“I am sending them out to blow their trumpets”

3rd Cameroonian GIC completed and the first 2 local GIC instructors have begun their training

This is what our programme manager for newborn training in Cameroon said today, as we were coming to the end of their successful “train the trainers” course.

Dr Ferenc Sari, European Resuscitation Council educator, and our educator on this week’s GIC course in Cameroon, has been impressed by the progress of the participants over the 2 days. We are privileged to be able to witness and support their first teaching experience which will occur when they teach on Neonatal Care Courses later in the week.

A GIC candidate taking Alison through a resuscitation scenario
GIC candidates discussing peer-to-peer learning

The Learning Conversation in Cameroon

The circle of trust

The learning conversation is a term used in adult education, and is a skill required for giving feedback to learners on their performance. A well-managed learning conversation should leave learners feeling “relieved, valued and clear about their next steps”. It is not an easy skill to master, and requires practice.

In Cameroon this week, NICHE instructors have spent a day refreshing the skills of newly qualified local Neonatal Care Course instructors. The learning conversation was one of the skills we spent time on together. During these sessions we sat in a circle with the candidates, sometimes know as “circle of trust”. This was a new concept to them, but they embraced the principles. The exercise emphasised the importance of trust, particularly as we all come from such different cultures and backgrounds.

Instructor Development Day, yaounde

Dr Alison Earley

This is the group of 11 Instructors who attended the first Instructor Development Day that NICHE has run. They came from 5 different Regions in Cameroon, and did their instructor training in 2016 and 2018. They are a mixture of doctors, nurses and midwives. All were keen to refresh and develop their skills as trainers and the course was lively and enjoyed by everyone.

helping out clinically in the lunch breaks

Grace directing Ugandan health professionals in how to make homemade CPAP

A premature baby (probably about 28 weeks gestation) was born on our first day in Bwindi. He weighed 1kg (2.2lbs). The paediatrician had just left the hospital and we were asked to help the young doctor pictured above who was covering the paediatric unit. Grace and Julia have visited daily for the last 5 days and supported the nurses in their excellent care of the tiny little boy who is now off CPAP and in skin to skin care with his mother for much of the day. It is normal for these babies to lose up to 10% of their birthweight and he now weighs 890g but is tolerating his expressed breast milk and I would expect him to start to put on weight from now on. He has had no blood tests, no x-rays and only homemade CPAP to support his breathing. He is a shining example of what good nursing care can do and we have used him throughout the course to illustrate what we teach about supporting preterm babies. These are the lives that can be saved by teaching staff the Neonatal Care Course.

Julia attending to the 28 week gestation baby on the neonatal unit

Uganda – step 1

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.

Alison spreading the word in a Scottish primary school

The children at the primary school where one of the trustees, Alison Grove, works are learning about charities, so she was asked to talk to the classes about NICHE International.

The children are aged between 4 and 12 – one composite class is spread across this whole age range – so there were different levels of understanding about the work we do.

We used coloured blocks to represent babies. With the help of volunteers – wearing our NICHE tee shirts – we counted out how many babies might be cared for if NICHE volunteers spent their visit working in hospitals.

And then how many if they trained local health care workers in the skills they were using so that the work could go on all year round. And finally, how many more babies might survive in good health if the local doctors and nurses learned how to train their co-workers … and so on. That made a lot of blocks.


We looked at ways to look after newborn babies:

 Helping them to breathe with a bag valve mask. There were lots of ideas of how to use the one I showed the children, but we soon realised that we would all need training – even the teachers – if we were to save the life of a newborn baby who wasn’t breathing.
 Keeping them warm. The children learned that babies must be kept warm even in hot countries. There were lots of suggestions about how to do this, but no-one could guess the amazing piece of equipment I held behind my back….. a knitted hat!
 Skin to skin contact. We borrowed baby dolls and pieces of fabric from the nursery and the children helped each other to tie the ‘babies’ on securely.

We talked about the different ways people are supporting NICHE – the course tutors, the donors and fund raisers, the work behind the scenes in the UK as well as in the countries we visit.

And there were lots of questions, such as:
How do you set up a charity?
How long does it take to get to Africa?
Why are the babies sick?
Do lions go to hospital?

The children were shocked to learn that newborn babies die so often in poorly resourced areas of the world. Many have baby brothers and sisters of their own and began to understand now how lucky they are to live in Scotland where there are enough well trained health care workers to look after sick babies.

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!


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

More trustee exertions!

Alison Grove and her friend, Helen, have just completed the Killin 10K in Scotland (in only just over an hour which is pretty impressive), raising just shy of £1000 towards NICHE’s next Liberia trip in November 2019.  You can still sponsor them at https://www.justgiving.com/fundraising/alison-helen.


Relief at the finish line

Exhaustion at the finish line















Fantastic work both of you!