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Fundraising for NICHE

Conal at 25k

On Sunday 15 October, Conal McDonagh completed the Amsterdam marathon – his first – to raise funds for NICHE’s work. Conal is the son of Alison Grove, NICHE Trustee.

Unable to take part in the run, his partner Gill Monaghan decided to do a ‘plank a day’ for a month to help raise funds. A professional dancer, Gill squeezed in her daily plank while touring in Europe.

Thanks to both for their tremendous efforts and for raising funds to support NICHE’s projects.

Gill planking all round the world for NICHE!

Link to their fundraising page is:

https://www.justgiving.com/page/conal-mcdonagh-1695145301040

First independent course in Bwindi, Uganda

6 members of the trained faculty in Bwindi taught their first independent NCC this week

We were delighted this week to briefly and remotely join Sadias and his faculty for their first 2.5 day Neonatal Care Course since their own instructor training in February. 6 of the trained faculty were teaching 16 trainee nurses from the nursing school which adjoins Bwindi Community Hospital.

Prescribing antibiotics workshop
intraosseous needle insertion
Happy learners with their certificates

Julia joined Sadias (remotely) at the first break on day 1 and was impressed with the set up for the course – lovely light rooms with plenty of space and all stations prepared, ready to go. NICHE International had sponsored the refreshment breaks as we believe so strongly that people learn better when their physiological needs are met. I therefore got to talk to one of the students while he was in the queue for coffee. He was delighted with the course and felt his learning needs were being well met. Cath joined the team on day 2 in the morning to answer any queries the new faculty had. Other than that, they were completely autonomous. Well done, the team!

We are waiting to hear what support the Ugandan faculty feel they might require next.

NICHE at the Advanced Life Support Group (ALSG) conference in Manchester, UK

Our newest trustee, Dr Cath Harrison, and Dr Julia Thomson were speaking at the ALSG conference yesterday.

NICHE’s presentation was based around Maslow’s motivational model and showcased the need for “forward thinking, innovation and flexibility” which was the theme of the conference

Maslow is often quoted in adult learning circles – he developed his hierarchy of needs over 30 years from 1940 to 1970, believing strongly that humans want to grow and develop themselves and others and that – once our deficiency needs are met – we will automatically move up the pyramid. We spoke about the importance of feeding everyone properly on a course (Physiological needs) and ensuring everyone feels part of the team (Belonging and Love Needs) and valued (Esteem Needs). Only then will learners start tending to their own Cognitive Needs (engaging with the Neonatal Care Course), formulate plans to apply their learning (Aesthetic Needs), become instructors themselves (Self-Actualisation) and feel the buzz of teaching others for the good of all babies in their country (Transcendence).

Neonatal resuscitation trainer in Liberia, Grace directing the recent NCCs in Uganda

Funds raised for NICHE from the North Downs Challenge

On the 22nd July two people took part in the North Downs Challenge to raise funds for our projects.

Paediatrician Julia Thomson, one of our NICHE trustees, completed 10k in an excellent time.

Charlie Crossley battled through wind and rain to complete 50k, accompanied by his friend Josh.  Charlie is the father of premature twins who are now 2 years old.

He and his wife were grateful for the care they received from the NHS, and Charlie wanted to support the work of NICHE International which helps to improve the care of new born babies in poorly resourced areas of the world.

Charlie and his friend Josh with NICHE trustee Alison, in the rain at 32k
Charlie and Josh finish 50k

We are very grateful to Charlie and Julia for rising to ‘the challenge’, and for their successful fund raising.

Mboppi hospital, Douala

The next NCC taking place in Douala, Cameroon, June 2023
Keen students on day 1
Where is Douala?

Grace and team have been busy this week with 2 Neonatal Care Courses in Cameroon. 24 keen midwives and nurses attended.

Rainy season challenges

A rainstorm threatened to bring the NCC to an early finish today as the crescendo on the chapel’s tin roof drowned out the lecturing

Undeterred, Judith found a microphone, the learners donned diocesan gowns from the vestry, moved their chairs to leeward and the lecture on the “Small Baby” continued.

The temperature dropped like a stone when the rains came. The learners were undaunted. The show went on.

Do as I Say and Do

Two instructors and two learners on this second Neonatal Care Course have breastfeeding babies with them. Look at the size of them! Great to have real life role models; we should encourage this on UK courses.

23 countries, including Uganda, have achieved exclusive breastfeeding rates above 60 per cent. The other countries are Bolivia, Burundi, Cabo Verde, Cambodia, Democratic People’s Republic of Korea, Eritrea, Kenya, Kiribati, Lesotho, Malawi, Micronesia, Federated States of Nauru, Nepal, Peru, Rwanda, São Tome and Principe, Solomon Islands, Sri Lanka, Swaziland, Timor-Leste,  Vanuatu, and Zambia. Is your country represented here? Can you do anything to get your own country on to this UNICEF list?

In Africa, nearly 70 per cent of countries have high rates of continued breastfeeding at one year, but in the Americas, only four countries have such high rates.  [Source: https://www.unicef.org/uganda/press-releases/babies-and-mothers-worldwide-failed-lack-investment-breastfeeding]

Transitioning to Ugandan instructors

Judith demonstrating insertion of an intraosseous needle into a dehydrated baby’s shin bone

Skills are taught as a 4-stage procedure – silent run through, demonstration with explanation, learners talking instructor through the skill and then all have a go. This imprints the skill on the learners’ minds. Which is why it is very important for the instructor to get it right and be consistent!

Phionah demonstrating how to make CPAP to support a premature baby’s breathing

There is no piped oxygen in Bwindi Community Hospital. The grey machine on the floor here is an oxygen concentrator. If the ensuing oxygen/air mix is then piped through a bottle of mineral water, the pressure at which it reaches the baby’s nostrils can be increased. Preterm babies’ lungs tend to collapse with each expiration and putting them on this CPAP helps to prevent that.

Dr Alex running a workshop on recognising “danger signs” and managing the sick infant in a timely fashion

We use the Global Health Media videos to illustrate much of what we are teaching. They are excellent videos on all aspects of medical care in resource poor areas of the world. Check out the breastfeeding ones which I think we should show more in the UK. Uganda has very high rates of breastfeeding so here we concentrate more on recognition of the sick infant, for which these videos are also very useful. https://globalhealthmedia.org/videos/

Looking after the mothers

Regular readers of this blog will know that we often talk about Skin to Skin Mothercare (S2SMC) or Kangaroo Mother Care (KMC) as the most appropriate way of keeping babies warm, promoting bonding, preventing infection, augmenting growth and supporting breastfeeding. Mothers can also be taught to keep an eye on their baby’s breathing and general health and alert the nurses if any apnoeas (pauses in breathing) or other concerns. But mothers too need looking after.

Washing facilities for resident mothers and mothers-to-be at Bwindi Community Hospital

Mothers need washing facilities for themselves and for their clothes and baby’s wraps. They need to be able to prepare food for themselves and to have access to clean drinking water. They need somewhere to sleep themselves. You can see the cook house in the background of this picture and the dormitory on the left. Some of these resident mothers are in the hospital for many weeks, either antenatally or postnatally if their baby is born early.

Women with high risk pregnancies come in antenatally and this project alone has had some impressive results when it comes to delivering the women before their babies run into trouble and therefore preventing hypoxic ischaemic encephalopathy (formerly “birth asphyxia”) in particular.

Having facilities like these available to the mothers of premature babies after delivery encourages them to stay on site and therefore be available to their baby for skin to skin mothercare.

And then they could fly….

We’ve just finished Day 1 of the first Neonatal Care Course being taught by Ugandan instructors. All 12 instructors passed the Generic Instructor Course yesterday and rose to the challenge of teaching the NCC today. We are running this course in the chapel. Grace is course directing and made sure everyone knew the ground rules.

It wasn’t long before the newly trained instructors took over from us:

Newly trained instructors teaching resuscitation skills
BCH chapel hosting the Neonatal Care Course