Frist Global Health Leader
Reporting from Les Cayes, Haiti
Yesterday and today I participated in a training called “Helping Babies Breathe” (HBB). The training materials are produced by the American Academy of Pediatrics, and our training was put on by a number of American doctors who do HBB trainings all over the world. I was lucky enough to be able to also participate as a trainer in the training, which was a lot of fun. There were about 40 people at our training—mostly nurses, though there were also a couple of doctors (but sadly no midwives). I had 6 women (all nurses) within my small training group.
The HBB curriculum teaches participants how to resuscitate a baby in resource-limited settings (i.e. all of Haiti). Using a Neo-Natalie blow-up baby I taught my group the basic steps of drying a baby, suctioning his/her mouth and nose, performing stimulation, and using a bag and mask to perform ventilations—all in hopes of resuscitating a baby who is born not breathing. We practiced various scenarios including: a baby born with clear amniotic fluid, with meconium, with the baby crying right after having been suctioned, and with the baby not crying or getting a high heart beat after correctly being ventilated for a number of minutes. Each of the participants were given training materials to use back at their specific clinics/hospitals to train additional staff, as well as a number of bags/masks and bulb suction devices to now use to resuscitate babies.
It’s amazing to think that such inexpensive/relatively low-tech products like a bulb suction device and a bag/mask can have such a dramatic difference on a baby’s outcome. It’s also very sad to think that without the proper training even in the presence of such devices, many providers here don’t make use of them.
I’ve had to resuscitate a number of babies at HIC, and each time I’ve been the only provider helping with the resuscitation. Often the nurses have told me that a baby looks dead—and why should I try to save him/her? When I have responded that the baby has a heartbeat, and is in fact not dead—which is why I’m working to get him/her to breathe again—they have laughed and thought me foolish. That mentality however, I think—I hope—is slowly changing. As the nurses I’ve consistently worked with have seen the fact that with proper resuscitation a baby can be brought “back to life”, they are at least telling me that they now see the utility in not automatically giving up on a baby, but instead trying to work to make him/her breathe.
No one from HIC came to the HBB training—despite the hospital having received a number of invitations—which is sad, but the training has inspired me to use any downtime during my night shifts to train the nurses I work with. Hopefully with such training—and seeing my example of resuscitating every possible baby—the night shift nurses will learn the HBB techniques and will be able to pass it on to the other maternity nurses, and save lots of babies lives in the days/months/years to come.
Likewise, I hope that the providers who were trained in the past two days go back to their institutions and train others—or at least serve as an example and spark some discussion—and in doing so help babies who might otherwise not been given a chance.