​Helping Babies Breathe training in Equateur Province, Democratic Republic of Congo

The Paul Carlson Partnership
January 20, 2015

My name is Eric Gunnoe and I work as a pediatric intensivist at Maine Medical Center in Portland, Maine. For the past 5 years I’ve volunteered with a Christian non-profit organization called, The Paul Carlson Partnership (PCP). This organization focuses its efforts in the Equateur Province of the Democratic Republic of Congo (DRC), which is where my small church denomination developed a healthcare system starting 70 years ago. This system of 5 hospitals and 108 clinics lies in the most remote and neglected province of the DRC, on the border with the Central African Republic. Like every province in the DRC, this one was not spared in the two devastating regional wars that were fought in the DRC from the late 1990s to the mid-2000s. Accordingly, the capacity of our little healthcare system was degraded tremendously.

For the past 5 years the PCP has featured healthcare education as a pillar of our work in Equateur. Specifically, we use a train-the-trainer model to integrate concise educational modules into the system. Because I’m a pediatrician, and because Helping Babies Breathe (HBB) was so practical, we used it as a pilot project for our working model. In October, 2012 a small group of us traveled to Karawa Hospital in Equateur, DRC to do teach this course. We funded the cost of bringing to Karawa 8 nurses and 4 physicians from throughout a large and untracked area. Literally, there are no paved roads, so their travel was by motorcycle or bicycle. We taught the course for 4 days, using the French-language version of HBB and the assistance of a translator. The trainers completed the course in 2 days. I was touched by the sight of experienced healthcare providers learning to do bag-valve-mask ventilation for the first time. My, what we take for granted in American healthcare! Once all of the trainers were certified we then asked them to choose an additional 12 trainees for whom they did HBB training. This allowed us to observe the quality of their teaching- and ours, to be honest. We then held a planning session with the Congolese medical leadership so that they could devise a system of dissemination of the HBB training throughout the rest of the system. The Congolese decided that they would train in pairs in order to maintain the fidelity of the curriculum. After all, humans love nothing more than to tweak each other. Haha! Each trainer was delighted (and I mean this sincerely) to receive an HBB certificate at the end of the week. In the ensuing 6 months the trainers traveled throughout the province training the remaining providers. For each of the 250 folks who were trained, they were given a newborn resuscitation kit (e.g. Ambu bag, mask, blankets, etc) that had been scrounged from a variety of hospitals in southern Maine. At this point nearly all of the staff of this healthcare system have been trained in newborn resuscitation. I’ve received the training for Essential Care for Every Newborn and we’re awaiting a French translation of the course before we do this training in Equateur.

The beauty of the Helping Babies Breathe is its pragmatism and simplicity. Once our Congolese students understood the structure of the course they were keen to learn. They were particularly fond of the hands-on training that features so prominently in the course. We purchased 200 student handbooks, which proved to be a source of pride for those who received them. Many told me that this was the only textbook that they had ever owned. We gave them out on the first day of the course and I was certain that every one of the students had memorized the booklets by the next morning, based upon their eagerness to answer questions. The course certificates set the occasion for a fine celebratory dinner on the last evening of the course.

I want to congratulate those who developed this course. The curriculum is concise and practical. I’d like to thank Laerdal for developing the lovely manikins and related equipment, the cost of which they’ve generously subsidized for Millennium Development Goal countries. I’ve used NeoNatalies to great effect as I’ve traveled and spoken in my fundraising efforts. Nothing draws a crowd of cute kids like a NeoNatalie demonstration! Thanks also to the American Academy of Pediatrics for promoting and overseeing HBB. Though it’s sometimes hard for us to perceive this in the United States, we pediatricians have an honored and important place in global health. I very much encourage all of us to use our training and skills to improve the health of children in the neglected regions of this world and I suggest that the Helping Babies Breathe course should be the tool to initiate your efforts.

Sincerely, Eric L. Gunnoe, MD

Portland, ME, 04102​​

Check out the inspiring vid​​eo below!