We’ve been running in Berlin this weekend, raising money for NICHE International and raising the profile a bit:
You can still sponsor us!
https://www.justgiving.com/fundraising/joannabruce-jones
Cameroonian doctors and nurses were entirely responsible for the teaching on the course on this occasion. They rose to the challenge; time keeping being the only aspect which needs a bit of work still. Stella, one of the younger teachers, gave an inspirational talk on ‘The baby who won’t live long’, which is one of the most challenging lectures on the course.
Hard for us to teach too, as many of the babies who fall into this category in Cameroon such as those with spina bifida or congenital heart disease, can be offered so much more in the UK. The reality is that the Cameroonian instructors do have a better idea of how to make these babies comfortable and also have more experience of having to do this than the UK instructors. It is yet another area where the UK instructors learn from our Cameroonian counterparts.
Jarlath and Alison have been in Yaounde, Cameroon to support Cameroonian Instructors who were teaching on their first or second courses following their training as Newborn Care Instructors.
The courses were being run in the Cameroon Baptist Convention Resource Centre, in Mvan a suburb of Yaoundé. This is a new centre, and building was still taking place on the site. There was a big room for teaching on the 3rd floor, as well as a dining room and accommodation on site.
Teachers had to contend with hammering from the builders, tropical thunderstorms and the odd powercut, but were undeterred.
Julia recently spoke at a national conference on “The challenge of sustainability” in newborn care training. NICHE International’s vision of the Holy Grail of sustainability is in the slide below:
There is much written on skills decay over time and the lack of sustainability in the model of flying outside instructors to a country for a week to teach resuscitation skills and expect attitudes and habits to change as a result. That is why we concentrate on training local instructors and have developed our 10-step path to sustainability (see under sustainability section of the website). That is also why we are so excited about the course currently running in Yaounde, Cameroon.
These workshops and lectures are being delivered by people we trained as instructors last year:
This is Alison and Jarlath, busy in Cameroon mentoring 12 local instructors through their instructor candidate newborn care courses. We use the UK model for training instructors. They first have to do a two day very intense instructor training course known as the generic instructor course (GIC). Then they have to teach on 2 newborn care courses but are supervised during that time by a more senior instructor. At the end of this they are fully fledged newborn care course instructors. It is quite demanding training, the same as the UK advanced life support instructors go through, but is one of the best short instructor training courses available. The NICHE instructors are on site this week to complete the training of the 12 local instructors who did their generic instructor course this time last year. As a team, we are very heartened by this step. It is step 8 in our sustainability plan and means that we can remove ourselves from Cameroon for a few years. Step 9 and 10 will take place when the trained local instructors have done enough courses to start training as instructor trainers themselves. We hope to be invited back for that stage in two or three years time.
Sustainability has nearly been achieved in Cameroon and so it seems fitting that Alison – who set all the wheels in motion with this project in the first place – should be returning for what will probably be the last trip for UK instructors for a while. She and Jarlath, one of the other very senior instructors, are travelling to Yaounde at the end of April to help Grace and the team of Cameroonian instructors with 2 more Newborn Care Courses. Their main role while there will be to mentor the next group of partly trained instructors as they teach on their first 2 courses and become fully fledged instructors in their own right. This will bring to 20 the number of local instructors and renders the project viable without any input from UK instructors.
We have worked out our plan of action for 2019 and 2020. The business plan is available via the “Our Mission” page at https://www.nicheinternational.org.uk/mission/. In short, we intend to do one trip to Cameroon this year to run two Newborn Care Courses and supervise the 12 partially trained local instructors through their first two teaching experiences. When we leave, there will be a faculty of 20 fully trained NCC instructors, many of whom are working in health facilities that the Foreign and Commonwealth Office advises UK personnel not to travel to currently. UK instructors will only need to return to Cameroon to run Generic Instructor Courses (GICs) in the future. We also hope to do 4 trips to Liberia over this period, to train healthcare workers and run two GICs to start developing the local faculty, replicating the model we developed in Cameroon. We have a lot of fundraising to do to realise this business plan. Any help gratefully received! You can donate at https://www.nicheinternational.org.uk/want-to-donate/. Thank you!
NICHE International trains local instructors to teach the Newborn Care Course. Here’s a little ice-breaker that I learnt from the lead neonatal nurse of Bamenda Hospital….
So we are back home again in the dark, cold UK. I wore the traditional dress I was given by CH Rennie Hospital today to cheer me up and help me wade through the mound of paperwork that awaited me at work.
We had a very successful trip all in all. We trained 26 midwives and neonatal nurses, further honed the course material and made friends with some wonderful people. Working alongside MCAI (www.mcai.org.uk) worked well. They are doing sterling work with extended skills training for midwives as well as supporting the neonatal nurse practitioner programme. Their medical director, Professor David Southall OBE, recently spoke about MCAI’s Liberian task sharing programmes, see https://torquaymedsoc.com/liberia.
Resuscitation of the newborn is all about team work and in the UK we train people as much in how to get the best out of and support their team as we do about what to actually do in a resus situation.
Our Liberian learners have a lot of experience with trying to resuscitate very sick babies. Much sicker than any we see nowadays in the UK thanks to better obstetric care and recognition of fetal distress before the baby is significantly deprived of oxygen. They are used to taking responsibility for these sick babies and their clinical skills are impressive. But when we try to get them to resuscitate in pairs or in threes, they will often ask if they can practice it “alone”. This is because many of our learners are single-handed practitioners in remote communities with no one who will answer their call for help in an emergency situation.
We teach them how to balance the bag on their arm to better facilitate rhythmic chest compressions and breaths for newborns in extremis – I find their earnestness humbling. When have I ever been in an emergency situation without 2 or 3 extra pairs of hands around me?
