infants.  About one quarter of these neonatal deaths are due to birth asphyxia - or not breathing after birth.  More often than not, mothers are giving birth at home and those assisting the delivery are not trained in caring for or resuscitating the new infant.  The focus is often on the Mom and the newborn is set aside to either live or die.   Helping Babies Breathe was designed specifically for resource-limited countries and teaches those caring for neonates at all education levels how to assess the baby with the goal of them breathing on their own or with assistance within the first minute of life.  More importantly, there is someone trained at every delivery that is caring specifically for the infant – warming, drying them and helping them to start taking their first breaths in this world.  The staff at Mbingo Baptist Hospital is very excited to be involved in this training and I can’t wait to work with them and something I’m passionate about. 

It’s going to be a wonderful experience, but hard to be away from my family and friends.  Please comment on any posts, send me an e-mail or facebook message and help me keep in touch.  I want to hear from all of you!

Next time you see a post – I’ll be in Africa!