Happy New Year! We’re sorry for the lack of posts during the holidays. We’ve had a lot going on as we get ready for our next trip to Rwanda in March. There are 8 confirmed traveling with us on the trip so far….still room for more if any of you are interested!

Our itinerary is set and it is going to be an amazing trip! I think we will be even busier than Lindsay and I were in July! Our trip will start off in Kigali with a city tour where we will learn about the history of Rwanda as we visit some of the historic sites, including some of the genocide memorials. Perhaps some time for shopping and a trip to see the neonatal unit at King Faisal Hospital.

Our second day we will transfer to the Akagera Game Lodge where members of the trip will be trained in the Helping Babies Breathe program. The Akagera Game Lodge is set in the Akagera National Park, and we will be treated to some late afternoon safaris after our training sessions. So watch for more photos of Rwanda’s wildlife!

After the training, we will return to Kigali to start training Rwandan healthcare workers in the Helping Babies Breathe program. This will allow our delegates to immediately use the training they receive on this trip. It will be an exciting time to have one-on-one time with Rwandan learners and share our experiences and practices with each other.

Next we will transfer to Gisenyi on the shores of Lake Kivu and bordering neighboring Democratic Republic of the Congo where we will train more Rwandan healthcare workers in the Helping Babies Breathe program. We’re hoping for a little down time as well so we can visit the Gisenyi district hospital and enjoy beautiful Lake Kivu! And of course, we have scheduled some time with our friends in Kanembwe village for an afternoon of traditional dance and fun! Watch for more awkward photos of the “muzungus” doing our best to dance with our friends!

After the training in Gisenyi, it will be back to Kigali for some last minute shopping at local co-ops for some of Rwanda’s beautiful handmade items before saying our farewells and heading back to the U.S.

Sound like a whirlwind of activity?!? It is, and we’ll LOVE it–and you could, too! Contact us if you are interested in joining this trip!

On March 22, 2012 we will leave Washington D.C. once again to go to Rwanda. This trip we will focus on training birth attendants in the Helping Babies Breathe Program. This program was designed specifically for developing countries and is a neonatal resuscitation program for resource limited areas. We first introduced the program to several hospitals and the Kigali Health Institute’s Nursing and Midwife Department last July. After receiving the endorsement of the Minister of Health, Dr. Binagwaho, we have been making plans for our return to begin training trainers in Rwanda.

The Helping Babies Breathe Program deals specifically with the “Golden Minute” after delivery, operating on the premise that getting an infant breathing in that first minute after delivery is crucial to their survival. As developing countries work toward achieving the Millennium Development Goals (MDGs) by 2015, this program targets MDG4 which is to reduce maternal and infant mortality by 2/3. We are committed to helping Rwanda achieve this goal.

Come be a part of our team as we first train those traveling with us and then immediately use that training in Rwanda as we “train the trainers.” For more information on how you can be a part of this team, contact Sherri at sbrown2126@kc.rr.com or sherri@onegooddeedkc.org. We will post the brochure for the trip as soon as it is available.

Our last full day in Rwanda was spent heading out to the Akagera Game Park to spend time communing with nature and some of Rwanda’s wild kingdom.

Here are some of the fascinating and beautiful animals we encountered:

As always at the end of a trip to this amazing country, I am torn. I am anxious to return home and share what we’ve learned and plan our return, but I always leave a part of my heart in Rwanda with my friends. It has truly become like a second home to me, and I find myself homesick when I am away from here.

A fitting end to our busy day at King Faisal and Kanombe was a trip to Les Enfants de Dieu to visit Rafiki and the boys. We found Rafiki in good spirits, as always, and I was amazed to see how much the project had changed since my last visit. Rafiki gave us a tour.

They have added a second story to the dormitory so the boys can spread out and will no longer have to sleep four boys in each set of bunk beds.

They have also added a new dining hall and kitchen, seen above, as well as a second story to the clinic which will house the offices for the staff.

They have also expanded their goat farm which is one of the projects that is helping them achieve self-sufficiency by selling the goat milk for operating funds.

