Cameroon Instructor Development Days

We have been busy putting together suitable programmes for our on-going development and support of the local instructors in both Cameroon and Liberia.  We have been asked by Grace and her team in Cameroon to return there once a year for the next 3 years to take them from Step 8 of the “10-steps to sustainability” plan to Step 10 (where they can train their own instructors).  We are actively fundraising for this project at the moment if anyone wants to help out – https://www.nicheinternational.org.uk/ways-to-donate/.

We have begun to put together a tentative programme for a 2-day instructor development course, termed CIDD, which will be delivered in-country to ensure instructors are up to date in both the content and delivery of their provider course, the Neonatal Care Course (NCC), and to furnish them with the skills needed to keep themselves developing professionally after 2023.

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“Apart from getting money, are we not also blessed?” [Kola on the “noble” profession of nursing]

Kola’s turns of phrase when he’s lecturing have been delighting Jo and I all day.  The title of this and the previous posts are good examples of the fervour with which he plays his role as MCAI’s on the ground neonatal trainer.  And he is not alone.  Gertrude, Agnes and Christina are equally dedicated to their patients and their unit, totally committed to the patients they look after.  And totally engaged in their roles today as instructor candidates on the Newborn Care Course.

Gertrude doing Stage 2 of the 4-stage procedure in how to tie a kalafong wrap for the baby to be skin-to-skin with its mother.
Christina overseeing resuscitation skills training.
Agnes (gesticulating with her hands) running an animated discussion workshop on pain in babies and how to manage the baby who won’t live long.

“God put all these good things into titty water so why are we deviating?” [Kola on being asked about using formula milk]

There is nothing, nothing so heartening as watching someone you’ve just trained as an instructor teaching better than you.

This is Kola putting his all into his lectures, carrying his learners with him on a wave of enthusiasm.  A truly inspirational educator.

He was good last year but, not only is he even better this year now that’s he been trained but he also keeps to time!  Just about….

 

 

First GIC courses in Liberia successfully completed!

Here are our 4 local instructors with their certificates of completion of the Generic Instructor Course in Zwedru. Well deserved. They put so much energy into the course and really developed as teachers over the 2 days.
And here are the 5 newly trained instructors in Monrovia where Colin and Alistair are running parallel courses to Jo and Julia. 1 X GIC followed by 2 x NCCs.

 

 

 

 

 

 

 

 

 

 

 

 

These neonatal clinicians and 1 doctor now have to teach on two Newborn Care Courses supervised in order to complete their training as instructors.  The NICHE International volunteer instructors should be able to complete this whole process in the one 10-day trip.  We will also be leaving a teaching set (4 manikins, scenario teaching sets and a projector) with the new Liberian faculty so that they can start to organise and run their own courses.  It would be nice to be invited back to help out though!

Zwedru

UK instructors, Jo and Julia, arrived in Zwedru on 2nd November along with local Liberian instructor trainees Kola, Advanced Neonatal Nurse Practitioner (ANNP) with Maternal and Child Health Advocacy International (MCAI), Agnes, Gertrude and Christina, all of whom have been trained as neonatal clinicians (nurses with extended roles) within the MCAI programme.  Kola has been training two neonatal clinicians here in Zwedru and they have set up a neonatal unit which they hope to expand.  UNICEF is collaborating with MCAI now to further develop the programme around safe delivery of babies and extend it into the rural areas around Zwedru.  Our role here this week is to help with the training of the nurses and midwives based in Grand Gedeh county.  Our 4 Liberian colleagues (well, Kola’s Nigerian actually but based here now) will do the Generic Instructor Course in the next 2 days and then – supervised by Jo and Julia – teach the Newborn Care Course to nurses and midwives here in Zwedru.

Getting here was quite fun!  The rainy season has gone on a little longer than usual in West Africa this year and the roads from the capital, Monrovia, are impassable.  So we came by twin engine plane….

Muddy, red laterite soil landing strip in Zwedru
Medical Aviation Fellowship (MAF) 10-seater twin-engine plane and a pretty impressive Australian pilot
Selfie of the instructor team on board the aircraft. 2 of them had never flown before.
Tropical rainforest from the plane window

Traffic light comprehension

 

 

With some French and some English speakers (and some hard to understand UK accents) we wanted to be sure that learners could hear and understand everything they were being taught.   Jarlath initiated his ‘traffic light system’, whereby everyone was given a piece of paper with a red light drawn on it.  They were asked to hold up the red light if they couldn’t hear or understand what was being said.  It works well with learners who are too polite to say they don’t follow.

 

 

We are very lucky to have such senior instructors involved with NICHE.  Their breadth of experience is humbling for those of us still hanging on their coat tails, they can adapt their teaching style to any situation, they are supremely patient with the learners and they never, ever, pass up an opportunity to pass on skills and knowledge – even if the only flat space available is a windowsill a few floors up (thank goodness it’s only a manikin).

The Newborn Care Course has reached a variety of health workers

On the NCCs at the end of April in Cameroon, altogether we had candidates from 6 of Cameroon’s 10 Regions. Participants came from a variety of work places, some small local health centres, some bigger hospitals. There were nurses, midwives, doctors and a paediatric surgeon taking part. There were English and French speakers. The workshops and small group teaching gave participants the chance to share their experiences, and discuss specific problems that they face at work.  This is important in a health environment where doctors and midwives and nurses do not usually share training experiences.

Paediatric surgeon, George, practises resuscitating a baby
Midwife, Julia, studies her course manual. Julia did particularly well on the course and is responsible for training other midwives in her health facility in Douala. NICHE left one of the manikins donated by the BMA with her so that she can continue to cascade what she learnt to others.

Civil unrest affects healthcare in Cameroon

Jarlath at breakfast with Grace, Ernestine and Margaret, instructors from Bamenda

Because of the civil unrest in Cameroon, some participants from the North West and South West Regions, which are the worst affected by violence, had difficulty travelling.  There are weekly ‘ghost towns and ‘lock downs’ in these regions, when no shops or schools are open and there is no public transport.

Nurses and doctors are forced to sleep on the floor in the hospital at these times. Pregnant women have difficulty reaching hospitals and health centres.  Three instructors from Bamenda NW Region, where we ran the first course in 2014, managed to get to Yaounde to teach.

Instructors and trustees raising money for NICHE in Berlin

We’ve been running in Berlin this weekend, raising money for NICHE International and raising the profile a bit:

One of NICHE’s senior instructors with her “magic sticks” which apparently make her run faster or more safely or something. Anyway, they worked.

 

 

 

You can still sponsor us!

https://www.justgiving.com/fundraising/joannabruce-jones

https://www.justgiving.com/fundraising/julia-thomson9

https://www.justgiving.com/fundraising/seb-palmer99

Sustainability, here we come!

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: