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.