Yvan has a go at the water pump!

And Lindsay “patty-cakes” her heart away to Dahlia, the daughter of Les Enfant’s cook.

Most Rwandans understand English even if they are not comfortable speaking it with us yet, but in order to ensure our message was being completely understood at the Military Hospital, we were aided by an interpreter.

We were surprised at the large turn out for our first introduction to this hospital. Yvan said he counted 42 staff members in the room for our training.

Unfortunately, one of the drawbacks to teaching in a packed house was that our photograper, Yvan, had to give up his space in order to let more of the staff in the room. The sad thing about this was that Lindsay did some great developmental care teaching after the Helping Babies Breathe program that we did not get photographs of because Yvan was outside!

All in all it was a very good day and we came away with promises to return to do the full program to train trainers very soon.

I always enjoy teaching at King Faisal Hospital in Kigali. The staff are eager learners and we always know we will be engaged in lively conversation and exchanges of ideas and information. It was the perfect place for Lindsay to pitch in and do some of the teaching, and she was welcomed warmly as I knew she would be!

Because I have taught neonatal material at this hospital before and the staff know me, I decided to try something during the training to get them involved right away. In many hospitals and clinics in Rwanda you will not find a clock. Since the central idea of the Helping Babies Breathe program is the “golden minute” after delivery, I wanted to give our learners a sense of exactly how long a minute is in a way that would leave an impression. I asked them all to stand and told them that when I said “go” I wanted them to take a breath and hold it. Yvan was to be the timekeeper, and as they felt they could no longer hold their breath they should take their seat again. It was a very good object lesson for them, although it might have been more accurate if they hadn’t gotten the giggles! Once the last person had taken their seat and all were breathing again, Yvan told us that the longest standing person had taken their seat at 45 seconds. I then told them to remember what it felt like to hold that breath as long as they could when they were at the delivery of an infant who was not breathing, and to make sure that they were taking steps to have that infant breathing by that one minute mark.

After the explanation of the program, I invited them to come to the front and work with the simulator manikin. I was a bit discouraged to have no takers, but was soon distracted by a young doctor who had some questions for me.

While I was talking to the doctor, I noticed that one by one the others were coming up to have a go at the simulator, their curiosity finally having gotten the better of them! That was when our fun really began! I find great joy in working with Rwandan healthcare workers because they are so open to learning and they take such pleasure in discovering things they didn’t know before. Lindsay and I spent the rest of our time with them demonstrating the simulator, helping them practice some clinical skills,  and answering their questions.

Lindsay and I demonstrated how the program works during the skills check off portion, with her being the “birthing mama” and me being the” birth attendant.”

After a very lively morning with the staff at King Faisal, we headed for lunch and then were off again to the Kanombe Military Hospital for more teaching.

 Thursday evening we had a meeting with Dr. Agnes Binagwaho, the Minister of Health of the Rwandan government. Dr. Binagwaho has quite an impressive resume and experience. I must say I was a bit intimidated about this meeting, and I’m afraid I drove poor Lindsay crazy with my obsessing and fretting about it! Better to have a healthy respect for a situation rather than to underestimate its importance, though.

Dr. Binagwaho is very direct and wastes no time getting to the point of her meetings. She listened as she looked over the brochure of the Helping Babies Breathe program, and then made a call to the Director of Maternal Child (this may not be his exact title) from the Ministry. In a few minutes, Dr. Fidele Ngabo arrived at our meeting. It was decided that he would work with us to bring this program and training to the country. We will be collaborating with him in the months ahead as we plan the training of trainers in Rwanda. It was agreed that he would provide us with the Neonatal Protocols for the country and assist us with setting up training opportunities at the district hospital level. We will also develop a plan for assessing the success of the training all the way down to the level of rural clinic settings to ensure that the integrity of the program is maintained at each level of teaching.

