Stories from the Field: Zimbabwe

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Stories from the Field - Zimbabwe​​​


My name is Jeri Burr, I am a pediatric nurse working in the Division of Pediatric Critical Care at the University of Utah. Currently, I am funded by NICHD to work as Program Director of the Data Coordinating Center for the Collaborative Pediatric Critical Care Research Network (CPCCRN).

I first became interested in Helping Babies Breathe training after hearing a presentation about HBB at a re-search meeting in Washington DC presented by Linda Wright from the Neonatal Research Network. I was moved by the presentation and the simplicity of the program. I had already participated in service projects in Chile and Indonesia and always have had an interest in going on a medical humanitarian mission. Upon dis-covering a master trainer course available in Denver, I flew there and got trained.

My first medical/humanitarian opportunity was in 2012 upon the USNS Mercy in the Philippines; however, I was disappointed that they di​d not utilize me to train HBB. In 2014, I was delighted to discover an opportunity to go to Zimbabwe, Africa on a medical humanitarian mission with a small medical team for ZimbabWEcare. They were very enthusiastic about having HBB taught in the rural areas where we would be traveling.

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ZimbabWEcare is a non-profit organization that provides Humanitarian and Medical Relief to the people of Zimbabwe and surrounding areas. This charity is dedicated to health care assistance and the promotion of education in rural Africa. To accomplish this, health care professionals and local service groups are organized to gather the necessary materials that are shipped and distributed to those in need.

On March 7-21, 2015, our medical team and small group of volunteers departed out of Salt Lake City to Harare, Zimbabwe. For 14 days, on this first mission for ZimbabWEcare, we spent provid​​ing health and humanitarian aid to remote villages in country. It was a once-in-a lifetime experience practicing in primitive bush settings, setting up clinics in small schools, existing clinics, and out in the open. We traveled to very remote areas that few medical personnel rarely see.

ZimbabWEcare is a non-profit organization that provides Humanitarian and Medical Relief to the people of Zimbabwe and surrounding areas. This charity is dedicated to ​health care assistance and the promotion of education in rural Africa. To accomplish this, health care professionals and local service groups are organized to gather the necessary materials that are shipped and distributed to those in need.

The appropriate permissions were obtained from the government to teach HBB in all loca-tions throughout the country where our team traveled.

Our medical team consisted of two physicians, two nurses and two local dentists. Jeri Burr, MS, RN-BC, CCRC, a pediatric nurse, was the only member of the medical team who had re-ceived HBB Master Trainer training. Her part-ner, Kelly Brock, RN, previously a Labor and De-livery nurse, assisted Jer​i with HBB training. Together, Jeri and Kelly provided HBB training in clinics at Nyanga, Angwa, and Regina Coeli Catholic Hospital, Mature, Zimbabwe.​

HBB supplies were ordered from Laerdal in China and shipped to the US for the medical team to carry into the country. We could not be guaranteed to receive the supplies if shipped directly to Zimbabwe so the medical team elected to carry the supplies on along with other medical and humanitarian supplies. Supplies included: one complete NeoNatalie Facilitator Set including 2 Flip Charts, 20 learn-er workbooks, 10 posters, 5 Bag-Masks and 5 NeoNatalie Suction devices.

The local environment where this teaching was provided was in very informal settings. The team drove great distances on very poor dirt roads to get to the remote clinics. The training was quite informal due to the setting and what we had to work with. HBB was well received in each area where it was provided.

First Area: Nyanga, Zimbabwe

We arrived after dark at this small clinic and the HBB training was requested immediately upon arrival. When entering the clinic, I noticed a HBB poster on the wall. Apparently this clinic is run by a man named Raymond, who also delivers all the babies in the area. His knowledge was excellent. Although he had never received HBB training, he was able to use the bag-mask and we treated him as an expert.

Second Area: Regina Coeli Catholic Hospital, Mature, Zimbabwe

This training was a little more formal because it was in a training room in a small rural hospital. We ar-rived around 5 PM and the nurses and student nurs-es had been waiting for us all day. They were very polite and eager to learn. We were aware that they already had a long day so our training did not go more than an hour or hour and a half. All learners were given a student workbook .​

The nurses were very receptive to the teaching style used and especially enjoyed the stories used about imagining that a baby was born, no one was there to help it breathe, and it died. Then when rephrased again, I said, “imagine you are there to help this baby breathe and the baby lives.” They were all happy. Utilizing the breath holding exercise was effective at the beginning and seemed to capture their attention for the rest of the class. When we got to the bag-mask training, no​​ one could do it properly at first. Each person that tried had to practice. After working with them till they each made the NeoNatalie chest rise and fall, everyone cheered. These young nurses and student nurses were all so enjoyable to teach. When I arrived back home, there was a heart felt thank-you email in my inbox from the sister who oversaw all the nurses (see below).

Challenges included not enough time to properly go through the course; however, all essential concepts were covered. It appeared that the understating was quite goo​​d. One thing we could have done better was to provide them all with a certificate when we were done. They asked for one and that was one thing that did not make it there with our supplies.​

 

Third Area: Angwa, Zimbabwe

At this clinic, we taught three midwives who deliver all the babies in their area. Again, this was very informal and done in a clinic room. This clinic also had a HBB poster and bag-mask, but it was apparent that the bag-mask was new and had never been used. They also had a very dirty bag-mask that looked like it had never been cleaned. The woman in charge, named Talent, said she went to HBB training in Kodoma, but no one else at her clinic had received any training. The three women were very interested in our training. They seemed to enjoy the personal attention, and were pleased after they were successful at using the bag-mask.​

 

Jeri Burr, MS, RN-BC, CCRC

University of Utah​
ZimbabWEc​​​are.org​

Summary: In all three areas, we taught how to take apart the bag-mask, clean it, reassemble and left lami-nated instructions on how to do this along with a new bag-mask and suction device. None of the clinics had proper cleaning solution, or access to cidex, so that was a problem. We taught them to make a bleach solu-tion to use for disinfecting. Overall the teaching of HBB on this medical mission was positive and successful. After having traveled to these remote areas, I would be much better at it next time knowing what the condi-tions are like and the needs of the people. The entire experience was very humbling and rewarding.​