En route to Cameroon after being grounded for 2 years!

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Skelleftea Airport in north Sweden

We are delighted to be welcoming Dr Ferenc Sari to the team for this week’s trip to Cameroon. An emergency department doctor and an educator with the European Resuscitation Council, he has lots of experience of living, working and teaching overseas. We were on tenterhooks for his Covid PCR result as he has only recently recovered from the illness but all 4 instructors had negative results yesterday and are now en route to Yaoundé from Sweden, Northern Ireland and the UK.

Ferenc’s journey is probably the longest

The team has a heavy week ahead of them. They are facilitating the first ever Instructors Development Day (IDD) as well as a Generic Instructor Course (GIC) followed by two Neonatal Care Courses (NCC).

Back to cameroon later this month

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Julia’s been packing up teaching equipment again

NICHE Instructors are excited to be returning to Cameroon later this month. We are piloting a specially written Instructors’ Development Day for the faculty members there to support their Continuing Professional Development. This will be followed by a Generic Instructor Course with two of the Cameroonian faculty beginning to train as instructor trainers themselves (see step 9 of the “10-steps to sustainability” plan) and two more Neonatal Care Courses (NCCs).

Over 300 healthcare professionals in Cameroon have been trained in the care of the newborn infant in the first 28 days of life and the team is beginning to see the positive effect on their neonatal mortality figures.

Uganda – step 1

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We are delighted and very excited that we are at last going abroad again – tomorrow!

I (and the family cat) have been packing up 4 teaching sets and trying to keep the weight down as our internal flights from Entebbe to Kihihi allow rather less baggage than we normally take with us.

Julia (and Chocco) packing up teaching equipment for NICHE’s first trip to Uganda

We are going to Bwindi Community Hospital to teach the first two Neonatal Care Courses and to recruit some keen would-be instructors.

We have a multinational team instructing this time around – Jarlath joining us from Ireland, Kirstie and Julia from the UK and Grace from Cameroon.

We are grateful to the charity Child Health Matters and to the Souter Trust for funding a large part of this trip.

Zooming to Cameroon

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Local Cameroonian instructors, who are now organising their own Newborn Care Courses, ran an NCC last week in Yaoundé, Cameroon.  Some NICHE Instructors joined them for parts of the course via zoom from UK, to try out the technology and assess the feasibility of remote training.

We were able, remotely, to:

1. Demonstrate how to run a simulation (this was management of a baby having fits).  NICHE Instructors from their homes in London and N. Ireland did this on zoom at the request of Cameroonian Instructors who watched.

2. Deliver one of the lectures on the NCC course via zoom

3. Join the faculty meetings in Cameroon at the end of each day.

4. Join the candidates for certificate presentation at the end of the course.

This was a useful exercise as we are thinking about the practicalities of training online, in particular delivering ‘Instructor Development Days’ for Cameroonian NCC Instructors, which before the pandemic, we had hoped to be able to do in person in November.

There are some technological improvements to make, but generally it was successful.

It was a pleasure to see our Cameroonian colleagues, who keep going despite pandemic and political difficulties.

Some comments from candidates on the course:

  • The training was an impacting one with lots of skills and knowledge acquired.  I could have wish that all health personnel around the world be train if possible to augment care of neonates.
  • I am confident now that I can take care of a newborn very well as compare to what i was doing in my station, especially resuscitating asphyxiated babies immediately after delivery.

Feedback from mboppi course

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“This course was very resourceful, I have gained more skills and will transmit the knowledge gained to my colleagues so that together we can improve the neonatal care outcome in Cameroon“

Grace and Dr Ngu Ernest, paediatrician in Douala, have just completed a Neonatal Care Course in Mboppi Hospital, one of the Cameroon Baptist Convention Heath Services institutions. 21 candidates attended and all passed the course. The programme used was the ALSG/MCAI one that NICHE instructors have used in the past. It was nice to see that Grace had also included an update for everyone on presentations from the 2nd African Neonatal Nurses Conference in Kenya that she attended with NICHE’s help in November 2019. We are proud to be associated with such an energetic campaigner for newborn care.

“Presentations were wonderful and work stations so interesting“

“Care of the newborn in Cameroon will improve greatly if health care workers are knowledgeable and only such training can help.  I wish such trainings could be open to other health facilities for awareness“

“I am more and well equip now than before on how to care for baby’s who will not live long“

“More time should be allocated for workshops“

“Care of newborn in CBCHS [Cameroon Baptist Convention Health Services] is very high than in other services, so I plead if this course can be extended out to other facilities, we will actually reduce the death rate of neonate in Cameroon“

“The practical were very educative and interesting“

See the blog post below for some images from the recent course delivered by 6 Cameroonian instructors with no input from UK-based NICHE instructors. New definition of sustainability – the excitement experienced when one puts oneself out of a job.

A socially distanced neonatal care course in douala, cameroon

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Covid has not deterred our Cameroonian colleagues from running their independent Neonatal Care Courses. Here they are, working hard at the Mboppi Baptist Hospital in Douala this month.

Covid has highlighted the importance of training local instructors. While we have to sit on our hands in the UK, unable to travel to teach, the instructors we have already trained in west Africa are busy cascading best neonatal practice and continuing our joint mission of reducing neonatal mortality.

1m+ social distancing in the classroom keeps the learners as safe as possible.

Credit to Grace and her team for keeping the programme going during this challenging period. An inspiration to us all.

Peer to peer review and mentoring

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Medical and nursing staff in the UK now have to undergo annual appraisals, usually with a peer who coaches them through their appraisal paperwork, discussing issues and highlights of the year with them and helping them to develop themselves as a health professional.  Although there’s always a mad rush at the end of the year to get all the relevant bits of paper uploaded to one’s appraisal file in time for the allotted meeting, the process if done well encourages the health worker to focus on their goals for the next year, helps to prevent burn out and allows us all the space to reflect on our own practice.

Agnes, instructor in Liberia

This process is in its infancy in Liberia and Cameroon.  Jarlath has put together a draft form which gathers information about skills and confidence decay, provides a method of assessing someone’s on-going competence and allows a structure for peer mentoring.  We are not quite sure how this will work in the field but will be rolling it out over the next few years in Cameroon while we work out how to help support local instructors in the long term.

Click here for a preview.

 

Breastfeeding workshop

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The Neonatal Care Course (NCC) is an educationally robust product.  We teach about the four main areas that the World Health Organisation identifies as contributing maximally to neonatal mortality rates: resuscitation at birth, early breast-feeding, keeping babies warm and early recognition and management of sepsis.  https://www.who.int/maternal_child_adolescent/topics/newborn/enap_consultation/en/).  Our feedback forms show increased confidence of learners in all 4 of these areas. Increased clinical confidence correlates with increased performance over time.

Here is Grace, a one time NCC learner and now in-country NICHE champion and convener of their own independent NCCs, delivering a workshop on breastfeeding to local midwives.  This is what empowerment of local health professionals does.  This is our legacy and we are proud of it and very grateful to all who donate time, money and expertise to our charity.

Cameroon Instructor Development Days

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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.

Click here for a preview.

Independent Neonatal Care Course

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Midwives in Bamenda this week (North West region of Cameroon) learning how to tie a “Kalafong” wrap for skin-to-skin mother care as part of their 2 day Neonatal Care Course.  22 learners with 100% pass rate in a town which is at the centre of the current sociopolitical unrest in Cameroon and to which UK instructors are no longer allowed to travel.  Hats off to Grace and her team for running their first independent course and thanks to our partners, the Cameroon Baptist Convention Health Services, for their support and encouragement.