Service in Action

By Dr. Karin Davies, member of the Rotary Club of Del Mar, CA, USA

During a recent visit to Ethiopia, I felt a very strong connection to this beautiful country and its remarkable people. Now a retired pediatrician, I returned to the place where I had spent my childhood and saw an opportunity to use my medical training to help address the country’s high neonatal mortality rate.

Joined by my colleague neonatologist Pat Bromberger, an expert in teaching Neonatal Resuscitation Program (NRP) teacher-training programs in low-resource communities, and by fellow Rotarian Dr. Zemene Tigabu and his colleagues at the College of Medicine and Health Sciences Gondar University in Gondar, Ethiopia, we designed a Vocational Training Team (VTT) project to develop a neonatal resuscitation training program for the university’s curriculum.

I had the privilege of leading our team of five U.S. team members which included Dr. Pat Bromberger, neonatal intensive care nurse Elisa Imonte, respiratory therapist Emilie Jean, and nurse and Rotarian logistics coordinator Fary Moini.

During the two week visit to the College of Medicine and Health Sciences at the University of Gondar, our team taught 17 health care providers (including pediatricians, obstetricians, general practitioners, midwives and nurses) to become instructors in neonatal resuscitation. The Neonatal Resuscitation Program (NRP) is sponsored by the Rotary Club of Del Mar with support from Rotary clubs, districts, and a grant from The Rotary Foundation.

“It really works” exclaimed Kosi, a third year obstetrical resident who had just delivered a term infant by vaginal breech extraction.  The baby was limp and not breathing.  After unsuccessful attempts to stimulate the baby’s breathing, Kosi began positive pressure ventilation using techniques learned in the NRP provider class. The baby was screaming within minutes.  A life was saved using skills just learned through NRP!  We saw the power of vocational training in improving health outcomes before our eyes, one baby at a time.

Our team mentored each group of four instructors to teach their first NRP provider class to their colleagues.  The new instructors trained 67 additional NRP providers involving all disciplines who are involved in caring for the newborn.   In all, 84 care professionals were trained as NRP providers (16 pediatricians, three general practitioners, 23 obstetricians, 20 midwives and 23 nurses).

The instructors and students were extremely enthusiastic about the training. In fact, ten additional people arrived unexpectedly for the last training session after hearing about the class through word of mouth.  In Ethiopia, most medical training involves lecture.  They know the “theory” very well.  But chances are rare for clinical skills practice with equipment.  The instructors continually emphasized the importance of “hands-on” practice and the students expressed confidence in their abilities to resuscitate a newborn as a direct result of this training.

Thanks to the Rotary Foundation grant and our partners in Rotary, the Gondar NRP instructors now have the equipment, educational materials and support to continue this training program so that all care providers and students may take this valuable training.  Our goal was to create a self-sustaining training program in Neonatal Resuscitation and Post Resuscitation Care at the College of Medicine and Health Sciences.  Our trained instructors are now the local experts.

In October 2015 our team plans to return for a second VTT focusing on Post Resuscitation Neonatal Care, training an additional group of doctors and nurses who will become the local experts in how to care for the ill newborns after resuscitation.

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