It was an exciting time for me, and left me with many things to think about as we move forward. I regret that we did not get any photos during our meeting, but felt it was not an appropriate time for pictures. Dr. Binagwaho had had a very busy day and still had meetings ahead of her after her meeting with us. We appreciate the opportunity to work with the Rwandan government in the future to have a part in helping them achieve Millennium Development Goal 4, the reduction of infant mortality in this country.

Thursday we met with Catherine Uwimana, the head of the midwifery program at the Kigali Health Institute (KHI), and her staff. We explained the Helping Babies Breathe program and demonstrated how to use the teaching materials and simulator doll.

There was much discussion over the afternoon about ways this program could be incorporated into the curriculum of not only the nursing program, but also of the nurse midwifery program. Ms. Uwimana also surprised me by asking if we would consider writing neonatal curriculum for the nursing program. Pending our meeting with the Minister of Health later in the day and whether we receive her endorsement of our work in Rwanda, I agreed to write neonatal curriculum. It is turning out to be a very productive, eventful trip for us!

Wednesday morning we returned to the Gisenyi district hospital to go through the donated items we brought with some of their staff. Above Lindsay is demonstrating a percussion device used for loosening chest secretions in infants so the secretions can be suctioned out.

 The phototherapy blanket donated by the Phillips company was a big hit! In fact, we were able to put it to immediate use. A nurse brought us a baby who was jaundiced and we put her on the light right away. The nurse below has undressed the infant so she can benefit from the phototherapy lights.

After placing a protective mask over her eyes, she is ready for the lights! 

 Lindsay swaddles the phototherapy blanket and the baby in a blanket and places her in the isolette.

Now the baby is cozy and happy, and the phototherapy light is doing its work. Thanks again to the generous folks at Phillips medical for donating this equipment for the hospital in Gisenyi! 

 The infant in the photo below caused Lindsay and I great concern. She had arrived at the hospital the night before, having been referred due to respiratory distress. When we arrived we noticed that she was having great difficulty breathing and was quickly progressing to gasping, which is an imminent sign of death if no intervention is taken. We began asking the doctor questions about the infant and suggesting treatment. One of the nurses placed an oxygen saturation probe on the infant and it was reading in the 70% range. A normal reading for this infant would have been above 95%. We were becoming increasingly alarmed as the infant had periods when she paused in her breathing. She looked quite pale and quite ill. It is a helpless feeling to be in a foreign hospital as a guest and see a situation where you know you could make a difference, but be limited in what you can do. We were somewhat comforted when the staff took some of our suggestions and intervened for this little girl, but we left that day still quite concerned about her outcome.

The nurses who were in the storage room where we had left the supplies we brought kept bringing us things and asking what they were. I gave a quick demonstration (without actually sticking the infant with the lancet) on how to use a lancet for the purpose of drawing blood via heelstick to obtain a specimen for labs. 

Once the “show and tell” with the donations was completed, we went to an area where we could present a brief introduction to the Helping Babies Breathe program for the staff. 

 The idea of the simulator doll was intriguing to them.

After a group photo, it was time for us to say our goodbyes and head back to Kigali for another day of training on Thursday.

Tuesday morning  we headed for Gisenyi on the border of the Democratic Republic of the Congo and the shores of Lake Kivu. We enjoyed many interesting sites along the way….

Once in Gisenyi, we went to the district hospital to meet with Dr. Mulindwa. We dropped off the donations we brought from our neonatal unit at the University of Kansas Hospital and the Phillips company before briefly introducing Dr. Mulindwa to the Helping Babies Breathe Program.

Above is Yvan Rubengabenga, our guide/translator, trying to explain the Helping Babies Breathe simulator doll that I am holding off camera. The Rwandans were quite intrigued with this “baby” and it reduced them to fits of giggles and pointing!

We presented Dr. Mulindwa with the donations we brought and left them in the storage room to be gone through in greater detail on Wednesday.

After a brief overview of the Helping Babies Breathe program, we headed back to our hotel for a little relaxation by the pool and walking by the lake before dinner.

Tomorrow…..back to the Gisenyi hospital for a more in-depth look at the Helping Babies Breathe program!