Ngora Freda Carr Hospital in Ngora, Uganda

Vocational Training Team in Obstetric and New-born Emergencies: Visit to Freda Carr Hospital Ngora, Uganda

‘It was really good’ Vincent replied when I asked him how the training went for him. Ugandans are always ever so polite, so I pushed further. ‘What was good about it?’, I probed. ‘I did not know about opening the airway and using the face mask to breath for the baby’ he said. ‘I usually wrap the baby and put the baby on the mother’s chest and try to bag the baby’. He went on, ‘I have meditated on what I have learnt and read the lecture notes again and again’. ‘It was really good’ he repeated.

Meditated. MEDITATED? That is a very powerful statement.  It is not the sort of word you associate with a day’s course in emergency skills course. The training he received on neonatal and obstetric emergencies had triggered a deep reflection in his personal and professional practice and he had resolved to change his old ways. Indeed, he was on his way to the library to do more research when I met him. How inspiring was that?

This feedback made this visit worthwhile when Gillian, Stella and I waved good bye to our friends and families and set out on the journey to Ngora, a hamlet 500km east from Kampala, the Ugandan capital city. It was not the easiest 9-hour journey on narrow carriageways and country ‘murram’ roads but the warm welcome at the end made up for it. Over a five-day period, we trained about two hundred and fifty nurses, midwives, clinical officers, dentists, doctors, nursing and midwifery students in obstetric and neonatal emergency skills.

Throughout the training days, the enthusiasm of the students was infectious. The students came in their droves together with nursing mothers. They came along with their suckling babies who were passed from trainee to trainee (and trainers as well!) whilst the lactating mothers participated in the training. The babies were incredibly well behaved. That is inclusivity!

The VTT was well equipped with training materials and Stella, a midwife educator and passionate scuba diver raised funds to buy necessary equipment such as ambubags, face masks, pulse oximeters and blood pressure monitors. All these were donated to Freda Carr Hospital and neighbouring health centres.

As a paediatrician, I took the opportunity to advocate for paediatric early warning charts to the clinical leadership team. At present, the hospital uses a single chart for every admitted patient. However, children with their changing maturity and physiology need specially adapted age appropriate charts for monitoring them. Rotary Club kindly funded several printed charts for different ages and I shared this with the team. They will consider piloting this as a Quality Improvement Project for their paediatric ward and if successful to scale this throughout the hospital. This will be a simple inexpensive way to improve quality of care.

Providing one-off training sessions once or twice a year is always an excellent idea and Rotary District 1090 has done this regularly since April 2014 when I went with the first VTT team out to Kamuli. But this visit was different. Gillian our team leader (and current District Governor) explored several strategies with the Hospital’s Leadership team on how to sustain and maintain the skills learnt from this training programme in between visits. Indeed, one of the staff at the hospital showed such promise, she was invited to support my work in neonatal emergencies skills training. It was great to have a partner at last!  I believe she and others like her should be incentivised to maintain a regular programme of emergency life support teaching sessions for staff in between VTT visits.

Furthermore, I will recommend that it should be a core evidence-based criteria for Rotary’s continuing interest with Freda Carr Hospital.

As we started out after a busy week at Ngora to face the long dusty road back home and to our loved ones, it was my turn to meditate.

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